title: MR-guided percutaneous drainage of abdominal fluid collections in combination with X-ray fluoroscopy: initial clinical experience.
abstract: The aim of this study was to examine the feasibility of a hybrid interventional MR system, which combines a closed bore magnet with a C-arm fluoroscopy unit for percutaneous drainage of abdominal fluid collections. During the past 2 years, we have performed four drainage procedures in four patients (mean age 47 years). Three patients had abscesses (psoas muscle, kidney, subphrenic location) and the fourth patient had a recurrent splenic cyst. All procedures were performed on an interventional MR system consisting of a 1.5-T ACS-NT scanner combined with a specially shielded C-arm. The drainages were guided by T1-weighted fast gradient-echo images, T2-weighted single-shot turbo spin-echo images or both. A standard 18 G (1.2 mm) nonferromagnetic stainless steel needle with a Teflon sheath was used for the punctures following which a 0.89 mm nitinol guidewire was inserted into the fluid collection. Thereafter, the patient was positioned in the immediate adjacent fluoroscopy unit and a drainage catheter was placed under fluoroscopic control. All drainage catheters were successfully placed into the fluid collections, as proven by fluid aspiration and resolution of the collection. The mean time needed for the entire drainage procedure (MR and fluoroscopy) was 110 min. No procedure-related complications occurred. It is feasible to perform drainage procedures on a closed-bore MR scanner. The multiplanar imaging capabilities of MR are particularly helpful for fluid collections in the subphrenic location.
authors.affiliation: Clinic for Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. buecker@rad.rwth-aachen
authors.forename: A
authors.initials: A
authors.lastname: Buecker
authors.forename: J M
authors.initials: JM
authors.lastname: Neuerburg
authors.forename: G B
authors.initials: GB
authors.lastname: Adam
authors.forename: C C
authors.initials: CC
authors.lastname: Nolte-Ernsting
authors.forename: D W
authors.initials: DW
authors.lastname: Hunter
authors.forename: A
authors.initials: A
authors.lastname: Glowinski
authors.forename: J J
authors.initials: JJ
authors.lastname: van Vaals
authors.forename: R W
authors.initials: RW
authors.lastname: Guenther
mesh_terms: D018784:Abdominal Abscess / Q000628:therapy*; D000328:Adult; D000368:Aged; D003560:Cysts / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D013158:Splenic Diseases / Q000628:therapy*; D016896:Treatment Outcome