MRI-guided percutaneous transhepatic cholangiodrainage: feasibility study in a porcine model

TY - JOUR

T1 - MRI-guided percutaneous transhepatic cholangiodrainage: feasibility study in a porcine model

AU - Papanikolaou, Ioannis S

AU - van der Voort, Ivo R

AU - Chopra, Sascha S

AU - Seebauer, Christian J

AU - Rump, Jens

AU - Papas, Maria G

AU - Triantafyllou, Konstantinos

AU - Baumgart, Daniel C

AU - Teichgräber, Ulf K

AU - Wiedenmann, Bertram

AU - Rösch, Thomas

PY - 2014/6/1

Y1 - 2014/6/1

N2 - BACKGROUND AND STUDY AIMS: MRI-guided procedures combine high-quality imaging with lack of radiation. Percutaneous transhepatic cholangiodrainage under real-time MRI guidance (MRI-PTCD) seems promising, allowing targeted puncture and avoiding multiple blind passes and use of contrast, which are associated with standard PTCD's heaviest complications.PATIENTS AND METHODS: Aim of this study was to investigate the feasibility of MRI-PTCD in three outbred piglets. Obstructive cholestasis was induced by common bile duct ligation. Two days later, MRI-PTCD was performed (open MRI, 1.0 Tesla) with prototype MRI-compatible accessories. Visualization was achieved with a balanced steady-state free precession real-time sequence (bSSFP: 0.75 frames/s, TR/TE [ms]: 7.2/3.6; flip angle: 45°; 200 × 200 matrix size; resolution: 1.3 × 1.3 mm(2), slice thickness: 7 mm). Cannulation of the bile ducts was followed by placement of Yamakawa drainages.RESULTS: Twelve punctures were performed (four per animal, 10/12 successful); in 2/10 the bile ducts could not be cannulated. Animal survival was 100% and no significant complications occurred.CONCLUSIONS: Initial data show that MRI-PTCD can be successfully performed. This may lead to establishment of a new optimized PTCD technique compared to the standard approach under fluoroscopy.

AB - BACKGROUND AND STUDY AIMS: MRI-guided procedures combine high-quality imaging with lack of radiation. Percutaneous transhepatic cholangiodrainage under real-time MRI guidance (MRI-PTCD) seems promising, allowing targeted puncture and avoiding multiple blind passes and use of contrast, which are associated with standard PTCD's heaviest complications.PATIENTS AND METHODS: Aim of this study was to investigate the feasibility of MRI-PTCD in three outbred piglets. Obstructive cholestasis was induced by common bile duct ligation. Two days later, MRI-PTCD was performed (open MRI, 1.0 Tesla) with prototype MRI-compatible accessories. Visualization was achieved with a balanced steady-state free precession real-time sequence (bSSFP: 0.75 frames/s, TR/TE [ms]: 7.2/3.6; flip angle: 45°; 200 × 200 matrix size; resolution: 1.3 × 1.3 mm(2), slice thickness: 7 mm). Cannulation of the bile ducts was followed by placement of Yamakawa drainages.RESULTS: Twelve punctures were performed (four per animal, 10/12 successful); in 2/10 the bile ducts could not be cannulated. Animal survival was 100% and no significant complications occurred.CONCLUSIONS: Initial data show that MRI-PTCD can be successfully performed. This may lead to establishment of a new optimized PTCD technique compared to the standard approach under fluoroscopy.

KW - Animals

KW - Bile Ducts

KW - Catheterization

KW - Cholestasis

KW - Drainage

KW - Feasibility Studies

KW - Female

KW - Magnetic Resonance Imaging, Interventional

KW - Surgery, Computer-Assisted

KW - Swine

U2 - 10.3109/00365521.2014.899619

DO - 10.3109/00365521.2014.899619

M3 - SCORING: Journal article

C2 - 24694300

VL - 49

SP - 722

EP - 726

JO - SCAND J GASTROENTERO

JF - SCAND J GASTROENTERO

SN - 0036-5521

IS - 6

ER -