title: MR-guided percutaneous sclerotherapy of low-flow vascular malformations: Clinical experience using a 1.5 tesla MR system.
abstract: To demonstrate the feasibility, safety, and effectiveness of image-guided sclerotherapy of low-flow vascular malformations using a 1.5 Tesla (T) MR scanner with real-time imaging capability and in-suite fluoroscopy.
  
  
  
  Thirty-three procedures were performed with real-time 1.5T MR-guidance on 22 patients with a vascular malformation in the neck (n = 2), chest (n = 6), abdomen and pelvis (n = 15), and extremities (n = 11). Quantitative analysis was performed for changes in (a) planning time, (b) targeting time (interval between needle skin puncture and lesion access), (c) intervention time (interval between needle skin puncture and needle removal), and (d) total procedure time. Qualitative analysis was performed for (a) success of therapy and (b) occurrence of complications.
  
  
  
  Technical success was achieved in 29 of 33 procedures. The average planning time did not significantly change between the first seven procedures and the last seven procedures (P = 0.447). The average targeting time decreased by 0:24:45 (hours:minutes:seconds) (P = 0.043), the average intervention time decreased by 0:26:58 (P = 0.022), and the average procedure time decreased by 0:28:41 (P = 0.046) when comparing the first seven procedures and the last seven procedures. Overall, there was an improvement in the patients' predominant symptoms following 82% of procedures, including a significant decrease in average pain following therapy (P < 0.001). There was a minor complication rate of 3% with no major complications.
  
  
  
  MR-guided percutaneous sclerotherapy seems to be a safe, effective, and versatile technique for treating low-flow vascular malformations.
  
  
  
  3 J. Magn. Reson. Imaging 2017;45:1154-1162.
authors: Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Daniel M
authors: DM
authors: O'Mara
authors: Vascular and Interventional Radiology, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Paul A
authors: PA
authors: DiCamillo
authors: Siemens Healthcare USA, Baltimore, Maryland, USA.
authors: Wesley D
authors: WD
authors: Gilson
authors: Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Daniel A
authors: DA
authors: Herzka
authors: Institute for Diagnostic and Interventional Radiology, Medical School Hanover, Hanover, Germany.
authors: Frank K
authors: FK
authors: Wacker
authors: Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Jonathan S
authors: JS
authors: Lewin
authors: Vascular and Interventional Radiology, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Clifford R
authors: CR
authors: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy / Q000379:methods*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult
keywords: lymphatic malformations; sclerotherapy; venous malformations