Gould S W, Darzi A
Minimal Access Surgical Unit, St Mary's Hospital, Paddington, London, UK.
Br J Radiol. 1997 Nov;70 Spec No:S89-97. doi: 10.1259/bjr.1997.0012.
Interventional magnetic resonance units give the surgeon the potential to use intraoperative imaging to guide the surgical procedure. The advantages of magnetic resonance (MR) over other intraoperative imaging modalities include excellent soft tissue resolution, lack of ionizing radiation and the ability to reconstruct images in any desired plane. Postulated advantages include the ability to confirm adequate tumour resection, reduction in procedure magnitude and complication rate, shortened inpatient stay and the development of novel minimally invasive techniques including the use of thermal energy to destroy lesions. Fully MR compatible anaesthetic and patient monitoring equipment is available. However, before the MR-guided minimally invasive surgery can become a reality, much work is required in the assessment and development of MR compatible surgical instrumentation and equipment. This review describes the testing and development of instruments and equipment for MR image-guided surgery that we have undertaken. We describe the techniques we employ for open and minimal access surgery within this unique environment. The difficulties of operating within such an environment and the safety issues that this engenders are discussed. The current applications of intraoperative MR in the main surgical specialities are reviewed, and possible future areas of development for MR-guided minimally invasive surgery described.
介入磁共振设备使外科医生有可能利用术中成像来指导手术过程。与其他术中成像方式相比，磁共振（MR）的优势包括出色的软组织分辨率、无电离辐射以及能够在任何所需平面重建图像。推测的优势包括能够确认肿瘤切除是否充分、减少手术规模和并发症发生率、缩短住院时间以及开发新型微创技术，包括利用热能破坏病变。现已具备完全兼容磁共振的麻醉和患者监测设备。然而，在磁共振引导的微创手术成为现实之前，在评估和开发兼容磁共振的手术器械和设备方面还需要大量工作。这篇综述描述了我们所进行的用于磁共振图像引导手术的器械和设备的测试与开发。我们描述了在这种独特环境下进行开放手术和微创手术所采用的技术。讨论了在这样的环境中操作的困难以及由此产生的安全问题。回顾了术中磁共振在主要外科专科的当前应用，并描述了磁共振引导微创手术未来可能的发展领域。
