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Related Concept Videos

Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Imaging Studies IV: Magnetic Resonance Imaging01:27

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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Endovascular MR-guided Renal Embolization by Using a Magnetically Assisted Remote-controlled Catheter System.

Prasheel V Lillaney1, Jeffrey K Yang1, Aaron D Losey1

  • 1From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.).

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The magnetically assisted remote-controlled (MARC) catheter system is feasible for in vivo renal artery embolization using magnetic resonance (MR) imaging guidance. This MR-guided system showed comparable physiologic outcomes to traditional x-ray guidance.

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Area of Science:

  • Medical Imaging
  • Interventional Radiology
  • Biomedical Engineering

Background:

  • Magnetic resonance (MR) imaging offers superior soft-tissue contrast compared to x-ray imaging.
  • Interventional procedures traditionally rely on x-ray guidance, limiting real-time soft-tissue visualization.
  • Developing MR-compatible catheter systems is crucial for advancing interventional MR imaging.

Purpose of the Study:

  • To evaluate the feasibility of a magnetically assisted remote-controlled (MARC) catheter system for renal artery embolization under MR imaging guidance.
  • To compare the performance of the MARC system with conventional x-ray guidance in vivo.
  • To identify areas for improvement in the MARC system for interventional MR procedures.

Main Methods:

  • The MARC catheter system, featuring a copper-braided catheter with a distal saddle coil, was tested in three farm pigs (43 kg ± 2 kg) under 1.5 T real-time MR imaging.
  • Renal artery embolization was performed using the MARC system under MR guidance and with standard catheters/guidewires under x-ray guidance.
  • Renal artery flow and perfusion were assessed using velocity-encoded and perfusion MR imaging before and after embolization.

Main Results:

  • Successful renal artery embolization was achieved in all six kidneys under both MR and x-ray guidance.
  • Mean catheterization time was longer with MR guidance (93s ± 56s) compared to x-ray guidance (60s ± 22s).
  • Post-embolization changes in perfusion rates (MR: 4.9 au/sec ± 0.8; X-ray: 4.6 au/sec ± 0.6) and renal flow rates (MR: 2.1 mL/min/g ± 0.2; X-ray: 1.9 mL/min/g ± 0.2) were comparable between the two guidance methods.

Conclusions:

  • The MARC catheter system is a feasible tool for renal artery catheterization and embolization under real-time MR imaging in vivo.
  • Quantitative physiologic measures obtained with MR guidance were similar to those achieved with x-ray guidance.
  • The MARC system shows potential for use in endovascular procedures guided by interventional MR imaging.