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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Spine ; Intervertebral disks ; Lasers ; MR imaging guidance ; MR imaging temperature monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to perform percutaneous laser disc decompression (PLDD) under MR guidance in an open configuration 0.5-T MR system. Following failed conservative treatment for 6 months, eight patients with contained disc herniations were enrolled in the study. Following MR guided introduction of the laser fiber into the targeted disc space, the laser-induced temperature distribution was visualized using a color-coded subtraction technique based on a T1-weighted GRE sequence. In seven patients PLDD could be performed. In all cases laser effects were depicted by MR. In this regard the color-coded technique was found to be superior to conventional magnitude images. Whereas no apparent decrease in the extent of herniation was discovered immediately following PLDD, T2-weighted FSE images showed signal intensity alterations in two of the seven patients. Clinical evaluation, obtained 3–4 months after PLDD, revealed a fair (n = 2) or good (n = 4) response to the treatment. One patient showed no change in symptoms. MR guidance and monitoring of PLDD is feasible within an open 0.5-T system and seems to render PLDD more safe and controllable.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Thyroid ; Biopsy ; Interventional MR ; MR guidance ; Stereotaxis ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to demonstrate the clinical feasibility and utility of an interactive MR-guidance system to target and biopsy thyroid lesions, and to compare resolution between ultrasound and interventional MR imaging in the evaluation of thyroid lesions. Twenty thyroid lesions of 18 patients were interactively biopsied using a 0.5-T superconducting open magnet system. Stereotactic localization of the needle and imaging was accomplished using T1-weighted gradient-recalled-echo (GRE) images. Representative cytological material was retrieved in 16 of 20 lesions (benign cystic or colloid goiter: n = 14; one de Quervain's thyroiditis and one follicular neoplasia). Lesions smaller than 1.5 cm detected by ultrasound could not be visualized adequately on GRE images. Lesions smaller than 1.5 cm were successfully biopsied by ultrasound (three colloid and haemorrhagic goiters and one adenoma). Magnetic-resonance-guided interactive biopsies and positioning of non-ferromagnetic needles in the thyroid gland are technically feasible and safe. Compared with high-resolution ultrasound, lesions larger than 1.5 cm can be adequately visualized and biopsied. Magnetic-resonance-guided placement of non-ferromagnetic needles is no substitute for high-resolution ultrasound in clinical work-up of thyroid lesions.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Endometriose ; Biopsie ; Nadel ; Magnetresonanztomographie ; Interventionelle Radiologie ; Key words Endometriosis ; Biopsy ; needle ; Magnetic resonance imaging ; Interventional radiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Introduction and Methods: A 0.5 T open-configuration MR system allows free access to the patient via a 58-cm-wide opening on both sides of the machine. A newly developed system for needle guidance enables the examiner to perform biopsies in combination with real-time imaging and to position laser fibers in the human body. For imaging, a 2D gradient echo sequence is used (TR 19 ms, TE 9 ms, flip angle 30 °, FOV 24 × 24 cm, slice thickness 10 mm matrix 256 × 128). The acquired images are displayed on two LCD screens localized within the MR system, thus allowing an interactive needle guidance. This procedure is illustrated by a case report. Discussion: The handling of the system for needle guidance was simple, mainly due to a real-time adaption of the scan plane to the needle direction. The possibility of multi-angulated approaches makes biopsies of hardly accessible anatomic regions feasible. Conclusion: We think that MR-guided needle positioning will play an important role in combination with thermosensitive therapies. Thermosensitivity of MR imaging allows extensive monitoring of such interventions.
    Notes: Zusammenfassung Ein offenes, interventionelles MR-Gerät (0,5 Tesla) erlaubt durch eine 58 cm breite Öffnung den Zugang zum im Gerät liegenden Patienten. Ein spezielles Punktionssystem ermöglicht es, unter Echtzeitbildgebung Punktionen vorzunehmen sowie auch Laserfasern im menschlichen Körper zu plazieren. Zur Bildgebung wird eine 2d-Gradientenechosequenz verwendet (TR 19 ms, TE 9 ms, Flipwinkel 30 °, FOV 24 × 24 cm, Schichtdicke 10 mm, Matrix 256 × 128). Die akquirierten Bilder werden dem punktierenden Radiologen auf 2 im Gerät angebrachten LCD-Monitoren angezeigt, wodurch eine interaktive Nadelführung ermöglicht wird. Es wurden bereits zahlreiche Punktionen an Patienten durchgeführt. Wichtig wird die MR-gesteuerte Punktion von Läsionen in Kombination mit der Durchführung thermosensitiver Therapien. Die der MR-Bildgebung inhärente Temperatursensitivität ermöglicht ein umfassendes Monitoring solcher Eingriffe in Echtzeit.
    Type of Medium: Electronic Resource
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