Toward MR-guided high intensity focused ultrasound for presurgical localization: Focused ultrasound lesions in cadaveric breast tissue
Toward MR-guided high intensity focused ultrasound for presurgical localization: Focused ultrasound lesions in cadaveric breast tissue
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DOI：
10.1002/jmri.23529
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发表时间：
2012-05-01
影响因子：
4.4
通讯作者：
Pauly, Kim Butts
中科院分区：
文献类型：
--
作者：
Bitton, Rachel R.;Kaye, Elena;Pauly, Kim Butts
目的：通过评价磁共振引导高强度聚焦超声(MR-HIFU)在体外身体乳腺组织中产生的病变的可触性，探讨MR-HIFU作为手术指南治疗不可触及的乳腺肿瘤的价值。材料和方法：使用ExAblate2000系统在18个部位进行MR-HIFU消融，消融间隔5 mm。消融术在混合的脂肪和纤维腺组织中形成一个方形的周长。消融使用T1加权快速自旋回波图像进行监测。用磁共振声辐射力脉冲(MR-ARFI)对每个消融部位进行远程触诊，测量热声前后的组织位移。绘制了以每个消融点为中心的位移分布图，以供比较。手工触诊身体乳房以评估消融病变的硬度，并解剖以进行大体检查。这项研究在三个身体乳房上重复进行。结果：MR-ARFI显示消融后峰值位移减少54.8%(消融前[4.41 6 1.48]mm，消融后[1.99 6 0.82]mm)，剪切波速度增加65.5%(消融前[10.69 6 1.60]mm，消融后[16.33 6 3.10]mm)，提示消融后组织变硬。手工触诊和乳房解剖显示可触及程度增加，消融范围变暗，在混合脂肪/纤维腺组织中可见个别消融。结论：这项初步研究结果表明，MR-HIFU能够在体外身体乳腺组织中产生可触及的病变，并有可能用于术前定位不可触及的乳腺肿瘤。关键词：磁共振引导聚焦超声；磁共振声辐射力；磁共振；乳腺；未触及的乳腺肿瘤；导线定位。雷森。成像2012；35：1089-1097。2011年威利期刊公司。
Purpose: To investigate magnetic resonance image-guided high intensity focused ultrasound (MR-HIFU) as a surgical guide for nonpalpable breast tumors by assessing the palpability of MR-HIFU-created lesions in ex vivo cadaveric breast tissue. Materials and Methods: MR-HIFU ablations spaced 5 mm apart were made in 18 locations using the ExAblate2000 system. Ablations formed a square perimeter in mixed adipose and fibroglandular tissue. Ablation was monitored using T1-weighted fast spin echo images. MR-acoustic radiation force impulse (MR-ARFI) was used to remotely palpate each ablation location, measuring tissue displacement before and after thermal sonications. Displacement profiles centered at each ablation spot were plotted for comparison. The cadaveric breast was manually palpated to assess stiffness of ablated lesions and dissected for gross examination. This study was repeated on three cadaveric breasts. Results: MR-ARFI showed a collective postablation reduction in peak displacement of 54.8% ([4.41 6 1.48] mm pre, [1.99 6 0.82] mm post), and shear wave velocity increase of 65.5% ([10.69 6 1.60] mm pre, [16.33 6 3.10] mm post), suggesting tissue became stiffer after the ablation. Manual palpation and dissection of the breast showed increased palpability, a darkening of ablation perimeter, and individual ablations were visible in mixed adipose/ fibroglandular tissue. Conclusion: The results of this preliminary study show MR-HIFU has the ability to create palpable lesions in ex vivo cadaveric breast tissue, and may potentially be used to preoperatively localize nonpalpable breast tumors. Key Words: MR guided focused ultrasound; MR acoustic radiation force; MRI; breast; nonpalpable breast tumor; wire localization J. Magn. Reson. Imaging 2012; 35: 1089-1097. VC 2011 Wiley Periodicals, Inc.