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  • 1
    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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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Breast MRI ; Mammography ; Breast neoplasm ; Contrast-enhanced MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to compare the diagnostic performance of conventional mammography and dynamic contrast-enhanced fast 3D gradient-echo (GRE) MRI regarding the detection and characterization of breast lesions relative to histopathologic analysis and to assess the results of a combined evaluation of both methods. fifty consecutive patients with 63 histopathologically verified breast lesions underwent dynamic contrast-enhanced GRE MRI in addition to routine conventional mammography. All lesions were classified by both methods on a five-point scale as benign or malignant, and the results were correlated to histopathology. Conventional mammography and dynamic MRI yielded a sensitivity and specificity of 82 and 64 %, and 92 and 76 %, respectively. The difference between the results was statistically not significant (p 〉 0.05) with areas under the receiver-operating-characteristics curves of 0.807 for mammography and 0.906 for MR imaging. Combination of the results of both methods slightly increased the sensitivity for detection of breast cancer to 95 % but decreased specificity to 52 %. In this selected patient subset, including only patients referred for excisional biopsy, contrast-enhanced dynamic MRI proved more sensitive and specific than conventional mammography regarding the detection of malignancy. While a combination of both methods yields a slightly improved sensitivity, specificity is vastly reduced.
    Type of Medium: Electronic Resource
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