Zangos S, Eichler K, Wetter A, Lehnert T, Hammerstingl R, Diebold T, Reichel P, Herzog C, Hansmann M-L, Mack M G, Vogl T J
Institute for Diagnostic and Interventional Radiology, J.W. Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
Eur Radiol. 2006 Feb;16(2):307-12. doi: 10.1007/s00330-005-2870-2. Epub 2005 Jul 30.
The purpose of this study was to evaluate the safety and precision of MRI-guided biopsies of retroperitoneal space-occupying tumors in an open low-field system. In 30 patients with indistinct retroperitoneal tumors [paraaortic lesion (n=20), kidney (n=2), suprarenal gland (n=3) and pancreas (n=5)] MR-guided biopsies were performed using a low-field system (0.2 T, Magnetom Concerto, Siemens, Germany). For the monitoring of the biopsies T1-weighted FLASH sequences (TR/TE=160/5 ms; 90 degrees ) were used in all patients and modified FLASH sequences (TR/TE=160/13 ms; 90 degrees ) in ten patients. After positioning of the needle in the tumors 114 biopsy specimens were acquired in coaxial technique with 16-gauge cutting needles (Somatex, Germany). The biopsies were successfully performed in all patients without vascular or organ injuries. The visualization of the aortic blood flow with MRI facilitated the biopsy procedures of paraaortic lesions. The size of the lesions ranged from 1.6 to 7.5 cm. The median distance of the biopsy access path was 10.4 cm. Adequate specimens were obtained in 28 cases (93.3%) resulting in a correct histological classification of 27 lesions (90%). In conclusion, MR-guided biopsies of retroperitoneal lesions using an open low-field system can be performed safely and accurately and is an alternative to CT-guided biopsies.
本研究的目的是评估在开放式低场系统中对腹膜后占位性肿瘤进行MRI引导活检的安全性和精确性。对30例腹膜后肿瘤不明确的患者[腹主动脉旁病变（n = 20）、肾脏（n = 2）、肾上腺（n = 3）和胰腺（n = 5）]，使用低场系统（0.2 T，德国西门子公司的Magnetom Concerto）进行MR引导活检。在所有患者中，活检监测均采用T1加权快速小角度激发序列（TR/TE = 160/5 ms；90°），10例患者采用改良快速小角度激发序列（TR/TE = 160/13 ms；90°）。将穿刺针置于肿瘤内后，采用同轴技术使用16G切割针（德国索马特克斯公司）获取114份活检标本。所有患者活检均成功进行，无血管或器官损伤。MRI对主动脉血流的可视化有助于腹主动脉旁病变的活检操作。病变大小范围为1.6至7.5 cm。活检进针路径的中位距离为10.4 cm。28例（93.3%）获得了足够的标本，27个病变（90%）得到了正确的组织学分类。总之，使用开放式低场系统对腹膜后病变进行MR引导活检可安全、准确地进行，是CT引导活检的一种替代方法。
