MR imaging guided percutaneous nephrostomy using a 1.0 Tesla open MR scanner

Area of Science:

• Radiology
• Interventional Radiology
• Medical Imaging

Background:

• Percutaneous nephrostomy (PCN) is crucial for urinary tract drainage.
• Ultrasonography-guided PCN can be challenging in patients with obesity or complex renal anatomy.
• Magnetic Resonance (MR) imaging offers superior soft-tissue contrast and multiplanar visualization.

Purpose of the Study:

• To evaluate the safety and feasibility of MR-guided percutaneous nephrostomy (PCN).
• To assess the utility of a 1.0 Tesla open MR-scanner with fast dynamic imaging for PCN.
• To determine the efficacy in patients with previously failed ultrasonographic attempts.

Main Methods:

• Thirty-five PCN procedures were performed on 25 patients using a 1.0 Tesla open MR-scanner.
• Fast T2w single-shot-TSE imaging in fluoroscopic mode guided needle insertion in a freehand technique.
• Nephrostomy catheters were placed using the Seldinger technique.

Main Results:

• The procedure was technically successful, achieving adequate drainage in all cases.
• MR guidance allowed precise needle placement into the collecting system, even in difficult anatomies.
• The average procedure time was 30 minutes, with needle insertion taking only 5 minutes.

Conclusions:

• MR-guided PCN using a 1.0 Tesla open system is a reliable, fast, and safe method.
• This technique is applicable in routine clinical settings, particularly for patients with challenging anatomy.
• It demonstrates pinpoint accuracy in accessing the renal collecting system.