ipath 200光学引导系统下MRI介入在骨骼系统的应用价值

目的：评价ipath 200光学引导系统下MRI介入在骨骼系统的应用价值。方法：对21例骨骼疾病患者行ipath 200光学引导系统下MRI穿刺检查，用抽吸针或骨钻获取标本。结果：ipath 200光学引导系统下MRI穿刺准确率达100％，活检正确率为90．5％。结论：ipath 200光学引导系统引导下MRI穿刺技术是一种安全而有效的方法。     

MRI引导下骨骼肌肉病变活检的应用价值

目的：介绍iPath200辅助MPI引导下骨骼肌肉系统活检的技术操作方法，并评价其应用价值。方法：24例骨骼肌肉系统病变患者，均在iPath200辅助MPI引导下进行经皮活检。所用设备为Philips公司生产的开放式0．23T。常导磁共振检查仪(Proview)，并配有iPath200光学引导系统。活检针采用德国Daum公司的磁共振兼容性活检针。24例病人中的6例在活检中行Nil对比增强检查。所用对比剂为Gd-DTPA。24例病人中的10例后来行外科手术治疗或活检。结果：MPI引导活检取得足够的标本，所有的病例均获得了组织病理学诊断(24／PA)。在10例后来行外科手术治疗或活检的病人中，初步诊断与最终诊断基本符合(10／10)。未发现明显并发症如严重出血及神经损害等。结论：iPath200辅助MPI引导下的骨骼肌肉系统病变的经皮活检是一种安全、准确的新技术。     

MRI多参数成像联合超声在前列腺癌诊断中的价值

目的 探讨前列腺MRI多参数成像联合超声引导下穿刺活检术在前列腺癌(PCa)诊断中的价值.方法 选取100例前列腺特异性抗原(PSA)升高的前列腺疾病患者,其中包括2组检查方法不同的患者:A组(50例)直接行超声引导下穿刺活检术,B组(50例)首先行前列腺MRI多参数成像,后在MRI提示下行超声引导下穿刺活检术;对2组...     

螺旋CT引导下胸部病变穿刺活检的临床应用

目的：螺旋CT引导下胸部病变穿刺活检的临床应用价值。方法：用半自动活检针对45例胸部病变在螺旋CT引导下穿刺活检，其中肺部病变40例，纵膈病变2例，胸膜病变2例，胸壁病变1例。结果：45例病变穿刺活检成功率为100％，诊断准确率93．3％（42/45），恶性病变准确率94．3％（33/35），良性病变准确率90％（9/10）。并发气胸5例，肺出血4例，痰中带血2例。结论：螺旋CT引导下胸部穿刺活检成功率高，并发症少，安全可靠，值得临床推广应用。     

开放性MRI引导下脑内病变穿刺病理学活检的应用价值

开放式MRI导引下的经皮穿刺活检是近年来医学影像学发展的先进技术之一，已开始广泛应用于全身各个系统，成为当今国际研究的热门课题之一。通过开放式MRI介入导向对中枢神经系统病变进行穿刺活检及切除国外已有报道。笔者旨在通过Philips开放式0．23TMRI结合ipath-200光学导引系统，对颅内疑难病例的穿刺活检术，探讨其可行性及临床应用价值。     

改良的CT引导下同轴法经皮肺穿刺活检术应用

目的：探讨CT引导下同轴法经皮肺穿刺活检术的临床应用价值。方法：选择因肺内病变需活检的116例患者,所有患者均采用CT引导下自动活检枪同轴法经皮肺穿刺活检术。结果：116例患者均成功获取病理标本,穿刺成功率100％,病变阳性率94．8％,并发症6例（5．2％）,经对症处理后2～7天后患者身体逐渐恢复。结论：改良CT引导下经皮肺穿刺活检术器材简单易得,费用低廉操作简便,穿刺成功率高、并发症发生率低。     

MRI介入导引下腰椎间盘突出症的臭氧治疗

目的探讨0．23 T开放式MR结合ipath200光学追踪系统进行椎间盘突出症臭氧治疗的方法步骤及其应用价值。方法在ipath200主动式光学追踪系统实时导引下，用19．5或21．0GMR兼容性穿刺针对73例椎间盘突出患者成功进行MRI导引下经小关节内侧入路臭氧治疗术。对其中临床体征与影像学检查结果不完全符合者及可疑为包容性椎间盘突出的26例患者先行椎间盘造影术，作为进一步行髓核溶解术的初选。本组共64例患者行三点注射法椎间盘突出的臭氧治疗：（1）椎间盘中心注入浓度为35—45μg／ml医用O2-O3混合气体6-10ml，采用分次反复注射、抽出，使髓核组织充分氧化；（2）依据穿刺针刻度标记，在光学引导装置指导下逐步退针，至局限性髓核突出物处，注射O2-O3混合气体10ml；（3）继续退针1．0—1.5cm至纤维环外、侧隐窝处，向神经根旁注射15—20ml O2—O3混合气体。9例患者因椎间盘造影认为行髓核溶解术疗效欠佳而仅行神经根旁臭氧注射治疗。结果73例患者均穿刺成功，未出现神经根损伤等严重并发症。经3—6个月随访，28例显效，39例有效，6例无效，总有效率达91．3％。结论开放式0．23TMR扫描仪，结合ipath200光学引导系统，能成功地进行微创性椎间盘突出臭氧治疗术．是一种安全、有效的微创治疗方法．     

介人性磁共振技术临床应用经验初探

目的：介绍我所引进Marconi公司介入磁共振系统进行的微创性介入MRI方法、步骤、准确性和操作经验体会。方法：采用Marconi公司生产的0.23T开放式磁共振成像仪，在介入MR ipath 200(大屏幕显示器和红外线被动示踪光学导航系统）引导下对38例患者清晰显示介入过程。结果：新的介入引导设备使所有手术均几乎在实时监控下完成，获的成功。结论：介入性磁共振可用来进行微创性经皮介入，包括导向、监测和随访。     

开放式MR引导下经皮胰腺占位性病变粗针穿刺活检的临床应用北大核心CSCD

目的探讨光学导航辅助0.4T开放式MR引导下胰腺占位性病变经皮粗针穿刺活检的安全性和有效性。方法回顾性分析2019年1月至2021年1月116例行胰腺穿刺活检患者的临床资料。术前增强CT或MRI评估,根据术前是否行PET-CT检查分为2组,行PET-CT检查组56例,未行PETCT检查组60例。0.4T开放式磁共振成像仪结合光学导航仪系统,采用17 G同轴穿刺针和18 G全自动活检枪行胰腺肿瘤穿刺活检术。术后送病理检查,记录腹痛、出血等并发症,通过手术或临床随访至少6个月确定最终诊断。结果所有病例准确穿刺至拟定靶点,一次成功率为100%,准确率为96.6%。3例发生穿刺后腹痛,2例出现腹腔出血,并发症发生率为4.2%。术前有PET-CT组的准确率和并发症率分别为98.3%和3.4%,无PET-CT组准确率和并发症率分别为94.6%和5.0%(P>0.05)。结论磁共振导航引导下胰腺占位性病变粗针穿刺活检术准确、安全,是一项值得推广的临床技术。     

光学导航介入性MR的临床应用

目的介绍在光学导航介入性MR引导下经皮穿刺活检及治疗的技术方法，并评价其临床应用价值。方法54例患者，均在光学导航介入性MR引导下进行经皮穿刺活检或治疗。所用设备为Philips公司生产的开放式0．23T常导型MR型检查仪，并配有iPath200光学导航系统。穿刺针采用德国Daum公司的MR兼容性穿刺针。结果本组54例介人性操作均1次穿刺成功，未发现病人出现严重出血、脏器损伤和神经损伤等明显并发症。结论光学导航介入性MR引导下的介人性操作是1种安全、准确的新技术。     

MR-guided core biopsies of soft tissue tumours on an open 0.23 T imager

Purpose: To assess the feasibility of MR-guided soft tissue core biopsies on an open 0.23 T magnet.Material and Methods: Twenty-nine consecutive patients with known or suspected benign or malignant soft tissue tumours underwent MR imaging. A one-slice dynamic enhancement sequence was used to obtain an enhancement curve of the tumour. MR-guided core biopsy of the tumour was performed in the same session.Results: All biopsies could be performed on an open 0.23 T magnet. Standard MR images and dynamic enhancement curves were used in deciding biopsy route and target. The MR-guided core biopsy specimens were sufficient for histopathological diagnosis in 27 of 29 cases.Conclusion: Open magnet configuration allows easy access to the patient and near real-time imaging guidance of soft tissue tumours. Minimally invasive MR-guided core biopsies of soft tissue tumours are feasible and help to avoid open surgical biopsies.     

开放式磁共振引导下介入操作的护理

目的：探讨iPATH-200开放式介入磁共振引导下经皮活检与治疗的术前、术中、术后的护理措施。方法：对80例行该手术的患者在术前、术中及术后各期进行相应的护理。结果：术后极少部分出现并发症，经相应的对症治疗、护理后，均痊愈。结论：开放式MR引导下的介入性操作是一种安全准确的新技术，但细致、周到的护理工作也是手术成功的重要保证。     

Dynamic contrast-enhanced MR imaging and MR-guided bone biopsy on a 0.23 T open imager

OBJECTIVE: To assess the feasibility of MR (magnetic resonance)-guided bone biopsies. DESIGN AND PATIENTS: Thirty-six consecutive patients with known or suspected benign or malignant bone lesions underwent comprehensive MR imaging. A dynamic contrast-enhanced sequence followed by stationary T1-weighted sequences were obtained and MR-guided bone biopsy of the tumor at the site with fastest enhancement was performed using an open 0.23 T MR imager. RESULTS: All MR-guided bone biopsies samples were estimated to be sufficient by the pathologists. The biopsy specimens were diagnostic in 34 of 36 cases. CONCLUSION: MR-guided bone biopsies combined with dynamic contrast-enhanced imaging are feasible and safe for the diagnostic investigation of equivocal bone lesions.     

Dynamic contrast-enhanced MR imaging and MR-guided bone biopsy on a 0.23T open imager

Objective:To assess the feasibility of MR-guided bone biopsies.Methods::Thirty-six consecutive patients with known or suspected benign or malignant bone lesions underwent comprehensive MR imaging.A dynamic contrast-enhanced sequence followed by stationary Ti-weighted sequences were obtained and MR-guided bone biopsy of the tumor at the site with fastest enhancement was performed using an open 0.23 T MR imager.Results:All MR-guided bone biopsies samples were estimated to be sufficient by the pathologists.The biopsy specimens were diagnostic in 34 of 36 cases.Conclusion:MR-guided bone biopsies combined with dynamic contrast-enhanced imaging are feasible and safe for the diagnostic investigation of equivocal bone lesions.     

介入性MR引导骨骼肌肉病变活检的应用价值

目的 介绍介入性MR引导下骨骼肌肉系统活检的技术操作方法，并评价其应用价值。方法 26例骨骼肌肉系统病变患者，均在介入性MR引导下进行经皮活检，所用设备为开放式0．23T常导MR检查仪，并配有iPath200光学引导系统(Proview，Philips)。其中10例病人术后行外科手术治疗或活检。活检针为MR兼容性。结果 24例病人获得了组织病理学诊断(24／26)。在10例后来行外科手术治疗或活检的病人中，MR活检诊断与最终诊断基本符合(10／10)。未发现明显并发症。结论 介入性MR引导下骨骼肌肉系统病变的经皮活检是1种安全、准确的新技术。     

Preliminary experience with interactive guided brain biopsies using a vertically opened 0.5-T MR system

The purpose of our study was to evaluate the feasibility and accuracy of brain biopsies performed within a vertically opened MR system. We worked with the interventional 0.5-T MR “SIGNA SP” (General Electric Medical Systems, Milwaukee, Wis.) with an integrated tracking device “Flashpoint Position Encoder” (Image Guided Technologies, USA). As a holding device for this instrument we constructed a special frame. The whole system allows an exact adjustment of an optimum biopsy direction and guidance of the biopsy in a non-stereotactic, interactive mode in near real-time. As biopsy tools we used MR-compatible aspiration and specially made side-cut needles (Daum, Germany; E-Z-EM, USA). We performed a prospective diagnostic brain biopsy study in 18 patients. Guidance of the needle was carried out using gradient-echo single-slice technique. The sample was taken after controlling the exact position of the needle tip on spin-echo images. In 12 cases an exact neuropathological diagnosis was possible. In 6 cases of negative biopsy (4 aspiration biopsies) the samples were not representative. Our results demonstrate the feasibility of interactive MR-guided minimally invasive brain biopsies in an open MR system. The best results were achieved using cut needles for biopsies of contrast-enhancing lesions visible on T1-weighted gradient-echo guidance sequence. Received: 2 February 1998; Revision received: 13 July 1998; Accepted: 2 September 1998     

MR-guided bone biopsy: preliminary report of a new guiding method.

PURPOSE: To evaluate the feasibility of a new MR compatible optical tracking guided bone biopsy system. MATERIALS AND METHODS: Wireless optical tracker elements were connected to a bone biopsy set. Biopsies of five different anatomic areas and lesions varying from 9 mm to 40 mm (mean 25 mm) in size, were performed. RESULTS: We were able to perform the biopsies in all cases, and the samples allowed for a pathologic diagnosis. The procedure time was limited to less than 40 minutes, and no complications occurred. CONCLUSION: MR-guided bone biopsy with this new guiding system was a feasible and fast procedure that did not compromise the usability of the bone biopsy set.     

MR-guided biopsies with a newly designed cordless coil in an open low-field system: Initial findings

The purpose of this study was to examine the feasibility and safety of MR-guided biopsies with a newly designed cordless coil in an open low-field magnetic resonance (MR) system. Eleven patients were biopsied using a low-field system (0.2 T, Magnetom Concerto, Siemens) by using the new cordless coil (Siemens). The biopsies were performed in different organ systems [liver (n=7), abdomen (n=1), shoulder (n=1), pelvis (n=1) and hip (n=1)]. The procedures were guided using T1-weighted FLASH (fast low-angle shot) sequences. The lesions were biopsied using the coaxial technique through a 15-gauge puncture needle with a 16-gauge biopsy handy. Coil handling, image quality and complications were evaluated. Imaging quality and visualization of the lesions were optimal up to a penetration depth of 9 cm. In all cases the biopsy procedures were successfully performed with MR guidance without any complications. Pathological findings revealed seven cases of malignant tissue and four cases of non-malignant tissue. The use of the cordless coil allows improved patient access during the biopsy and an improved handling of the coil system. MR-guided biopsy using the novel cordless coil system can be performed safely and precisely with easy handling of the coil. This coil concept, however, is restricted to special indications.     

MR-guided biopsy of musculoskeletal lesions in a low-field system

Thirty magnetic resonance (MR)-guided biopsies were obtained from 20 skeletal and 10 soft-tissue lesions in 31 patients using an open 0.2 T MR system equipped with interventional accessories. The results from aspiration (N = 3), core biopsy (N = 15), and transcortical trephine biopsy (N = 12) were evaluated for accuracy and clinical efficacy. Specimens were successfully obtained from 29 patients. Results were clinically effective in 23 patients, rated definitive in 16, nonconclusive in 9, and unspecific in 2 patients. A false diagnosis due to sampling error occurred in 2 patients, and biopsy sampling was impossible in one case. The best diagnostic yield was achieved from nontranscortical biopsies of osteolytic or soft-tissue masses. Results from transcortical biopsies were less specific due to the predominance of benign lesions. MR fluoroscopy for needle guidance was applied in 13 patients. Complete needle placement inside the magnet could be performed in 16 patients. MR-guided biopsy using an open low-field MR imager is feasible and clinically effective and will become a valuable tool in the management of musculoskeletal lesions. J. Magn. Reson. Imaging 2001;13:761-768.