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CardioVascular and Interventional Radiology

, Volume 34, Issue 4, pp 857–863 | Cite as

MR Imaging Guided Percutaneous Nephrostomy using a 1.0 Tesla Open MR Scanner

  • Frank Fischbach
  • Markus Porsch
  • Felix Krenzien
  • Maciej Pech
  • Oliver Dudeck
  • Jürgen Bunke
  • Uwe-Bernd Liehr
  • Jens Ricke
Technical Note

Abstract

Purpose

The purpose of this study was to assess the safety and feasibility of MR-guided percutaneous nephrostomy (PCN) using a 1.0 Tesla open MR-scanner with fast dynamic imaging.

Methods

Twenty-five patients with failed ultrasonographic insertion due to various reasons, such as nondilated pelvic systems, obesity, and parapelvic cysts, were investigated.

Results

In summary, 35 nephrostomy procedures were performed; 15 patients received monolateral and 10 patients bilateral placement. For guidance and monitoring, fast T2w single-shot-TSE imaging in a fluoroscopic mode in two orthogonal planes was used to guide the insertion of the needle into a predetermined calyx in freehand technique. Nephrostomy was inserted via Seldinger-technique. The procedure was regarded as technically successful if the placement of the catheter provided adequate drainage of the collecting system. Demonstration of an intrapelvic position of the catheter was verified by antegrade pyelography using T1w GRE imaging after injection of diluted Gd-DTPA into the collecting system. Under the experimental conditions of the study, the time for the complete procedure was 30 (range, 23–39) min. Puncture and placement of the nephrostomy was performed in 5 (range, 3–10) min on average.

Conclusions

Our results demonstrated a pinpoint puncture of the pelvic system in a reasonable timeframe even in patients with difficult conditions, suggesting that MR-guided PCN using the open 1 Tesla system can be assessed as a reliable, fast, and safe method applicable in the clinical routine setting.

Keywords

Percutaneous Nephrostomy Compute Tomography Guidance Pelvic System Interventional Magnetic Resonance Imaging Antegrade Pyelography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

Juergen Bunke is an employee of Philips Medical Healthcare. Frank Fischbach and Jens Ricke received a research and consultant grant from Philips Medical Healthcare and Bayer Schering. The other authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2010

Authors and Affiliations

  • Frank Fischbach
    • 1
  • Markus Porsch
    • 2
  • Felix Krenzien
    • 1
  • Maciej Pech
    • 1
  • Oliver Dudeck
    • 1
  • Jürgen Bunke
    • 3
  • Uwe-Bernd Liehr
    • 2
  • Jens Ricke
    • 1
  1. 1.Department of RadiologyOtto von Guericke University, Medical SchoolMagdeburgGermany
  2. 2.Department of UrologyOtto von Guericke University, Medical SchoolMagdeburgGermany
  3. 3.Philips Healthcare, Philips Medical SystemsHamburgGermany

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