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Society for Pediatric Radiology – Poster Archive
Final ID: Poster #: EDU-03 (R)
Title: Intraoperative MRI (iMRI) needle guidance for rectal pull- through procedures
Purpose or Case Report: Purpose:
IMRI is utilized for surgical guidance in patients with an imperforate anus. It helps for visualizing the muscle tracts as a road map for a successful pull-through procedure via needle guidance. IMRI allows the surgeon a unique perspective of the patient’s anatomy in real time and identifies potential issues that may require additional interventions during the procedure.
Methods & Materials: Method & Materials:
Clinical patients were selected based on diagnosis of imperforate anus and pediatric age. The procedure scheduling required coordinating so that the appropriate surgical team, the interventional radiologist and two MRI technologists were present. An MRI safe needle was used for guidance. The needle was placed and manipulated by an interventional radiologist. One of the MRI technologist serves as an MR safety officer, as three or more clinicians may enter and exit the MRI suite several times during the procedure. This technologist also assists the interventional radiologist, who is gowned and gloved during the procedure. The second MRI technologist is tasked with imaging and manipulating the acquired images, as directed by the interventional radiologist.
Results: Results:
Approximately sixty rectal pull-through procedures with iMRI guidance have been performed at this institution since 2007. The iMRI method takes between 30 and 45 minutes, including preparation of the OR suite for MRI. Surgical outcomes compare favorably to other methods, such as fluoroscopy or ultrasound guided procedures.
Conclusions: Conclusion:
MRI guidance in the operating room for rectal pull-through procedures affords the surgeon a navigational edge. Surgeons report improved visibility compared to ultrasound and fluoroscopy guided procedures. iMRI eliminates the need for radiation exposure compared to fluoroscopy guidance. IMRI requires staffing with two MRI technologists during the procedure to assure a safe MRI environment and to help surgeons and interventional radiologists with the use image guidance.
IMRI is utilized for surgical guidance in patients with an imperforate anus. It helps for visualizing the muscle tracts as a road map for a successful pull-through procedure via needle guidance. IMRI allows the surgeon a unique perspective of the patient’s anatomy in real time and identifies potential issues that may require additional interventions during the procedure.
Methods & Materials: Method & Materials:
Clinical patients were selected based on diagnosis of imperforate anus and pediatric age. The procedure scheduling required coordinating so that the appropriate surgical team, the interventional radiologist and two MRI technologists were present. An MRI safe needle was used for guidance. The needle was placed and manipulated by an interventional radiologist. One of the MRI technologist serves as an MR safety officer, as three or more clinicians may enter and exit the MRI suite several times during the procedure. This technologist also assists the interventional radiologist, who is gowned and gloved during the procedure. The second MRI technologist is tasked with imaging and manipulating the acquired images, as directed by the interventional radiologist.
Results: Results:
Approximately sixty rectal pull-through procedures with iMRI guidance have been performed at this institution since 2007. The iMRI method takes between 30 and 45 minutes, including preparation of the OR suite for MRI. Surgical outcomes compare favorably to other methods, such as fluoroscopy or ultrasound guided procedures.
Conclusions: Conclusion:
MRI guidance in the operating room for rectal pull-through procedures affords the surgeon a navigational edge. Surgeons report improved visibility compared to ultrasound and fluoroscopy guided procedures. iMRI eliminates the need for radiation exposure compared to fluoroscopy guidance. IMRI requires staffing with two MRI technologists during the procedure to assure a safe MRI environment and to help surgeons and interventional radiologists with the use image guidance.
More abstracts on this topic:
Maintaining MRI Safety in an Intra-operative Environment
Raymer Trista, Jones Richard, Grattan-smith Damien
Becoming a Pediatric Diagnostic Imaging Center of ExcellenceClavijo Rebecca
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