Bakker C J, Smits H F, Bos C, van der Weide R, Zuiderveld K J, van Vaals J J, Hurtak W F, Viergever M A, Mali W P
Department of Radiology, Image Sciences Institute, University Hospital Utrecht, The Netherlands.
J Magn Reson Imaging. 1998 Jan-Feb;8(1):245-50. doi: 10.1002/jmri.1880080141.
The purpose of this study was to demonstrate the potential of MRI for guiding, monitoring, and evaluating endovascular interventions. This was done by investigating the feasibility of MR-guided balloon angioplasty in a stenosed vessel model. Catheters and guidewires were prepared for susceptibility-based MR visualization by incorporating paramagnetic markers into their walls. Near real-time monitoring (up to 1 image/sec) of the interventional procedure was achieved by using a dynamic two-dimensional gradient-echo technique. Devices were localized by on-the-fly subtraction of a baseline image from consecutive dynamic images and by merging the subtraction images with a previously acquired road map. All steps involved in balloon angioplasty, from the introduction and placement of a guidewire to the positioning of a catheter across the stenosis, inflation of the balloon, and dilatation of the stenosis could adequately be monitored with MR fluoroscopy. The beneficial effect of dilatation could be substantiated by a reduction of stenosis-related hypointensities and hyperintensities in the posttreatment MR angiogram as compared to the pretreatment angiogram and by a posttreatment increase of the volumetric flow rate.
本研究的目的是证明磁共振成像（MRI）在指导、监测和评估血管内介入治疗方面的潜力。这是通过研究在狭窄血管模型中进行磁共振引导的球囊血管成形术的可行性来实现的。通过将顺磁性标记物纳入导管和导丝壁，为基于敏感性的磁共振可视化准备导管和导丝。通过使用动态二维梯度回波技术实现对介入过程的近实时监测（高达每秒1幅图像）。通过从连续动态图像中实时减去基线图像，并将减法图像与先前获取的路线图合并来定位设备。球囊血管成形术涉及的所有步骤，从导丝的引入和放置到导管穿过狭窄部位的定位、球囊充气以及狭窄部位的扩张，都可以通过磁共振透视进行充分监测。与治疗前血管造影相比，治疗后磁共振血管造影中狭窄相关的低信号和高信号减少，以及治疗后体积流速增加，可证实扩张的有益效果。
