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超声引导介入放射学中的磁共振导航。

Magnetic navigation in ultrasound-guided interventional radiology procedures.

机构信息

Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai, China.

出版信息

Clin Radiol. 2012 May;67(5):447-54. doi: 10.1016/j.crad.2011.10.015. Epub 2011 Dec 6.

Abstract

AIM

To evaluate the usefulness of magnetic navigation in ultrasound (US)-guided interventional procedures.

MATERIALS AND METHODS

Thirty-seven patients who were scheduled for US-guided interventional procedures (20 liver cancer ablation procedures and 17 other procedures) were included. Magnetic navigation with three-dimensional (3D) computed tomography (CT), magnetic resonance imaging (MRI), 3D US, and position-marking magnetic navigation were used for guidance. The influence on clinical outcome was also evaluated.

RESULTS

Magnetic navigation facilitated applicator placement in 15 of 20 ablation procedures for liver cancer in which multiple ablations were performed; enhanced guidance in two small liver cancers invisible on conventional US but visible at CT or MRI; and depicted the residual viable tumour after transcatheter arterial chemoembolization for liver cancer in one procedure. In four of 17 other interventional procedures, position-marking magnetic navigation increased the visualization of the needle tip. Magnetic navigation was beneficial in 11 (55%) of 20 ablation procedures; increased confidence but did not change management in five (25%); added some information but did not change management in two (10%); and made no change in two (10%). In the other 17 interventional procedures, the corresponding numbers were 1 (5.9%), 2 (11.7%), 7 (41.2%), and 7 (41.2%), respectively (p=0.002).

CONCLUSION

Magnetic navigation in US-guided interventional procedure provides solutions in some difficult cases in which conventional US guidance is not suitable. It is especially useful in complicated interventional procedures such as ablation for liver cancer.

摘要

目的

评估磁共振导航在超声(US)引导下介入性操作中的应用价值。

材料与方法

共纳入 37 例拟行 US 引导下介入性操作的患者(20 例肝癌消融术,17 例其他介入术)。采用三维 CT(3D-CT)、磁共振成像(MRI)、3D-US 及定位标记磁共振导航进行引导,并评估其对临床结局的影响。

结果

在 20 例肝癌消融术中,磁共振导航辅助完成 15 例多灶性消融操作,增强了 2 例常规 US 下不可见、但 CT 或 MRI 可见的小肝癌的引导,在 1 例肝癌经导管动脉化疗栓塞术后显示残余活性肿瘤。在 17 例其他介入术中,4 例应用定位标记磁共振导航增强了针尖可视化。磁共振导航对 20 例消融术中有 11 例(55%)有益,5 例(25%)增加了信心但未改变处理方式,2 例(10%)增加了部分信息但未改变处理方式,2 例(10%)无变化。在其他 17 例介入性操作中,相应比例分别为 1(5.9%)、2(11.7%)、7(41.2%)和 7(41.2%)(p=0.002)。

结论

磁共振导航为常规 US 引导不适用的某些困难病例提供了解决方案,尤其在肝癌消融等复杂介入性操作中具有重要价值。

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