title: Percutaneous transhepatic cholangiodrainage under real-time MRI guidance: initial experience in an animal model.
abstract: OBJECTIVE
  To assess percutaneous transhepatic cholangiodrainage (PTCD) under real-time MRI-guidance and compare it to procedures performed under fluoroscopy.
  
  
  METHODS
  We developed an in vitro model for MRI-guided and conventional PTCD, using an animal organ set including liver and bile ducts placed in an MRI-compatible box and tested it in a 1.0-Tesla open MRI-scanner. Prototype 18G needles and guide wires, standard guide wires, dilatation bougies, and drainages were used (MRI-compatible). MRI-visualization was by means of a bFFE real-time sequence using a surface coil (Flex-L). Outcome measurements were success rates and time needed for bile duct puncture using real-time MRI-guidance versus conventional radiologic methods in the model. Cannulation and drainage placement were also analysed.
  
  
  RESULTS
  Fifty MRI-guided experiments were performed, leading to rapid (mean: 43s, range: 15-72s) and successful puncture and cannulation in 96% of procedures. Median drainage placement time was 321.5s (range: 241-411s). In 35 control experiments under fluoroscopy, puncture success was 69%, whereas times were significantly longer (mean 273s, range 45-631s).
  
  
  CONCLUSIONS
  Initial in vitro experience shows that PTCD can be successfully and rapidly performed under real-time MRI-guidance and demonstrates improved performance compared to the conventional radiologic approach.
authors: Central Interdisciplinary Endoscopy Unit, Charité University Hospitals Berlin, Campus Virchow Hospital, Berlin, Germany. ispapn@hotmail.com
authors: Ioannis S
authors: IS
authors: Papanikolaou
authors: Ivo R
authors: IR
authors: van der Voort
authors: Jens
authors: J
authors: Rump
authors: Christian J
authors: CJ
authors: Seebauer
authors: Sascha S
authors: SS
authors: Chopra
authors: Florian
authors: F
authors: Wichlas
authors: René
authors: R
authors: Schilling
authors: Thula
authors: T
authors: Walter
authors: Maria G
authors: MG
authors: Papas
authors: Bertram
authors: B
authors: Wiedenmann
authors: Ulf K
authors: UK
authors: Teichgräber
authors: Thomas
authors: T
authors: Rösch