Intravascular mri diagnostic and therapeutic potentials
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Intravascular mri diagnostic and therapeutic potentials
- 1. Vascular InterventionsVascular Interventions Ergin Atalar, Ph.D.Ergin Atalar, Ph.D. Johns Hopkins UniversityJohns Hopkins University Departments of Radiology and Biomedical EngineeringDepartments of Radiology and Biomedical Engineering DISCLOSURE:DISCLOSURE: E. Atalar is a founder and stock holder of Surgi-Vision, Inc.E. Atalar is a founder and stock holder of Surgi-Vision, Inc.
- 2. Johns Hopkins University OverviewOverview – Intravascular MRI (first human experiments)Intravascular MRI (first human experiments) – Balloon AngioplastyBalloon Angioplasty – Stent PlacementStent Placement – MR-guided Gene TherapyMR-guided Gene Therapy
- 3. Johns Hopkins University Intravascular MRIIntravascular MRI
- 5. Johns Hopkins University mm B FSE, 1200/13-msec TR/TE, Double IR blood suppression, 16 ETL, 4-cm FOV, 32 NEX, 256x256 matrix, 10 min 14 sec acquisition time ACM • Resolution: 150 µm J. M. Serfaty et al. Watanabe rabbit with a 0.032” MRI-Guidewire Aortic wall imaging
- 6. Johns Hopkins University Post stent: human iliac IVMRIPost stent: human iliac IVMRI L. Hofmann, D. Bluemke Rt common iliac art. Guidewire (venous) Fibrous cap Lipid core T1 - pre gad T1 - post gad
- 7. Johns Hopkins University L. Hofmann, D. Bluemke Fibrous cap Lipid core Plaque CharacterizationPlaque Characterization
- 8. Johns Hopkins University Restenosis - s/p renal stentRestenosis - s/p renal stent 5 mm L. Hofmann, D. Bluemke Rt renal artery Guidewire in IVC restenosis
- 9. In-Vivo Human Iliac Artery:In-Vivo Human Iliac Artery: Concentric AtherosclerosisConcentric Atherosclerosis Angiography 20 MHz IVUS IVMRI No Abnormality Concentric Atherosclerosis 5 mm 5 mm Vein K. Yucel, et. al. Brigham and Women’s Hospital
- 10. Johns Hopkins University MR-guided Balloon AngioplastyMR-guided Balloon Angioplasty Technical Challenges:Technical Challenges: – MR compatible/visible Balloon AngioplastyMR compatible/visible Balloon Angioplasty CatheterCatheter – Methods for Monitoring Balloon AngioplastyMethods for Monitoring Balloon Angioplasty ProcedureProcedure
- 13. Johns Hopkins University Scan RoomScan Room J. Serfaty et. al.
- 14. Johns Hopkins University MRI-guided PTCAMRI-guided PTCA 90° 10° 90°10° slice selection projection J. Serfaty et. al.
- 16. DilatationDilatation of the Pulmonary Arteryof the Pulmonary Artery C. Rickers, 2001
- 17. Dilatation with Gd filled balloonDilatation with Gd filled balloon C. Rickers, 2001
- 18. Dilatation with air filled balloonDilatation with air filled balloon C. Rickers, 2001
- 19. Johns Hopkins University MR-guided Stent PlacementMR-guided Stent Placement Technical ChallengesTechnical Challenges – MR compatible and visible stent deploymentMR compatible and visible stent deployment devicedevice – MR compatible stentMR compatible stent – Methods of monitoring stent placementMethods of monitoring stent placement procedureprocedure
- 20. Johns Hopkins University MR Guidewire Tracking/PlacementMR Guidewire Tracking/Placement sheath FGREFGRE 256x162256x162 20 mm slice20 mm slice 4 element4 element cardiac coilcardiac coil A. Lardo et. al.
- 21. Johns Hopkins University MRI Guided Stent Positioning and DeploymentMRI Guided Stent Positioning and Deployment stent liver stomach Ao SPGRSPGR 256x162256x162 TR/TE=4.4/1.2TR/TE=4.4/1.2 20 mm slice20 mm slice 4 element cardiac4 element cardiac coilcoil A. Lardo et. al.
- 22. Johns Hopkins University Intravascular Wire StentIntravascular Wire Stent CrossingCrossing SPGRSPGR 256x162256x162 TR/TETR/TE 20 mm slice20 mm slice 3 element3 element cardiac coilcardiac coil + 1 element+ 1 element internal coilinternal coil stent 1 stent 2 MRI guidewire A. Lardo et. al.
- 23. Johns Hopkins University High Resolution Aortic ImagingHigh Resolution Aortic Imaging stent MRIG (Imaging Guidewire) SPGR, 256x256, FOV=4 cm Guidewire element only stented wall 156µm A. Lardo et. al.
- 24. Johns Hopkins University MR-guided Gene Therapy
- 25. A Remedy gene delivery balloon catheter Gene delivery channel Angioplasty balloon channel Guidewire channel 0.014” MRIG Tuning box X. Yang, et al. Circulation 2001
- 26. Johns Hopkins University Design Plaque Plaque Vessel 0.014” MRIG Balloon inflation with 3% Gd Gd/blue-dye medium or Gd/GFP-lentivirus medium X. Yang, et al. Circulation 2001
- 27. Johns Hopkins University BA X Clinical significance? X. Yang, et al. Circulation 2001
- 28. Johns Hopkins University ConclusionConclusion MRI has potential to guide new and conventional vascular interventions
Hinweis der Redaktion
- The whole experiment is shown on these images with successsively Placement of the gc in the asc aorta, Cathet of the coronary Dynamic 2D proj coronary angio Placement of the gw and balloon catheter in the coronary artery, And finally inflation of the balloon angioplasty catheter with dilution of gadolinium