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MR Imaging-Guided Biopsy and Therapeutic Intervention in a Closed-Configuration Magnet

Single-Center Series of 361 Punctures

¹ Ludwig Boltzmann Institute of Interventional Magnetic Resonance at the Department of Radiology, AKH St. Pölten, Propst Führer Str. 4, A-3100 St. Pölten, Austria.

View larger version (107K): [in a new window]   Fig. 1A. —MR-guided lung biopsy in a 48-year-old man with suspected tumor within scar. Unenhanced T2-weighted fast spin-echo MR image of 10-mm slice thickness obtained with patient in prone position (TR/TE, 1800/100) reveals soft-tissue lesion (arrow) within lung parenchyma. Grid pellets (arrowheads) are seen on patient's back.

View larger version (132K): [in a new window]   Fig. 1B. —MR-guided lung biopsy in a 48-year-old man with suspected tumor within scar. T1-weighted fast gradient-echo MR image of 2-mm slice thickness obtained at same level as A (12/4) shows shaft and tip position of 19.5-gauge aspiration biopsy needle in transverse plane.

View larger version (129K): [in a new window]   Fig. 1C. —MR-guided lung biopsy in a 48-year-old man with suspected tumor within scar. MR image obtained in sagittal orientation, perpendicular to and using same technique as B, shows needle tip (arrow) at the lesion border.

View larger version (112K): [in a new window]   Fig. 1D. —MR-guided lung biopsy in a 48-year-old man with suspected tumor within scar. Final T2-weighted fast spin-echo sequence of 6-mm slice thickness (1500/100) shows no evidence of hemorrhage or pneumothorax. Histologic examination revealed a fibrotic area (confirmed by 2 years of follow-up; no malignancy next to scar).

View larger version (118K): [in a new window]   Fig. 2A. —MR-guided biopsy of vertebral body in a 39-year-old woman with spondylitis. T2-weighted fast spin-echo MR image of 10-mm slice thickness (TR/TE, 1800/100) obtained with patient in prone position shows lumbar vertebra L5 and grid pellets for planning access route.

View larger version (135K): [in a new window]   Fig. 2B. —MR-guided biopsy of vertebral body in a 39-year-old woman with spondylitis. MR image obtained with short T2-weighted fast spin-echo sequence using 6-mm slice thickness (1500/100) in parasagittal plane reveals region of high signal intensity in vertebral body (arrow) and shows advancement of 16-gauge cutting biopsy needle directed toward lesion.

View larger version (115K): [in a new window]   Fig. 2C. —MR-guided biopsy of vertebral body in a 39-year-old woman with spondylitis. MR image obtained using same technique as in B shows achievement of target volume.

View larger version (126K): [in a new window]   Fig. 2D. —MR-guided biopsy of vertebral body in a 39-year-old woman with spondylitis. Needle is clearly discernible in axial plane in this MR image obtained using same technique as in C, and at same level as in A. No complications were encountered during or after procedure. Histologic examination revealed tuberculous spondylitis.

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