Interventional magnetic resonance. Initial clinical experience with a 1.5-tesla magnetic resonance system combined with c-arm fluoroscopy.

RATIONALE AND OBJECTIVES

The authors evaluate the feasibility of performing magnetic resonance (MR) procedures on a 1.5-tesla (T) system combined with conventional c-arm fluoroscopy.

METHODS

A 1.5-T MR imaging system was combined with a conventional c-arm fluoroscopy unit in one room. The two systems were connected via a floating table top. Twenty-six interventional procedures (biopsies, MR-portography, percutaneous alcohol injection, laser ablation, fluid aspiration, and breast marking) were performed in 22 patients under MR, fluoroscopic control, or both. For MR guidance, fast gradient echo sequences were used, initiated from a panel at the front of the magnet. Images were displayed on an liquid crystal display screen positioned on the magnet.

RESULTS

All MR-guided procedures were performed successfully without complications. The addition of c-arm fluoroscopy was useful for bone interventions and MR-portography. All diagnostic biopsies yielded sufficient amounts of tissue for histologic diagnosis. In breast lesions, the target identified on dynamic MR imaging was marked correctly in each case. In interstitial laser thermotherapy the laser effect could be visualized, and in percutaneous ethanol injection the distribution of the alcohol could be seen. Both imaging systems worked without image distortions and high-quality MR images were obtained.

CONCLUSIONS

The combination of a 1.5-T MR imager with a c-arm fluoroscopy system seems to be a promising technical solution for performing interventional MR procedures.