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Comparative Study
. 2003 Apr;24(4):626-9.

MR-guided catheter navigation of the intracranial subarachnoid space

George Rappard  1 , Gregory J Metzger, James L Fleckenstein, Evelyn E Babcock, Paul T Weatherall, Robert E Replogle, G Lee Pride Jr, Susan L Miller, Christina E Adams, Phillip D Purdy
Affiliations
Comparative Study

MR-guided catheter navigation of the intracranial subarachnoid space

George Rappard et al. AJNR Am J Neuroradiol. 2003 Apr.

Abstract

Percutaneous intraspinal navigation (PIN) is a new minimally invasive approach to the CNS. The authors studied the utility of MR-guided intracranial navigation following access to the subarachnoid compartment via PIN. The passive tracking technique was employed to visualize devices during intracranial navigation. Under steady-state free precession (SSFP) MR-guidance a microcatheter-microguidewire was successfully navigated to multiple brain foci in two cadavers. SSFP MR fluoroscopy possesses adequate contrast and temporal resolution to allow MR-guided intracranial navigation.

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Figures

F<sc>ig</sc> 1.
Fig 1.
SSFP image in human volunteer. The image was produced in 253 milliseconds (four frames per second), with the following parameters: TR/TE, 4.4/2.2/90; flip angle, 192 × 256; section thickness, 10 mm; FOV, 200 mm; 80% reduced FOV; 60% image; and 50% keyhole. Note the paucity of CSF pulsation artifact or magnetic susceptibility effects at the skull base.
F<sc>ig</sc> 2.
Fig 2.
A 3F catheter (curved arrow) and 0.014-inch guidewire (straight arrow) are in the pontine cistern. Note that magnetic susceptibility artifact allows adequate visualization of the microguidewire.
F<sc>ig</sc> 3.
Fig 3.
The 3F microcatheter (arrow) traverses cerebellopontine angle.
F<sc>ig</sc> 4.
Fig 4.
The catheter-guidewire (curved arrows) is advanced through prepontine cistern; it impacts the posterior clinoid process (straight arrows) and buckles in the pontine cistern. The catheter-guidewire is then redirected to suprasellar cistern and advanced to the left sylvian fissure (arrowhead).
F<sc>ig</sc> 5.
Fig 5.
A 5F catheter (arrow) contacts the vertebral artery (arrowhead).
See this image and copyright information in PMC

Comment in

References

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