MR-guided transjugular intrahepatic portosystemic shunt creation with use of a hybrid radiography/MR system
MR-guided transjugular intrahepatic portosystemic shunt creation with use of a hybrid radiography/MR system
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DOI：
10.1097/01.rvi.0000143766.08029.6e
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发表时间：
2005-02-01
影响因子：
2.9
通讯作者：
Dake, MD
中科院分区：
文献类型：
--
作者：
Kee, ST;Ganguly, A;Dake, MD
目的：评价在经颈静脉肝内门体分流术(TIPS)的建立过程中，使用组合的X线摄影/磁共振(MR)设备引导门静脉(PV)穿刺术的性能。材料和方法：对14例在标准的临床应用中进行TIPS建立的患者进行研究。患者被麻醉，然后放置在一个开放的MR单元中，其中包含一个平板放射透视单元。结合使用透视和MR成像，进入PV并执行TIPS程序。尖端置入无覆膜镍钛合金支架或覆膜支架移植物。记录所需穿刺量、手术总时间、透视时间、手术成功率、并发症、超声及临床随访情况。结果：14例患者中13例获得临床成功。在1例患者中，肝外静脉被刺穿，导致出血，需要放置覆膜支架以控制出血。平均穿刺数为2.6+/-1.7次，手术总时间为2.5小时+/-0.6小时。平均透视时间22.3分钟+/-5.5分钟。临床和超声随访的结果与以前发表的报告相比是有利的。结论：使用混合放射成像/磁共振设备创建TIPS是可行的，并且可以减少所需的穿针次数和辐射暴露，与文献报道的研究相比，总体结果相似。
PURPOSE: To evaluate the performance of a combined hybrid radiography/magnetic resonance (MR) unit to guide portal vein (PV) puncture during human transjugular intrahepatic portosystemic shunt (TIPS) creation.MATERIALS AND METHODS: Fourteen patients undergoing TIPS creation were studied during standard clinical applications. Patients were anesthetized and then positioned in an open MR unit containing a flat-panel radiographic fluoroscopic unit. With use of a combination of fluoroscopy and MR imaging, the PV was accessed and the TIPS procedure was performed. A noncovered nitinol stent or a covered stent-graft was placed in the TIPS tract. Number of punctures required, total procedure time, fluoroscopy time, procedural success rate, complications, and ultrasonographic and clinical follow-up were recorded.RESULTS: Clinical success was obtained in 13 of 14 patients. In one patient, extrahepatic puncture of the PV occurred, resulting in hemorrhage and requiring placement of a covered stent to control the bleeding. The mean number of punctures required to access the PV was 2.6 +/- 1.7, and the total procedure time was 2.5 hours +/- 0.6. Mean fluoroscopy time was 22.3 minutes +/- 5.5. Results of clinical and ultrasonographic follow-up compare favorably to previously published reports.CONCLUSION: TIPS creation with a combination hybrid radiography/MR unit is feasible and may reduce the number of needle passes required and radiation exposure, with similar overall outcomes compared with studies reported in the literature.