Magnetic Resonance Imaging of the Cardiac Venous System and Magnetic Resonance-Guided Intubation of the Coronary Sinus in Swine

Neizel, Mirja; Krämer, Nils; Schütte, Adrian; Schnackenburg, Bernhard; Krüger, Sascha; Kelm, Malte; Günther, Rolf W.; Kühl, Harald P.; Krombach, Gabriele A.

doi:10.1097/rli.0b013e3181e45578

Cited by 16 publications

(10 citation statements)

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“…However, recent developments in this field have been published [7] and aortic stenting, renal stenting and cava filter placement guided exclusively by MR using a MR-compatible guide wire have been safely and effectively performed in swine models [8,9]. Also, the feasibility of MR-visualization and MR-guided intubation of the coronary sinus has been demonstrated recently in an animal study [10], which might have relevance in the near future for procedures that require improved three-dimensional knowledge about the cardiac vein anatomy, such as cardiac resynchronization therapy and percutaneous transcatheter mitral annuloplasty. In another animal study, MR imaging roadmaps of cardiac structures were obtained from miniature swine with spontaneous VSDs and registered with live X-ray using external fiducial markers [11].…”

Section: Magnetic Resonance-guided Percutaneous Interventionsmentioning

confidence: 99%

New imaging modalities in the catheterization laboratory

Pedra

Fleishman²,

Pedra

et al. 2011

Current Opinion in Cardiology

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Section: Magnetic Resonance-guided Percutaneous Interventionsmentioning

confidence: 99%

New imaging modalities in the catheterization laboratory

Pedra

Fleishman²,

Pedra

et al. 2011

Current Opinion in Cardiology

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“…However, the materials selection indicates dynamic development promising rapid progress. Larger arterial and venous vessels can be safely and gently probed with the currently available wires [54].…”

Section: Instruments and New Operating Concepts For Vascular Intervenmentioning

confidence: 99%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function.Method The current status of interventional MRI for the clinical routine was analyzed.Results The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion IntroductionMRI has an intrinsically high soft-tissue contrast and can be used to measure physiological parameters, such as blood flow (flow rate and flow volume), diffusion, temperature, and movement. Since its introduction into the clinical routine in the 1980 s, it has also been used for guiding and monitoring interventions. However, in contrast to CT and ultrasound, the use of MRI for guiding interventions requires significant technical effort. Due to the disruptive effect of the strong main magnetic field and the alternating electromagnetic fields, the monitoring of patients during an intervention by measuring ECG signals, oxygen saturation, or blood pressure requires special equipment. These monitoring systems must not interfere with the MRI scan and must be MR-safe (according to DIN EN 62 570:2010 -05). The list of requirements regarding monitoring equipment provides an indication of the development effort, with suitable monitoring equipment representing only one of the components necessary for MR-guided interventions.In addition to MRI safety, all catheters and instruments must be adapted to this modality. To ensure MRI safety, metal must be largely avoided since, depending on the length and orientation to the main magnetic field, it can heat up and consequently even result in burns. Achieving rigidity and torsion stability of catheters or guide wires without the use of metal for reinforcement represents a technical challenge. In the case of needles, breaking resistance is one of the more difficult properties to achieve for MR-safe designs. Moreover, instruments must be able to be effectively visualized without adjacent structures being superimposed by artifacts. The tip must be able to be identified and definitively differentiated from the shaft since MRI as a cross-sectional imaging method typically uses individual slices even for guiding interventions and does not use projections as in fluoroscopy...

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“…Therefore, the catheters, and in particular the coronary sinus catheter, were initially inserted with fluoroscopic guidance to be able to spend more time on the ablation procedure. A previous study, however, demonstrated that MR imaging-guided intubation of the coronary sinus is reproducibly feasible in swine (18). The authors visualized the anatomy of the coronary sinus by using a three-dimensional steady-state free precession whole-heart sequence prior to real-time steady-state free precession guidance.…”

Section: Ep Ablation Studiesmentioning

confidence: 99%