磁共振引导聚焦超声:现状与前景Magnetic Resonance-guided Focused Ultrasound: Present and Prospect
周慷;石海峰;苏佰燕;薛华丹;金征宇;
ZHOU Kang;SHI Hai-feng;SU Bai-yan;XUE Hua-dan;JIN Zheng-yu;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;
摘要(Abstract):
磁共振引导聚焦超声是近年出现的肿瘤热消融技术,利用超声束可穿过软组织并聚焦于靶区的特点,使靶区产生高温,致使组织凝固坏死,并通过磁共振实时监控治疗范围及靶区内温度变化,从而保证治疗效果及安全性。这种技术的优势在于完全无创、无须住院治疗、无须麻醉(仅需少量镇静剂)、无离子辐射,目前已广泛应用于子宫肌瘤/腺肌症、骨肿瘤、前列腺癌、功能性神经疾病、乳腺癌等的临床治疗,成为国内外研究的热点。
Magnetic resonance-guided focused ultrasound( MRgFUS) is a new technique of tumor thermal ablation that has appeared in recent years. It is a kind of treatment that can use the ultrasonic beam to focus on the target after passing through soft tissue so that the target area produces a high temperature instantaneously and makes coagulating necrosis in the tissue. The range and temperature change of the treatment area are monitored by MR synchronously. This technology is completely non-invasive and non-ionizing with no anesthesia,no hospitalization,but only a small amount of sedatives required. At present,this treatment method is widely used in uterine fibroids/adenomyosis,bone tumors,prostate cancer,functional neural diseases,breast cancer,and so on. MRgFUS has become a hot topic of research and clinical application.
关键词(KeyWords):
磁共振引导聚焦超声;医学影像技术
magnetic resonance-guided focused ultrasound;medical imaging technology
基金项目(Foundation): 中国医学科学院中央级公益性科研院所基本科研业务费专项项目(2019PT320008、2018PT32003、2017PT32004)
作者(Author):
周慷;石海峰;苏佰燕;薛华丹;金征宇;
ZHOU Kang;SHI Hai-feng;SU Bai-yan;XUE Hua-dan;JIN Zheng-yu;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;
Email:
DOI:
参考文献(References):
- [1]金征宇,苏佰燕,薛华丹.磁共振引导下聚焦超声新技术进展及其临床应用[J].磁共振成像,2014,5:26-30.
- [2] Cline HE,Schenck JF,Hynynen K,et al. MR-guided focused ultrasound surgery[J]. J Comput Assist Tomogr,1992,16:956-965.
- [3] Focused Ultrasound Foundation. State of the Field 2018[EB/OL]. https://www. fusfoundation. org/the-foundation/news-media/state-of-the-field-report-2018-now-available.
- [4]许永华,符忠祥,杨利霞,等.MRI导航和温度监控下高强度聚焦超声治疗子宫肌瘤[J].介入放射学杂志,2010,19:869-874.
- [5]李妮,王月玲.磁共振成像引导下高强度聚焦超声治疗子宫平滑肌瘤的研究进展[J].中国介入影像与治疗学,2015,12:709-712.
- [6] Stewart EA,Rabinovici J,Tempany CM,et al. Clinical outcomes of focused ultrasouind surgery for the treatment of uterine fibroids[J]. Fertil Steril,2006,85:22-29.
- [7]侯静,刘晟,王维,等.MRI T2WI信号强度与高强度聚焦超声消融子宫肌瘤疗效关系的研究[J].医学影像学杂志,2014,24:820-823.
- [8]苏佰燕,薛华丹,金征宇.子宫肌瘤的影像诊断及与影像医学相关的治疗[J].协和医学杂志,2011,2:273-276.
- [9] Clark NA,Mumford SL,Segars JH. Reproductive impact of MRI-guided focused ultrasound surgery for fibroids:a systematic review of the evidence[J]. Curr Opin Obstet Gynecol,2014,26:151-161.
- [10] Gorny KR,Borah BJ,Brown DL,et al. Incidence of Additional Treatments in Women Treated with MR-Guided Focused US for Symptomatic Uterine Fibroids:Review of 138Patients with an Average Follow-up of 2. 8 Years[J]. J Vasc Interv Radiol,2014,25:1506-1512.
- [11] Machtinger R,Fennessy FM,Stewart EA,et al. MR-guided focused ultrasound(MRgFUS)is effective for the distinct pattern of uterine fibroids seen in African-American women:data from phase III/IV, non-randomized, multicenter clinical trials[J]. J Ther Ultrasound,2013,1:23.
- [12] Taran FA,Stewart EA,Brucker S. Adenomyosis:epidemiology,risk factors,clinical phenotype and surgical and interventional alternatives to hysterectomy[J]. Geburtshilfe Frauenheilkd,2013,73:924-931.
- [13] Osada H,Silbe RS,Kakinuma T,et al. Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis[J]. Reprod Biomed Online,2011,22:94-99.
- [14]王欣,成九梅,段华.腹腔镜子宫动脉阻断联合子宫腺肌病灶切除对子宫、卵巢血流及内分泌激素的影响[J].中国微创外科杂志,2012,12:869-872.
- [15] Fukunishi H,Funaki K,Sawada K,et al. Early results of magnetic resonance-guided focused ultrasound surgery of adenomyosis:analysis of 20 cases[J]. J Minim Invasive Gynecol,2008,15:571-579.
- [16] Ferrari F,Arrigoni F,Miccoli A,et al. Effectiveness of Magnetic Resonance-guided Focused Ultrasound Surgery(MRgFUS)in the uterine adenomyosis treatment:technical approach and MRI evaluation[J]. Radiol Med,2016,121:153-161.
- [17] Polina L,Nyapathy V,Mishra A,et al. Noninvasive treatment of focal adenomyosis with MR-guided focused ultrasound in two patients[J]. Indian J Radiol Imaging,2012,22:93-97.
- [18] Napoli A,Anzidei M,Marincola BC,et al. MR Imagingguided Focused Ultrasound for Treatment of Bone Metastasis[J]. Radiographics,2013,33:1555-1568.
- [19] Hurwitz MD,Ghanouni P,Kanaev SV,et al. Magnetic Resonance-Guided Focused Ultrasound for Patients with Painful Bone Metastases:PhaseⅢTrial Results[J]. J Natl Cancer Inst,2014,106. pii:dju082. doi:10. 1093/jnci/dju082.
- [20] Ghai S,Perlis N,Lindner U,et al. Magnetic resonance guided focused high frequency ultrasound ablation for focal therapy in prostate cancer-phase 1 trial[J]. Eur Radiol,2018,28:4281-4287.
- [21] Moser D,Zadicario E,Schiff G,et al. Measurement of targeting accuracy in focused ultrasoundfunctional neurosurgery[J]. Neurosurg Focus,2012,32:E2.
- [22] Halpern CH,Santini V,Lipsman N,et al. Three-year follow-up of prospective trial of focused ultrasound thalamotomy for essential tremor[J]. Neurology,2019. doi:10. 1212/WNL. 0000000000008561.[Epub ahead of print].
- [23] Anzidei M,Napoli A,Sandolo F,et al. Magnetic resonance-guided focused ultrasound ablation in abdominal moving organs:a feasibility study in selected cases of pancreatic and liver cancer[J]. Cardiovasc Intervent Radiol,2014,37:1611-1677.
- [24] Mainprize T,Lipsman N,Huang Y,et al. Blood-Brain Barrier Opening in Primary Brain Tumors with Non-invasive MR-Guided Focused Ultrasound:A Clinical Safety and Feasibility Study[J]. Sci Rep,2019,9:321.
- 周慷
- 石海峰
- 苏佰燕
- 薛华丹
- 金征宇
ZHOU Kang- SHI Hai-feng
- SU Bai-yan
- XUE Hua-dan
- JIN Zheng-yu
- Department of Radiology
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences &Peking Union Medical College
- 周慷
- 石海峰
- 苏佰燕
- 薛华丹
- 金征宇
ZHOU Kang- SHI Hai-feng
- SU Bai-yan
- XUE Hua-dan
- JIN Zheng-yu
- Department of Radiology
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences &Peking Union Medical College