Leung D A, Debatin J F, Wildermuth S, McKinnon G C, Holtz D, Dumoulin C L, Darrow R D, Hofmann E, von Schulthess G K
Department of Radiology, Zürich University Hospital, Switzerland.
AJR Am J Roentgenol. 1995 May;164(5):1265-70. doi: 10.2214/ajr.164.5.7717244.
This article reports on the preliminary evaluation of a new technique for guiding intravascular interventional procedures with MR imaging. Active real-time position monitoring of catheters with MR imaging is made possible by incorporating a small RF coil into the tip of the catheter. The purpose of this study was to evaluate the practicability and localizing precision of this MR catheter tracking technique in vitro and in vivo in comparison with fluoroscopy.
Feed cables employing a 0.9-mm-diameter coaxial cable, a 0.5-mm-diameter partially shielded coaxial cable, and a twisted pair cable attaching RF coils at the catheter tip to a coaxial plug at the catheter base were assessed. Further, miniature copper loop RF coils of two, three, and four turns were tested. In vitro validation of MR tracking was achieved by using a phantom consisting of a water-filled harvested segment of human aorta and iliac arteries embedded in gel. Accuracy of catheter placement was compared with MR and fluoroscopy. Subsequently, the MR tracking technique was evaluated in a swine model using a prototype 5-French MR tracking catheter.
A fully shielded coaxial cable was found to be crucial for localizing the attached RF coil by means of the tracking technique. The number of coil turns had a lesser impact. Positions of the catheter tip measured with the MR technique and with fluoroscopy correlated well (r > .98), with a 6-mm 95% confidence interval of positional differences. Active real-time tracking of the coil-tipped catheters was achieved both in vitro and in vivo. The 5-French tracking catheter was successfully placed in the splenic and renal arteries of the swine.
Robust in vivo tracking and accurate placement of catheters equipped with miniature RF coils are possible with MR imaging.
本文报道了一种利用磁共振成像(MR)引导血管内介入操作的新技术的初步评估。通过将一个小型射频线圈集成到导管尖端,实现了利用MR成像对导管进行主动实时位置监测。本研究的目的是与荧光透视法相比,在体外和体内评估这种MR导管跟踪技术的实用性和定位精度。
评估了采用直径0.9毫米同轴电缆、直径0.5毫米部分屏蔽同轴电缆以及将导管尖端的射频线圈与导管基部的同轴插头相连的双绞线电缆的馈线电缆。此外,还测试了两圈、三圈和四圈的微型铜环射频线圈。通过使用一个由嵌入凝胶中的充满水的人体主动脉和髂动脉采集段组成的模型,对MR跟踪进行体外验证。将导管放置的准确性与MR和荧光透视法进行比较。随后,使用一个原型5法式MR跟踪导管在猪模型中评估MR跟踪技术。
发现一条完全屏蔽的同轴电缆对于通过跟踪技术定位附着的射频线圈至关重要。线圈匝数的影响较小。用MR技术和荧光透视法测量的导管尖端位置相关性良好(r>.98),位置差异的95%置信区间为6毫米。在体外和体内均实现了对带线圈尖端导管的主动实时跟踪。5法式跟踪导管成功地放置在了猪的脾动脉和肾动脉中。
利用MR成像可以实现对配备微型射频线圈的导管进行可靠的体内跟踪和准确放置。