MR-guided percutaneous sclerotherapy of low-flow vascular malformations: Clinical experience using a 1.5 tesla MR system

Daniel M O'Mara; Paul A DiCamillo; Wesley D Gilson; Daniel A Herzka; Frank K Wacker; Jonathan S Lewin; Clifford R Weiss

doi:10.1002/jmri.25502

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MR-guided percutaneous sclerotherapy of low-flow vascular malformations: Clinical experience using a 1.5 tesla MR system

Journal article

Open access

Peer reviewed

MR-guided percutaneous sclerotherapy of low-flow vascular malformations: Clinical experience using a 1.5 tesla MR system

Daniel M O'Mara, Paul A DiCamillo, Wesley D Gilson, Daniel A Herzka, Frank K Wacker, Jonathan S Lewin and Clifford R Weiss

Journal of magnetic resonance imaging, Vol.45(4), pp.1154-1162

04/2017

DOI: 10.1002/jmri.25502

PMCID: PMC5352530

PMID: 27796061

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https://www.ncbi.nlm.nih.gov/pmc/articles/5352530View

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Abstract

To demonstrate the feasibility, safety, and effectiveness of image-guided sclerotherapy of low-flow vascular malformations using a 1.5 Tesla (T) MR scanner with real-time imaging capability and in-suite fluoroscopy. Thirty-three procedures were performed with real-time 1.5T MR-guidance on 22 patients with a vascular malformation in the neck (n = 2), chest (n = 6), abdomen and pelvis (n = 15), and extremities (n = 11). Quantitative analysis was performed for changes in (a) planning time, (b) targeting time (interval between needle skin puncture and lesion access), (c) intervention time (interval between needle skin puncture and needle removal), and (d) total procedure time. Qualitative analysis was performed for (a) success of therapy and (b) occurrence of complications. Technical success was achieved in 29 of 33 procedures. The average planning time did not significantly change between the first seven procedures and the last seven procedures (P = 0.447). The average targeting time decreased by 0:24:45 (hours:minutes:seconds) (P = 0.043), the average intervention time decreased by 0:26:58 (P = 0.022), and the average procedure time decreased by 0:28:41 (P = 0.046) when comparing the first seven procedures and the last seven procedures. Overall, there was an improvement in the patients' predominant symptoms following 82% of procedures, including a significant decrease in average pain following therapy (P < 0.001). There was a minor complication rate of 3% with no major complications. MR-guided percutaneous sclerotherapy seems to be a safe, effective, and versatile technique for treating low-flow vascular malformations. 3 J. Magn. Reson. Imaging 2017;45:1154-1162.

Adolescent

Adult

Child

Feasibility Studies

Female

Fluoroscopy

Humans

Magnetic Resonance Imaging, Interventional - methods

Male

Middle Aged

Sclerotherapy - methods

Treatment Outcome

Vascular Malformations - diagnostic imaging

Vascular Malformations - therapy

Young Adult

Details

Title: Subtitle: MR-guided percutaneous sclerotherapy of low-flow vascular malformations: Clinical experience using a 1.5 tesla MR system
Creators: Daniel M O'Mara - Johns Hopkins Medicine
Paul A DiCamillo - Johns Hopkins Medicine
Wesley D Gilson - Siemens Healthcare
Daniel A Herzka - Johns Hopkins Medicine
Frank K Wacker - Hannover Medical School
Jonathan S Lewin - Johns Hopkins Medicine
Clifford R Weiss - Johns Hopkins Medicine
Resource Type: Journal article
Publication Details: Journal of magnetic resonance imaging, Vol.45(4), pp.1154-1162
DOI: 10.1002/jmri.25502
PMID: 27796061
PMCID: PMC5352530
NLM abbreviation: J Magn Reson Imaging
ISSN: 1053-1807
eISSN: 1522-2586
Grant note: UL1 TR001079 / NCATS NIH HHS
Language: English
Date published: 04/2017
Academic Unit: Radiology
Record Identifier: 9984318692302771

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