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MR fluoroscopy in vascular and cardiac interventions (review).

Saeed M, Hetts SW, English J, Wilson M - Int J Cardiovasc Imaging (2011)

Bottom Line: Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures.At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions.MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107-1701, USA. Maythem.Saeed@radiology.UCSF.edu

ABSTRACT
Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.

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Related in: MedlinePlus

Two types of hybrid XMR suites equipped with a closed bore 1.5T MR magnet and C-arm X-ray fluoroscopy. The a suite consists of 2 rooms separated by a sliding door (Phillips Medical Systems). The recently developed hybrid system b is an example of a more advanced facility, where both C-arm X-ray fluoroscopy and 1.5T MR systems are in the same room, thereby making interventional procedures shorter and more efficient (courtesy of Dr. Graham Wright, Sunnybrook, Toronto)
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Fig1: Two types of hybrid XMR suites equipped with a closed bore 1.5T MR magnet and C-arm X-ray fluoroscopy. The a suite consists of 2 rooms separated by a sliding door (Phillips Medical Systems). The recently developed hybrid system b is an example of a more advanced facility, where both C-arm X-ray fluoroscopy and 1.5T MR systems are in the same room, thereby making interventional procedures shorter and more efficient (courtesy of Dr. Graham Wright, Sunnybrook, Toronto)

Mentions: Different MR magnet designs have been developed, namely open and hybrid, for MR guided vascular and cardiac interventions [51]. Open magnets were designed to ease patient access. Both open and double donut XMR hybrid magnets use 0.2T and 0.5T fields and have low gradient strength. These low field magnets offer suboptimal image quality and slow switching speeds that do not meet the need of cardiovascular interventions. For example, Wacker et al. [52] found that 1.0T closed-bore halved the procedure time during stent deployment compared to 0.2T open-bore magnet. Another hybrid XMR system consists of an angiographic laboratory adjacent to closed-bore 1.5T MR magnet, wherein an on-track patient table could be moved rapidly between the two imaging modalities (Fig. 1a) [53, 54]. More recently, another XMR hybrid system has been developed that has a side-by-side 1.5T magnet and C-arm X-ray system (Personal communication) (Fig. 1b). The in-suite operation consoles and display monitors are of great help in instant imaging acquisition and monitoring.Fig. 1


MR fluoroscopy in vascular and cardiac interventions (review).

Saeed M, Hetts SW, English J, Wilson M - Int J Cardiovasc Imaging (2011)

Two types of hybrid XMR suites equipped with a closed bore 1.5T MR magnet and C-arm X-ray fluoroscopy. The a suite consists of 2 rooms separated by a sliding door (Phillips Medical Systems). The recently developed hybrid system b is an example of a more advanced facility, where both C-arm X-ray fluoroscopy and 1.5T MR systems are in the same room, thereby making interventional procedures shorter and more efficient (courtesy of Dr. Graham Wright, Sunnybrook, Toronto)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3275732&req=5

Fig1: Two types of hybrid XMR suites equipped with a closed bore 1.5T MR magnet and C-arm X-ray fluoroscopy. The a suite consists of 2 rooms separated by a sliding door (Phillips Medical Systems). The recently developed hybrid system b is an example of a more advanced facility, where both C-arm X-ray fluoroscopy and 1.5T MR systems are in the same room, thereby making interventional procedures shorter and more efficient (courtesy of Dr. Graham Wright, Sunnybrook, Toronto)
Mentions: Different MR magnet designs have been developed, namely open and hybrid, for MR guided vascular and cardiac interventions [51]. Open magnets were designed to ease patient access. Both open and double donut XMR hybrid magnets use 0.2T and 0.5T fields and have low gradient strength. These low field magnets offer suboptimal image quality and slow switching speeds that do not meet the need of cardiovascular interventions. For example, Wacker et al. [52] found that 1.0T closed-bore halved the procedure time during stent deployment compared to 0.2T open-bore magnet. Another hybrid XMR system consists of an angiographic laboratory adjacent to closed-bore 1.5T MR magnet, wherein an on-track patient table could be moved rapidly between the two imaging modalities (Fig. 1a) [53, 54]. More recently, another XMR hybrid system has been developed that has a side-by-side 1.5T magnet and C-arm X-ray system (Personal communication) (Fig. 1b). The in-suite operation consoles and display monitors are of great help in instant imaging acquisition and monitoring.Fig. 1

Bottom Line: Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures.At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions.MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107-1701, USA. Maythem.Saeed@radiology.UCSF.edu

ABSTRACT
Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.

Show MeSH
Related in: MedlinePlus