Abstract
Magnetic resonance imaging (MRI) has excellent soft tissue contrast,
which can be enhanced by different contrast agents, multiplanar imaging
capability and high temporal and spatial resolution. Even blood vessels
can be easily visualised, and MRI parameters are sensitive to temperature.
Therefore, MRI has the greatest potential for guiding and monitoring
interventional and surgical procedures.
The aim of this study was to design and evaluate new solutions for
MR-guided procedures and surgery, to develop the technique and to assess
the feasibility of MR-guided nerve root infiltration, bone biopsy and
sacroiliac (SI) joint arthrography.
The possibilities for versatile use of MR scanners were studied with
a setup where an MR scanner with a 0,23 T open magnet was installed in a
full-scale operating room (OR) to allow diagnostic MRI examinations,
research, radiological interventions and neurosurgical operations to be
performed in the same facility. All of the 144 MR-guided radiological
interventions and neurosurgical operations performed in Oulu University
Hospital between February 1999 and September 2000 were included in the
study. The studied setup was a functionally feasible solution for combined
neurosurgical and radiological use.
To further improve MR-guided interventions, a new user interface was
developed and preliminary tested with simulated clinical experiments. The
new user interface seemed to be easily adobted by radiologists for
interventional procedures.
MR-guided nerve root infiltrations were studied by using MRI
guidance on 34 consequent patients referred for first sacral root
infiltration. Needle placement into the first sacral nerve root sheath was
successful in 34 of the 35 (97%) cases, and the average duration of the
procedure was 32 minutes.
Bone biopsies were performed using a bone biopsy set designed in our
institution to be connected to an optical tracking system. The feasibility
of this new guiding system was evaluated with biopsies from five different
anatomical areas. The bone biopsy system was successfully applied to all
patients and provided a safe and accurate guidance method for all phases
of the procedure.
Twenty patients with low back pain suspected to arise from the SI
joint underwent MR-guided SI joint arthrography. The procedure was
successfully performed in all cases. The needle guiding with optical
tracking inside the soft tissues proved to be accurate enough for
successful procedures.
In conclusion, versatile use of MR scanners for diagnostic imaging,
radiological procedures and neurosurgery is feasible if planned properly.
The prototype of a new user interface for MR-guided procedures allows
radiologist to fully control the MR-scanner during the procedure. MRI is a
suitable and accurate guidance method for musculoskeletal interventions.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-6638-2 |
| Date | 26 April 2002 |
| Creators | Ojala, R. (Risto) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 2002 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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