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. 2011 Nov;34(5):1159-66.
doi: 10.1002/jmri.22715.

MRI-guided vascular access with an active visualization needle

Christina E Saikus  1 , Kanishka Ratnayaka, Israel M Barbash, Jessica H Colyer, Ozgur Kocaturk, Anthony Z Faranesh, Robert J Lederman
Affiliations

MRI-guided vascular access with an active visualization needle

Christina E Saikus et al. J Magn Reson Imaging. 2011 Nov.

Abstract

Purpose: To develop an approach to vascular access under magnetic resonance imaging (MRI), as a component of comprehensive MRI-guided cardiovascular catheterization and intervention.

Materials and methods: We attempted jugular vein access in healthy pigs as a model of "difficult" vascular access. Procedures were performed under real-time MRI guidance using reduced field of view imaging. We developed an "active" MRI antenna-needle having an open-lumen, distinct tip appearance and indicators of depth and trajectory in order to enhance MRI visibility during the procedure. We compared performance of the active needle against an unmodified commercial passively visualized needle, measured by procedure success among operators with different levels of experience.

Results: MRI-guided central vein access was feasible using both the active needle and the unmodified passive needle. The active needle required less time (88 vs. 244 sec, P = 0.022) and fewer needle passes (4.5 vs. 9.1, P = 0.028), irrespective of operator experience.

Conclusion: MRI-guided access to central veins is feasible in our animal model. When image guidance is necessary for vascular access, performing this component under MRI will allow wholly MRI-guided catheterization procedures that do not require adjunctive imaging facilities such as x-ray or ultrasound. The active needle design showed enhanced visibility, as expected. These capabilities may permit more complex catheter-based cardiovascular interventional procedures enabled by enhanced image guidance.

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Conflict of interest statement

Financial Interest

No author has a financial conflict of interest. NHLBI and Siemens have a collaborative research and development agreement covering inteventional cardiovascular MRI.

Figures

Figure 1
Figure 1
Active needle with close up of tip uncovered (top) and covered (bottom).
Figure 2
Figure 2
Access set-up and imaging. (A) Photo of neck access site, prepped with small loop coil in sterile bag. Examples of imaging with (B) and without (C) small loop coil and reduced field of view.
Figure 3
Figure 3
Active Needle in Phantom. (A) Parallel to B0 and (B) Perpendicular to B0. (C) SNR map for device channel only and sample positioning evaluation (inset).
Figure 4
Figure 4
Active Needle in vivo. (A) Planning trajectory with needle on skin surface. (B) Entire needle length and tip location clearly visible. (C) Distal 2 markers seen in vessel.
Figure 5
Figure 5
Access results in 12 animals with bilateral attempts comparing active and passive needles in success rate, time to access, and number of needle passes.
Figure 6
Figure 6
Passive Needle in vivo. Passive needle tip location (indicated by round artifact highlighted with white arrowhead) is visible when aligned in plane (A) but difficult to locate if part of the needle is out of plane (B). Arrow pointing at vessel.
See this image and copyright information in PMC

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