经皮置针的CT导航:我是怎么做的

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Anna M. Sorensen MD , Annie M. Zlevor BA , Meridith A. Kisting MA , Allison B. Couillard MD , Timothy J. Ziemlewicz MD , Giuseppe V. Toia MD, MS , J. Louis Hinshaw MD , Michael Woods MD , Lindsay M. Stratchko DO , Perry J. Pickhardt MD , Marcia L. Foltz RN , Walter W. Peppler PhD , Fred T. Lee Jr. MD , Erica M. Knavel Koepsel MD
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引用次数: 0

摘要

CT导航(CTN)最近发展起来,结合了传统CT和CT透视引导放置针头的许多优点。CTN系统显示叠加在CT数据集上的实时针位。这是通过将电磁(EM)或光学发射器/传感器放置在患者和针头上,结合放置在扫描场中的基准,将已知的针头位置叠加到CT数据集中来实现的。CTN的优点包括:使用患者处于治疗位置的同步CT数据集实时跟踪针头,减少对医生的辐射,简化龙门平面外的手术,在针头放置过程中减少螺旋扫描,以及基于诊断质量CT数据集的针头引导。局限性包括虚拟(相对于实际)针头位置的显示,如果针头弯曲、基准移动或患者在扫描之间移动,则可能不准确,并且在高度运动的解剖区域(如肺基底)存在局限性。本文综述了最近介绍的CTN技术与CT针导向的历史方法的比较。接下来是“我是怎么做的”部分,介绍了CT导航如何集成到研究中心的常规和具有挑战性的程序中,包括一步一步的解释、技术提示和陷阱。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CT Navigation for Percutaneous Needle Placement: How I Do It

CT navigation (CTN) has recently been developed to combine many of the advantages of conventional CT and CT-fluoroscopic guidance for needle placement. CTN systems display real-time needle position superimposed on a CT dataset. This is accomplished by placing electromagnetic (EM) or optical transmitters/sensors on the patient and needle, combined with fiducials placed within the scan field to superimpose a known needle location onto a CT dataset. Advantages of CTN include real-time needle tracking using a contemporaneous CT dataset with the patient in the treatment position, reduced radiation to the physician, facilitation of procedures outside the gantry plane, fewer helical scans during needle placement, and needle guidance based on diagnostic-quality CT datasets. Limitations include the display of a virtual (vs actual) needle position, which can be inaccurate if the needle bends, the fiducial moves, or patient movement occurs between scans, and limitations in anatomical regions with a high degree of motion such as the lung bases. This review summarizes recently introduced CTN technologies in comparison to historical methods of CT needle guidance. A “How I do it” section follows, which describes how CT navigation has been integrated into the study center for both routine and challenging procedures, and includes step-by-step explanations, technical tips, and pitfalls.

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来源期刊
Techniques in Vascular and Interventional Radiology
Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.70
自引率
0.00%
发文量
47
期刊介绍: Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.
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