MR-guided

MR 引导
  • 文章类型: Journal Article
    背景:评估磁共振引导经皮微波凝固术(MR引导PMC)治疗乳腺恶性肿瘤的技术成功和患者安全性。
    方法:从2018年5月至2019年12月,招募26例2厘米或以下的乳腺肿瘤患者参加前瞻性,单机构临床研究。这项研究的主要终点是评估每位患者的治疗效果。使用α-烟酰胺腺嘌呤二核苷酸和还原的(NADH)-黄递酶的组织化学染色来确定PMC后的细胞活力和功效。还评估了所有患者在消融期间和之后的并发症和自我报告的感觉。当NADH-心肌黄递酶阴性区域的区域完全覆盖肿瘤中的苏木精-伊红(H&E)染色区域时,确定PMC程序的技术成功。
    结果:所有患者对消融有完全反应,组织病理学标本上没有残留癌。平均能量,消融持续时间,每个肿瘤的手术持续时间为36.0±4.2kJ,252.9±30.9S,104.2±13.5分钟,分别。在消融期间,14例患者接受了延长的消融时间,1名患者需要调整天线位置。11名患者有轻微的发热或肿胀的感觉,3例患者出现轻微疼痛。消融后,一个病人因为中度疼痛服用了两种止痛药,PMC术后无渗血或其他并发症。16例患者出现消融区域周围的持续时间。
    结论:MR引导下乳腺小肿瘤的PMC是可行的,可用于临床。
    MR引导下乳腺小肿瘤的PMC是可行的,可以在未来的临床实践中应用。
    结论:•MR引导下乳腺小肿瘤的PMC是可行的。•对所有患者成功进行了PMC。•所有患者对最终的美容结果满意。
    BACKGROUND: To evaluate the technical success and patient safety of magnetic resonance-guided percutaneous microwave coagulation (MR-guided PMC) for breast malignancies.
    METHODS: From May 2018 to December 2019, 26 patients with breast tumors measuring 2 cm or less were recruited to participate in a prospective, single-institution clinical study. The primary endpoint of this study was the evaluation of treatment efficacy for each patient. Histochemical staining with α-nicotinamide adenine dinucleotide and reduced (NADH)-diaphorase was used to determine cell viability following and efficacy of PMC. The complications and self-reported sensations from all patients during and after ablation were also assessed. The technical success of the PMC procedure was defined when the area of the NADH-diaphorase negative region fully covered the hematoxylin-eosin (H&E) staining region in the tumor.
    RESULTS: All patients had a complete response to ablation with no residual carcinoma on histopathological specimen. The mean energy, ablation duration, and procedure duration per tumor were 36.0 ± 4.2 kJ, 252.9 ± 30.9 S, and 104.2 ± 13.5 min, respectively. During the ablation, 14 patients underwent prolonged ablation time, and 1 patient required adjusting of the antenna position. Eleven patients had feelings of subtle heat or swelling, and 3 patients experienced slight pain. After ablation, one patient took two painkillers because of moderate pain, and no patients had postoperative oozing or other complications after PMC. Induration around the ablation area appeared in 16 patients.
    CONCLUSIONS: MR-guided PMC of small breast tumors is feasible and could be applied in clinical practice in the future.
    UNASSIGNED: MR-guided PMC of small breast tumors is feasible and could be applied in clinical practice in the future.
    CONCLUSIONS: • MR-guided PMC of small breast tumors is feasible. • PMC was successfully performed for all patients. • All patients were satisfied with the final cosmetic result.
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  • 文章类型: Journal Article
    目的:本研究评估了术后磁共振(MR)引导的125I粒子间质植入治疗口腔颌面部恶性肿瘤的疗效。
    方法:本研究共纳入了127例口腔颌面部恶性肿瘤患者,这些患者在手术切除后接受了125I间质治疗。植入前,所有患者均接受MR扫描以评估病变范围,范围,和自然。125个I植入目标区域基于术前成像。在MR的实时指导下,通过穿刺针将125I种子输送到目标区域。植入后立即进行计算机断层扫描(CT)或MR,每3个月再次进行。
    结果:125I植入成功后,所有患者也定期检查以检测肿瘤复发,淋巴管,和远处转移。迄今为止,CT或MR证实13/127例患者出现肿瘤复发或淋巴转移或远处转移。没有观察到种子迁移,没有严重的治疗相关并发症影响患者的生活质量,并且没有重要的器官(例如主要的宫颈血管,脊髓,等。)观察到受伤。
    结论:我们的结果表明,MR引导125I植入是口腔颌面部肿瘤特定部位治疗的有效方法,这可能会降低术后并发症和肿瘤复发率,提高患者生存率,提高生活质量。
    OBJECTIVE: This study assessed the therapeutic efficacy of postoperative magnetic resonance (MR)-guided interstitial 125 I seed implantation for treatment of oral and maxillofacial malignant tumors.
    METHODS: A total of 127 patients with oral or maxillofacial malignant tumors were included in this study who received interstitial 125 I treatment after the surgery resection. Before implantation, all the patients received MR scans to assess the lesion scope, extent, and nature. 125 I implantation target regions were based on the pre-operative imaging. 125 I seeds were delivered to target regions via puncture needles under the real-time guidance of MR. Computed tomography (CT)or MR was performed immediately after implantation and again every 3 months later.
    RESULTS: After successful 125 I implantation, all patients were also examined regularly to detect tumor recurrence, lymphatic, and distant metastases. To date, CT or MR verification showed that 13/127 patients experienced tumor recurrence or lymphatic metastasis or distant metastasis. No seeds migration was observed, no serious treatment-related complications affected patient quality of life, and no important organ (such as major cervical vessels, spinal cord, etc.) injuries were observed.
    CONCLUSIONS: Our results show that MR-guided 125 I implantation is an effective approach to site-specific treatment for oral and maxillofacial tumor, which could potentially reduce postoperative complications and tumor recurrence rates, increase patient survival, and improve quality of life.
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  • 文章类型: Journal Article
    Magnetic resonance (MR)-guided microwave ablation is a well-developed technique for the treatment of tumors, especially hepatic carcinomas. However, there are no detailed reports on the changes in the MR images and histology observed after the ablation. This study aimed to dynamically map the pathological changes after ablation and the changes occurring on MR images.
    We performed MR-guided microwave ablation in 10 Wuzhishan pigs and obtained an MR scan immediately after ablation (0 weeks) and at 1, 2, 3, and 4 weeks after ablation. We compared the ablation assessed on MR images to tissue specimens obtained during follow-up.
    We found no significant difference in the ablation size between MR images and tissue specimens; the mean length and width of the ablated zone were 4.27 cm and 2.42 cm, respectively, on MR images and 4.26 cm and 2.45 cm, respectively, on specimens (P > 0.05). Immediately after ablation, carbonization and cavities were observed in the center of the ablation zone. Surrounding layer cells were necrotic but maintained their original shapes. The outermost layer was inflamed, but gradually showed fibrotic characteristics. The MR images accurately reflected the exact histological tissue changes after the ablation procedure.
    The dynamic imaging and pathological features of liver ablation outlined in this study will provide a useful reference for patient follow-up after MR-guided microwave ablation.
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  • 文章类型: Journal Article
    BACKGROUND: Owing to the high risk of abscess drainage by craniotomy, imaging-guided stereotactic aspiration is considered an ideal choice in the management of brain abscesses. Interventional magnetic resonance imaging (MRI) represents a valuable technique for the treatment of brain abscess as a guiding modality.
    OBJECTIVE: To evaluate the safety and efficacy of an interventional MRI system in performing the procedure.
    METHODS: Thirteen brain abscesses in 11 patients were treated with percutaneous aspiration. All procedures were performed solely under the guidance of a 0.23-T open-configuration MRI scanner with optical tracking. Clinical and imaging follow-up was at 1 week, 1 month, 3 months, and 6 months. The changes of abscess, MRI features, and clinical symptoms were recorded. Procedure efficacy and safety were evaluated by success rate, procedure time, decrease of abscess, recovery rate, and complication. Descriptive statistical analysis was performed.
    RESULTS: MRI-guided stereotactic aspirations were performed successfully in 13/13 (100%) abscesses. The mean operating time was 70 min (range, 45-100 min). Follow-up MRI at 1 week after the procedure showed average reduction of abscesses by 60% (2.1/3.5). And the abscesses continued to get smaller by up to 89.7% (3.14/3.5) at 1-month follow-up. All cavities resolved at the end of the 6-month follow-up period. The recovery rate was 100% for fever, headache, vomiting, papilledema, meningismus, altered sensorium, 75% (3/4) for hemiparesis, and 83.3% (5/6) for epilepsy. There were no complications.
    CONCLUSIONS: Punctures of brain abscesses with subsequent aspiration can be performed safely and efficiently by monitoring the procedure using an open interventional MRI system.
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