Magnetresonanztomografie-gestützte endovaskuläre Interventionen

Zusammenfassung

Interventionen unter MRT-Kontrolle waren in der Vergangenheit aufgrund langer Messzeiten und des eingeschränkten Patientenzugangs nur mit großen Schwierigkeiten durchzuführen. Die Weiterentwicklung der MR-Geräte, die Verbesserungen der MR-Messsequenzen, die schnelle Bildgebung ermöglichen, und die zunehmende Verfügbarkeit von im MRT einsetzbaren Instrumenten haben viele dieser Hindernisse beseitigt. Parallel zur Entwicklung der MRT werden perkutane und endovaskuläre Interventionen unter Bildkontrolle immer komplexer und stellen immer höhere Ansprüche an die Bildgebung, mit denen solche Eingriffe gesteuert und kontrolliert werden. Diese zunächst parallel laufenden Trends zeigen in den letzten Jahren eine gewisse Konvergenz. Das Interesse an der MRT-Kontrolle von perkutanen und endovaskulären Interventionen nimmt zu, nicht zuletzt auch aufgrund der Eigenschaften der MRT, sowohl die Morphologie mit exzellentem Weichteilkontrast als auch funktionelle Informationen darzustellen. Das Ziel dieser Übersicht ist es, die technischen Voraussetzungen MRT-gesteuerter endovaskulärer Interventionen darzustellen, erste experimentelle und klinische Anwendungen zu diskutieren und Sicherheitsaspekte der Technik zu erörtern.

Abstract

Historically, the combination of relatively long imaging times and restricted patient access has made MRI-guided intervention an impractical technique. Recent developments in MR hardware, pulse sequence improvements that have allowed the development of rapid imaging, and the availability of instruments that can be used under MR guidance have helped to overcome many of the disadvantages of MRI. Parallel to the development of MRI, image-guided percutaneous and endovascular interventions are becoming increasingly complex and require progressively more sophisticated imaging techniques to guide and control such interventions. These initially parallel trends have converged in the last couple of years. The ability of MRI to provide both unprecedented morphology and functional information has created a growing interest in both percutaneous and endovascular MRI-guided interventions. The goal of this review is to describe the technical prerequisites for MR-guided endovascular interventions, to discuss experimental and clinical applications, and to explain safety aspects of this technique.

contrast agents - interventional procedures - interventional MR - technical aspects - safety - MR angiography

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