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磁共振成像引导下的凝血术:一种新型的动脉瘤修复微创方法。

MR Coagulation: A Novel Minimally Invasive Approach to Aneurysm Repair.

作者信息

Cohen Ouri, Zhao Ming, Nevo Erez, Ackerman Jerome L

机构信息

Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Radiology, Harvard Medical School, Boston, Massachusetts.

Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, Massachusetts.

出版信息

J Vasc Interv Radiol. 2017 Nov;28(11):1592-1598. doi: 10.1016/j.jvir.2017.06.036. Epub 2017 Aug 9.

Abstract

PURPOSE

To demonstrate a proof of concept of magnetic resonance (MR) coagulation, in which MR imaging scanner-induced radiofrequency (RF) heating at the end of an intracatheter long wire heats and coagulates a protein solution to effect a vascular repair by embolization.

MATERIALS AND METHODS

MR coagulation was simulated by finite-element modeling of electromagnetic fields and specific absorption rate (SAR) in a phantom. A glass phantom consisting of a spherical cavity joined to the side of a tube was incorporated into a flow system to simulate an aneurysm and flowing blood with velocities of 0-1.7 mL/s. A double-lumen catheter containing the wire and fiberoptic temperature sensor in 1 lumen was passed through the flow system into the aneurysm, and 9 cm of protein solution was injected into the aneurysm through the second lumen. The distal end of the wire was laid on the patient table as an antenna to couple RF from the body coil or was connected to a separate tuned RF pickup coil. A high RF duty-cycle turbo spin-echo pulse sequence excited the wire such that RF energy deposited at the tip of the wire coagulated the protein solution, embolizing the aneurysm.

RESULTS

The protein coagulation temperature of 60°C was reached in the aneurysm in ∼12 seconds, yielding a coagulated mass that largely filled the aneurysm. The heating rate was controlled by adjusting pulse-sequence parameters.

CONCLUSIONS

MR coagulation has the potential to embolize vascular defects by coagulating a protein solution delivered by catheter using MR imaging scanner-induced RF heating of an intracatheter wire.

摘要

目的

演示磁共振(MR)凝血的概念验证,即通过在导管内长线末端利用磁共振成像扫描仪诱导的射频(RF)加热来加热并凝结蛋白质溶液,从而通过栓塞实现血管修复。

材料与方法

通过对体模中的电磁场和比吸收率(SAR)进行有限元建模来模拟MR凝血。将一个由连接到管子侧面的球形腔组成的玻璃体模纳入流动系统,以模拟动脉瘤和流速为0 - 1.7 mL/s的流动血液。将一根在一个管腔内包含导线和光纤温度传感器的双腔导管穿过流动系统插入动脉瘤,并通过第二个管腔向动脉瘤内注入9 cm的蛋白质溶液。导线的远端作为天线放置在检查台上以耦合来自体线圈的RF,或者连接到一个单独的调谐RF接收线圈。一个高RF占空比的涡轮自旋回波脉冲序列激励导线,使得沉积在导线末端的RF能量凝结蛋白质溶液,从而栓塞动脉瘤。

结果

在约12秒内动脉瘤内蛋白质达到60°C的凝血温度,形成一个基本填满动脉瘤的凝结块。通过调整脉冲序列参数来控制加热速率。

结论

MR凝血有潜力通过利用磁共振成像扫描仪诱导的导管内导线RF加热来凝结由导管输送的蛋白质溶液,从而栓塞血管缺损。

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