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PubMedDate not supplied

[Fluoroscopy-controlled percutaneous gastrostomy in ambulatory care. Our experience].

The present article describes our experience and evolution of 96 patients who underwent 96 percutaneous gastrostomies with fluoroscopic control. In 74 cases (75.5%), the procedure was performed in the out patient setting. There was technical success in 100%. 17.3% (n = 17) of the patients had permeability problems. There was an accidental catheter exit in 2% (n = 2) of the cases, and gastro-esophageal reflux in 9.1% (n = 9).

Adolescent↗
PubMed1997

Stereo fluoroscopy-assisted percutaneous needle puncture of the vertebral body.

The purpose was to determine whether real-time three-dimensional imaging by stereo fluoroscope could alleviate the nuisance of moving the fluoroscope C-arm during needle biopsy of the spine. Fifteen lumbar vertebrae of four beagle dog cadavers were used in a simulation. We used a newly devised portable-type stereo fluoroscope, which alternatively exposes the X-ray from left and right X-ray tubes so that a surgeon can decode left and right images displayed alternately on a monitor by using polarizing glasses. A 2-mm-diameter Kirschner wire was inserted into the vertebral bodies by a posterolateral approach without moving the C-arm. An axial view of the roentgenogram of each vertebra found all 15 wires to be appropriately inserted. This would appear to be a time-saving feature.

Animals↗
PubMed1997

Weight bearing influence on knee joint bony contact movements: an in vivo video-fluoroscopy study.

In order to understand the effects of body weight-bearing on knee joint bony contact movements, a video-fluoroscopic digitizing system with in vivo human knee extension-flexion motions of 12 healthy adults under body weight-bearing and non-weight-bearing conditions was studied. These 12 subjects were equally separated into two groups consisting of a body weight-bearing group and a non-weight-bearing group. Video-fluoroscopic images were digitized to get three parameters from the knee joint bony geometry. These three parameters were the radius of rotation, the are length of rotation, and the contact point of the tibiofemoral joint, and they were used to decide the knee joint bony contact status of the sliding, spinning and rocking motions. The results showed that the knee bony contact movements under body weight-bearing conditions had about 4 times the incidence rate of the sliding motion under non-weight-bearing conditions. The incidence rate of the sliding motion was greatest when the knee flexion was less than 30 degrees. The knee bony contact movements under non-weight-bearing conditions had a larger spinning motion incidence rate and smaller rocking motion incidence rate than they did under weight-bearing conditions. The larger spinning motion incidence rate when the knee joint flexion was greater than 60 degrees. In conclusion, the body weight-bearing factor should be considered in studying knee joint bony contact movements.

Adult↗
PubMed2000

Real-time MR fluoroscopy for MR-guided iliac artery stent placement.

The purpose of this study was to test the feasibility of real-time magnetic resonance (MR) guidance of iliac artery stent placement. Radial scanning together with the sliding window reconstruction technique was implemented on a 1.5 T magnet, yielding a frame rate of 20 images per second. Seven prototype nitinol ZA stents were deployed in iliac arteries of living pigs under MR control. All stents were well visualized on the radial MR images, allowing depiction of the mounted stents as well as stent deployment without anatomy-obscuring artifacts. Stent placement was sucessful in all cases and took 6 minutes on average. The position of the stents was correctly visualized by real-time radial MR scanning, as proved by digital subtraction X-ray angiography. Combined radial scanning and the sliding window reconstruction technique allow real-time MR-guided stent placement in iliac arteries.

Alloys↗
PubMed2001

Catheter tracking for MR fluoroscopy: design of a transmit/receive coil for use with a nasogastric tube.

A coil tuned to 21.3 MHz was incorporated into a nasogastric tube and used as a marker of tube position during magnetic resonance (MR) imaging in a 0.5-T scanner. Catheter tracking was investigated with the coil used in both transmit/receive and in receive-only modes. Data acquired from this coil were overlaid on images obtained using the body coil of the scanner. Visualization of the full length of the catheter with local high signal at the tip was achieved with a temporal resolution of approximately 1 second. J. Magn. Reson. Imaging 2001;13:127-130.

Equipment Design↗
PubMed1997

Guidewire antennas for MR fluoroscopy.

Before MRI can be used for guiding vascular interventions, the problem of dependably visualizing guidewires must be solved. Ideally, the position and curvature of the tip of the guidewire should be visible to facilitate steering through the vascular system. In this paper, various antennas are described that can be incorporated into a guidewire tip. These antennas allow the guidewire to be visualized with high contrast. Computer simulation and experimental evidence are presented showing the value of adding a passive MR signal source, with a short T1, internal to the coil. The internal source increases the available signal, narrows the apparent width of the guidewire, and allows the use of fast imaging sequences.

Blood Vessels↗
PubMed2005

Computing intraoperative dosimetry for prostate brachytherapy using TRUS and fluoroscopy.

RATIONALE AND OBJECTIVES: There is a need to provide real-time dosimetric feedback during prostate brachytherapy based on the location of the implanted seeds. The objective of our approach is to develop a system to accurately locate seeds with minimal impact on the current protocol for prostate brachytherapy and without additional imaging equipment. MATERIALS AND METHODS: A new approach for intraoperatively computing dosimetry for prostate brachytherapy is presented. The approach uses transrectal ultrasound (TRUS) and fluoroscopic images. A fluoroscopic image of the TRUS probe is required to register the fluoroscopic and ultrasound images. The C-arm is not moved during the procedure and all images are acquired from the same C-arm angles. A needle path is interpolated for each needle based on the location of the needle tip in TRUS images and the known entry point of the needle. Throughout the procedure, fluoroscopic images are acquired to determine the coronal plane coordinates of the seeds and the remaining coordinate of each seed is computed from the needle path. For accurate results, intraoperative seed motion tracking is advised and a method to achieve such tracking is also presented. RESULTS: Experimentally, the TRUS and fluoroscopic images are registered with a mean and maximum error of 1.3 mm and 5.8 mm, respectively. In a phantom, 12 seeds are located using our approach and compared with the known locations, with a mean error in the x, y, and z direction of 0.96 mm, 0.33, and 0.68 mm, respectively, and a corresponding maximum error of 1.85 mm, 0.56 mm, and 1.63 mm. Experimental results show motion tracking in the y-direction with submillimeter accuracy. The feasibility of our approach is tested on five cases of clinical data using a semiautomated version of our system and the resulting dosimetry is compared with that found using postoperative computed tomography images. The D90 and V100 metrics computed using our approach and the computed tomography images differ by a maximum of 16.6% and 1.7%, respectively. CONCLUSIONS: TRUS can be combined with single pose fluoroscopic images to compute delivered dose intraoperatively for prostate brachytherapy. Phantom results demonstrate the accuracy of the method and preliminary clinical results show its potential.

Brachytherapy↗
PubMed1998

Removal of a Norplant implant located near a major nerve using interventional radiology-digital subtraction fluoroscopy.

Norplant implants can be removed easily, if inserted properly. When they are inserted deeply and can not be palpated, or if they are located close to the neurovascular structures of the upper arm, radiological guidance may be needed to locate and remove the implants without causing injury to the surrounding vital structures. Digital subtraction fluoroscopic guidance is helpful in removing deeply located contraceptive implants and those that are close to the neurovascular structures, where blind removal may result in injury to those structures. We describe a case in which an implant that was located close to a major nerve near the axilla was removed under digital subtraction fluoroscopic guidance.

Adult↗