MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: A feasibility study
MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: A feasibility study
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DOI：
10.1148/radiology.219.1.r01ap02176
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发表时间：
2001-04-01
期刊：
影响因子：
19.7
通讯作者：
Jolesz, FA
中科院分区：
文献类型：
--
作者：
Hynynen, K;Pomeroy, O;Jolesz, FA
目的：探讨无创磁共振（MR）成像引导下聚焦超声手术治疗乳腺良性纤维腺瘤的可行性。材料与方法：9例局麻患者11例纤维腺瘤采用磁共振成像引导下的FUS治疗。基于靶体积的t2加权定义，连续超声治疗整个靶。在每次超声期间进行基于温度敏感相位差的MR成像，以监测病灶定位和组织温度变化。手术后，进行t2加权和对比材料增强t1加权MR成像以评估近期和长期效果。结果：热成像序列在治疗期间得到改善，在最后7次治疗中，82%（342例中的279例）的热点可见。磁共振成像仪用于测量这些处理的温度升高（12.8度-49.9度）。治疗的11个病变中有8个在治疗后加权图像上显示完全或部分缺乏造影剂摄取。3个病变未见造影剂摄取明显减少。这种缺乏有效治疗很可能是由于较低的声功率和/或患者运动导致误配。除1例胸肌在治疗后2天出现短暂性水肿外，未发现其他不良反应。结论：磁共振成像引导下的FUS可用于无创凝固乳腺良性纤维腺瘤。
PURPOSE: To test the feasibility of noninvasive magnetic resonance (MR) imaging-guided focused ultrasound surgery (FUS) of benign fibroadenomas in the breast.MATERIALS AND METHODS: Eleven fibroadenomas in nine patients under local anesthesia were treated with MR imaging-guided FUS. Based on a T2-weighted definition of target volumes, sequential sonications were delivered to treat the entire target. Temperature-sensitive phase-difference- based MR imaging was performed during each sonication to monitor focus localization and tissue temperature changes. After the procedure, T2-weighted and contrast material-enhanced T1-weighted MR imaging were performed to evaluate immediate and long-term effects.RESULTS: Thermal imaging sequences were improved over the treatment period, with 82% (279 of 342) of the hot spots visible in the last seven treatments. The MR imager was used to measure temperature elevation (12.8 degrees -49.9 degreesC) from these treatments. Eight of the 11 lesions treated demonstrated complete or partial lack of contrast material uptake on posttherapy ii-weighted images. Three lesions showed no marked decrease of contrast material uptake. This lack of effective treatment was most likely due to a lower acoustic power and/or patient movement that caused misregistration. No adverse effects were detected, except for one case of transient edema in the pectoralis muscle 2 days after therapy.CONCLUSION: MR imaging-guided FUS can be performed to noninvasively coagulate benign breast fibroadenomas.