Schell B, Eichler K, Mack M G, Müller C, Kerl J M, Czerny C, Beeres M, Thalhammer A, Vogl T J, Zangos S
Institut für Diagnostische und Interventionelle Radiologie, Johann-Wolfgang-Goethe-Universität, Frankfurt a.M.
Rofo. 2012 Jan;184(1):42-7. doi: 10.1055/s-0031-1281774. Epub 2011 Oct 27.
The purpose of this study was to examine the clinical use of MR-guided biopsies in patients with suspicious lesions using a new MR-compatible assistance system in a high-field MR system.
Six patients with suspicious focal lesions in various anatomic regions underwent percutanous biopsy in a high-field MR system (1.5 T, Magnetom Espree, Siemens) using a new MR-compatible assistance system (Innomotion). The procedures were planned and guided using T 1-weighted FLASH and TrueFISP sequences. A servopneumatic drive then moved the guiding arm automatically to the insertion point. An MRI compatible 15G biopsy system (Somatex) was introduced by a physician guided by the needle holder and multiple biopsies were performed using the coaxial technique. The feasibility, duration of the intervention and biopsy findings were analyzed.
The proposed new system allows accurate punctures in a high-field MR system. The assistance device did not interfere with the image quality, and guided the needle virtually exactly as planned. Histological examination could be conducted on every patient. The lesion was malignant in four cases, and an infectious etiology was diagnosed for the two remaining lesions. Regarding the differentiation of anatomical and pathological structures and position monitoring of the insertion needle, TrueFISP images are to be given preference. The average intervention time was 41 minutes. Lesions up to 15.4 cm beneath the skin surface were punctured.
The proposed MR-guided assistance system can be successfully utilized in a high-field MR system for accurate punctures of even deep lesions in various anatomic regions.
本研究旨在使用高场磁共振系统中的一种新型磁共振兼容辅助系统，探讨磁共振引导活检在可疑病变患者中的临床应用。
6例在不同解剖区域有可疑局灶性病变的患者，在高场磁共振系统（1.5T，Magnetom Espree，西门子）中使用新型磁共振兼容辅助系统（Innomotion）进行经皮活检。使用T1加权快速小角度激发（FLASH）序列和稳态自由进动（TrueFISP）序列规划并引导操作过程。然后，一个伺服气动驱动器将引导臂自动移动到穿刺点。在持针器引导下，由医生引入一个磁共振兼容的15G活检系统（索马特克斯），并使用同轴技术进行多次活检。分析了该操作的可行性、干预持续时间和活检结果。
所提出的新系统能够在高场磁共振系统中进行精确穿刺。辅助设备不影响图像质量，并几乎完全按计划引导穿刺针。每位患者均能进行组织学检查。4例病变为恶性，其余2例诊断为感染性病因。关于解剖和病理结构的区分以及穿刺针的位置监测，TrueFISP图像更具优势。平均干预时间为41分钟。对皮肤表面以下达15.4厘米的病变进行了穿刺。
所提出的磁共振引导辅助系统可成功应用于高场磁共振系统，用于精确穿刺不同解剖区域的深部病变。
