Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892-1061, USA.
J Magn Reson Imaging. 2011 Nov;34(5):1159-66. doi: 10.1002/jmri.22715.
To develop an approach to vascular access under magnetic resonance imaging (MRI), as a component of comprehensive MRI-guided cardiovascular catheterization and intervention.
We attempted jugular vein access in healthy pigs as a model of "difficult" vascular access. Procedures were performed under real-time MRI guidance using reduced field of view imaging. We developed an "active" MRI antenna-needle having an open-lumen, distinct tip appearance and indicators of depth and trajectory in order to enhance MRI visibility during the procedure. We compared performance of the active needle against an unmodified commercial passively visualized needle, measured by procedure success among operators with different levels of experience.
MRI-guided central vein access was feasible using both the active needle and the unmodified passive needle. The active needle required less time (88 vs. 244 sec, P = 0.022) and fewer needle passes (4.5 vs. 9.1, P = 0.028), irrespective of operator experience.
MRI-guided access to central veins is feasible in our animal model. When image guidance is necessary for vascular access, performing this component under MRI will allow wholly MRI-guided catheterization procedures that do not require adjunctive imaging facilities such as x-ray or ultrasound. The active needle design showed enhanced visibility, as expected. These capabilities may permit more complex catheter-based cardiovascular interventional procedures enabled by enhanced image guidance.
开发一种在磁共振成像（MRI）下进行血管入路的方法，作为综合 MRI 引导心血管导管术和介入治疗的一部分。
我们尝试以健康猪的颈静脉入路作为“困难”血管入路的模型。在实时 MRI 引导下，使用小视野成像进行手术。我们开发了一种具有开放腔、独特尖端外观和深度及轨迹指示的“主动”MRI 天线-针，以增强手术过程中的 MRI 可视性。我们比较了主动针和未修改的商用被动可视针的性能，以不同经验水平的操作人员的手术成功率来衡量。
使用主动针和未修改的被动针均可行 MRI 引导的中心静脉入路。主动针所需的时间更少（88 秒与 244 秒，P = 0.022），所需的针数更少（4.5 次与 9.1 次，P = 0.028），与操作人员的经验无关。
在我们的动物模型中，MRI 引导的中心静脉入路是可行的。当血管入路需要图像引导时，在 MRI 下进行此操作部分将允许进行完全 MRI 引导的导管术，而不需要附加的成像设备，如 X 射线或超声。预期主动针设计会增强可视性。这些功能可能允许通过增强的图像引导来实现更复杂的基于导管的心血管介入治疗程序。
