Streitparth Florian, Althoff Christian, Jonczyk Martin, Guettler Felix, Maurer Martin, Rathke Hendrik, Sponheuer Keno Moritz, Hamm Bernd, Teichgräber Ulf K, de Bucourt Maximilian
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Biomed Tech (Berl). 2017 Nov 27;62(6):557-563. doi: 10.1515/bmt-2015-0163.
To assess the feasibility, image quality, and accuracy of freehand biopsies of liver, bone, muscle, vertebral disc, soft tissue, and other lesions using balanced steady-state free precession (SSFP, balanced fast field echo: bFFE), spoiled and nonspoiled gradient echo (FFE), and turbo spin echo (TSE) sequences for interactive continuous navigation in an open magnetic resonance imaging (MRI) system at 1.0 tesla (T).
Twenty-six MR-guided biopsies (five liver, five bone, four muscle, four vertebral disc, one lung, one kidney, one suprarenal gland, and five soft or other tissue) were performed in 23 patients in a 1.0-T open magnetic resonance (MR) scanner (Panorama HFO, Philips Healthcare, Best, the Netherlands). A total of 42 samples were obtained. Depending on lesion size and location, 14-18-gauge MR-compatible biopsy sets with a length of 100 or 200 mm (Somatex Medical, Teltow, Germany), 14-18-gauge MR-compatible semiautomatic biopsy guns with a length of 100 or 150 mm (Invivo, Schwerin, Germany), or 11-gauge MR-compatible bone marrow biopsy needles with a length of 100 mm (Somatex Medical, Teltow, Germany) were employed.
All lesions were visible with continuous interactive imaging. Our initial results indicate that bFFE is particularly suitable for fast-moving organs (pulmonary, paracardial); moving organs are targeted better with T1-weighted (T1W) TSE, T1W FFE (liver) or T2-weighted (T2W) TSE (complicated cysts, adrenal glands), and static organs are successfully approached with proton density (PD) (spine) or T1W TSE (peripheral bones, musculoskeletal system). No adverse events related to the use of MRI were obtained. No complications occurred according to the Society of Interventional Radiology (SIR) clinical practice guidelines.
Applying tailored interactive dynamic imaging sequences for continuous navigation to liver, bone, muscle, vertebral disc, soft tissue, and other lesions can improve the feasibility, image quality, and interventional accuracy of freehand MR-guided biopsies and may hence reduce the risk of complications.
评估在1.0特斯拉（T）的开放式磁共振成像（MRI）系统中，使用平衡稳态自由进动（SSFP，平衡快速场回波：bFFE）、扰相和非扰相梯度回波（FFE）以及涡轮自旋回波（TSE）序列对肝脏、骨骼、肌肉、椎间盘、软组织及其他病变进行徒手活检的可行性、图像质量和准确性，以实现交互式连续导航。
在一台1.0-T开放式磁共振（MR）扫描仪（Panorama HFO，飞利浦医疗保健公司，荷兰贝斯特）中，对23例患者进行了26次MR引导下的活检（5例肝脏、5例骨骼、4例肌肉、4例椎间盘、1例肺、1例肾脏、1例肾上腺以及5例软组织或其他组织）。共获取了42个样本。根据病变大小和位置，使用了长度为100或200毫米的14-18号MR兼容活检套装（德国特尔托夫索马特克斯医疗公司）、长度为100或150毫米的14-18号MR兼容半自动活检枪（德国什未林英维沃公司）或长度为100毫米的11号MR兼容骨髓活检针（德国特尔托夫索马特克斯医疗公司）。
通过连续交互式成像，所有病变均清晰可见。我们的初步结果表明，bFFE特别适用于快速移动的器官（肺部、心包旁）；对于移动器官，T1加权（T1W）TSE、T1W FFE（肝脏）或T2加权（T2W）TSE（复杂囊肿、肾上腺）能更好地靶向；对于静态器官，质子密度（PD）（脊柱）或T1W TSE（外周骨骼、肌肉骨骼系统）能成功接近目标。未获得与使用MRI相关的不良事件。根据介入放射学会（SIR）临床实践指南，未发生并发症。
应用定制的交互式动态成像序列对肝脏、骨骼、肌肉, 椎间盘、软组织及其他病变进行连续导航，可提高徒手MR引导活检的可行性、图像质量和介入准确性，从而可能降低并发症风险。
