磁粒子成像引导下的支架置入术。

Magnetic Particle Imaging-Guided Stenting.

机构信息

1 Department of Diagnostic and Interventional Radiology, Würzburg, Germany.

2 Comprehensive Heart Failure Center, University Hospital Würzburg, Germany.

出版信息

J Endovasc Ther. 2019 Aug;26(4):512-519. doi: 10.1177/1526602819851202. Epub 2019 May 27.

Abstract

To assess the feasibility of magnetic particle imaging (MPI) to guide stenting in a phantom model. MPI is a new tomographic imaging method based on the background-free magnetic field detection of a tracer agent composed of superparamagnetic iron oxide nanoparticles (SPIOs). All experiments were conducted on a custom-built MPI scanner (field of view: 29-mm diameter, 65-mm length; isotropic spatial resolution 1-1.5-mm). Stenosis phantoms (n=3) consisted of polyvinyl chloride (PVC) tubes (8-mm inner diameter) prepared with centrally aligned cable binders to form a ~50% stenosis. A dedicated image reconstruction algorithm allowed precise tracking of endovascular instruments at 8 frames/s with a latency time of ~115 ms. A custom-made MPI-visible lacquer was used to manually label conventional guidewires, balloon catheters, and stainless steel balloon-expandable stents. Vascular stenoses were visualized by injecting a diluted SPIO tracer (ferucarbotran, 10 mmol iron/L) into the vessel phantoms. Balloon angioplasty and stent placement were performed by inflating balloon catheters and stent delivery balloons with diluted ferucarbotran. After deployment of the stent, the markers on its ends were clearly visible. The applied lacquer markers were thin enough to not relevantly alter gliding properties of the devices while withstanding friction during the experiments. Placing an optimized flexible lacquer formulation on the preexisting radiopaque stent markers provided enough stability to withstand stent expansion. Final MPA confirmed successful stenosis treatment, facilitated by the disappearance of the lacquer markers on the stent due to differences in SPIO concentration. Thus, the in-stent lumen could be visualized without interference by the signal from the markers. Near real-time visualization of MPI-guided stenting of stenoses in a phantom model is feasible. Optimized MPI-visible markers can withstand the expansion process of stents.

摘要

评估磁粒子成像(MPI)引导支架置入在体模模型中的可行性。MPI 是一种基于超顺磁性氧化铁纳米颗粒(SPIOs)示踪剂的背景磁场自由检测的新型断层成像方法。所有实验均在定制的 MPI 扫描仪(视野:29mm 直径,65mm 长度;各向同性空间分辨率 1-1.5mm)上进行。狭窄体模(n=3)由聚氯乙烯(PVC)管(内径 8mm)制成,并用中心对齐的电缆固定器制成,形成约 50%的狭窄。专用的图像重建算法允许以 8 帧/s 的速度精确跟踪血管内器械,潜伏期约为 115ms。使用定制的 MPI 可见漆手动标记常规导丝、球囊导管和不锈钢球囊扩张支架。通过将稀释的 SPIO 示踪剂(ferucarbotran,10mmol 铁/L)注入血管体模中,可视化血管狭窄。通过用稀释的 ferucarbotran 充气球囊导管和支架输送球囊进行球囊血管成形术和支架放置。支架放置后,其末端的标记物清晰可见。应用的漆标记物足够薄,不会显著改变器械的滑动性能,同时在实验过程中承受摩擦。将优化的柔性漆配方放置在预先存在的不透射线支架标记物上,为支架扩张提供足够的稳定性。最终的 MPA 证实了狭窄治疗的成功,由于 SPIO 浓度的差异,支架上的漆标记物消失,从而使支架内腔可视化,不受标记物信号的干扰。在体模模型中,MPI 引导的狭窄支架置入的近实时可视化是可行的。优化的 MPI 可见标记物能够承受支架扩张过程。

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