In vitro evaluation of the accuracy of open-configuration MRI in endovascular techniques

The purpose of this study was to determine the accuracy of an interventional magnetic resonance imaging (iMRI) system to position an endovascular catheter in an in vitro model that simulated an infrarenal aortic aneurysm. Adequate visualization of abdominal aortic aneurysms (AAAs) was shown previously in humans. A dedicated near-real-time imaging protocol readily available on a Signa SP 0.5T open configuration MRI unit (General Electric Medical Systems, Milwaukee, WI, USA) was used to image the AAAs of ten human volunteers. A pulsatile in vitro model that simulated an AAA was built, which included the kidneys, the renal arteries, the aorta, and the iliac arteries. A catheter was advanced to a predetermined target through one of the iliac limbs of the model. Using two different techniques, the accuracy with which an interventionist could position the endovascular catheter under the near-real-time guidance of the iMRI system was evaluated. The AAAs of all ten patients were visualized, including the aneurysm wall, the thrombus within it, and the residual lumen, while maintaining adequate contrast, signal, and imaging speed. The position of the catheter was evaluated on target in 42 in vitro procedures. This series of tests showed an average accuracy of 1 mm for catheter positioning. The near-real-time imaging mode of the iMRI system enabled satisfactory evaluation of human AAAs, and it showed great accuracy for catheter positioning in the in vitro model. These results provide optimism regarding the potential of iMRI in endovascular surgery.