文章：

体内利用超汇聚磁共振引导高强度聚焦超声消融器和伪肿瘤模型对深部肝内靶点进行热消融

In Vivo Thermal Ablation of Deep Intrahepatic Targets Using a Super-Convergent MRgHIFU Applicator and a Pseudo-Tumor Model

原文发布日期：3 August 2023

DOI: 10.3390/cancers15153961

类型: Article

开放获取: 是

英文摘要：

Background: HIFU ablation of liver malignancies is particularly challenging due to respiratory motion, high tissue perfusion and the presence of the rib cage. Based on our previous development of a super-convergent phased-array transducer, we aimed to further investigate, in vivo, its applicability to deep intrahepatic targets. Methods: In a series of six pigs, a pseudo-tumor model was used as target, visible both on intra-operatory MRI and post-mortem gross pathology. The transcostal MRgHIFU ablation was prescribed coplanar with the pseudo-tumor, either axial or sagittal, but deliberately shifted 7 to 18 mm to the side. No specific means of protection of the ribs were implemented. Post-treatment MRI follow-up was performed at D7, followed by animal necropsy and gross pathology of the liver. Results: The pseudo-tumor was clearly identified on T1w MR imaging and subsequently allowed the MRgHIFU planning. The peak temperature at the focal point ranged from 58–87 °C. Gross pathology confirmed the presence of the pseudo-tumor and the well-delineated MRgHIFU ablation at the expected locations. Conclusions: The specific design of the transducer enabled a reliable workflow. It demonstrated a good safety profile for in vivo transcostal MRgHIFU ablation of deep-liver targets, graded as challenging for standard surgery.

摘要翻译： 

背景：由于呼吸运动、高组织灌注及肋骨屏障的存在，肝恶性肿瘤的高强度聚焦超声消融面临特殊挑战。基于我们此前研发的超会聚相控阵换能器，本研究旨在通过体内实验进一步探究其对深部肝内病灶的适用性。方法：在六头猪实验中，采用在术中磁共振成像及死后大体病理学中均可显影的伪肿瘤模型作为靶点。经肋磁共振引导高强度聚焦超声消融的预设平面（轴向或矢状面）与伪肿瘤共面，但有意向侧方偏移7至18毫米。未实施特殊的肋骨保护措施。治疗后第7天进行磁共振随访，随后实施动物尸检及肝脏大体病理学检查。结果：T1加权磁共振成像清晰显示伪肿瘤，并据此完成磁共振引导高强度聚焦超声治疗方案制定。焦点处峰值温度范围为58-87°C。大体病理学证实伪肿瘤存在，且磁共振引导高强度聚焦超声消融灶边界清晰，位置与预设相符。结论：该换能器的特殊设计实现了可靠的操作流程，在经肋磁共振引导高强度聚焦超声消融深部肝脏靶区（传统手术难度较高的部位）中展现出良好的安全性概况。

原文链接：

In Vivo Thermal Ablation of Deep Intrahepatic Targets Using a Super-Convergent MRgHIFU Applicator and a Pseudo-Tumor Model