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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 38 (1998), S. 210-217 
    ISSN: 1432-2102
    Keywords: Key words MR-Angiography • Interventional MRI • Intravascular MRI ; Schlüsselwörter Magnetresonanz-Angiographie • Interventionelle MRT • Intravaskuläre MRT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Obgleich die klinische Umsetzung des Konzeptes der Interventionellen MR-Angiographie noch in weiter Zukunft liegt, sind in den letzten Jahren die technischen Voraussetzungen für die Evaluation eines solchen Konzeptes geschaffen worden. So ermöglichen offene Gerätekonfigurationen einen zunehmend freien Zugang des Untersuchers zum Patienten. Hochleistungsgradientensysteme erlauben die Akquisition von komplexen dreidimensionalen Datensätzen, mit deren Hilfe das arterielle wie auch das venöse Gefäßsystem umfassend dargestellt werden kann. Mit der Entwicklung der MR-Tracking- und MR-Profiling-Methoden stehen nunmehr auch Techniken zur Verfügung, mit deren Hilfe intravaskulär geführte Katheter und Führungsdrähte beinahe in Echtzeit sichtbar gemacht werden können. Diese Übersichtsarbeit beschreibt die technischen Voraussetzungen zur Sichtbarmachung von Kathetern und Führungsdrähten in der MRT-Umgebung und beschreibt die Durchführung erster MRT-gesteuerter Interventionen am Tier sowie am Menschen. Darüber hinaus wird das Potential der intravaskulären Bildgebung zur Charakterisierung arteriosklerotischer Plaquestrukturen beleuchtet.
    Notes: Summary The flow sensitivity inherent to the MR experiment allows for the non-invasive assessment of both the arterial and venous vasculature in any desired plane with good spatial resolution. Data can be acquired in a three-dimensional form, permitting reformating in any plane. In addition, MRI is capable of providing quantitative blood flow information with the use of phase-contrast flow-mapping techniques. Ultrafast gradient echo and echoplanar data acquisition strategies even permit imaging in near-real time. The availability of open MRI configurations now permits one to take advantage of the unique imaging features inherent to MR imaging for the purpose of guidance and control of various intravascular procedures. With the recent development of the MR tracking and MR profiling techniques, permitting visualization of guide-wires and catheters relative to their surroundings in the MR environment in real time, one of the last obstacles to 'Interventional MR angiography' has in effect been overcome. In addition, MR catheters can be modified to acquire high-resolution MR images of the vascular wall, thereby opening vast possibilities regarding characterization of atherosclerotic plaques. This review introduces the underlying techniques for catheter and guide-wire visualization in the MR environment, describes preliminary interventions in animals and humans and discusses the potential of intravascular MRI.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2218
    Keywords: Laparoscopic hernioplasty ; Video-assisted failure analysis ; Reduction of complication and recurrence rates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Studies performed to date show that laparoscopic hernia repair is superior to conventional procedures with regard to postoperative pain, complications, and duration of inability to work. Methods: From August 1, 1992, to February 16, 1995, we performed 245 laparoscopic hernia procedures on 224 patients utilizing a transabdominal preperitoneal polypropylene mesh-plasty (TAPP). Results: We observed in the first 100 patients a total of 21 postoperative complications in 20 patients (21%). We observed 3 hernia occurrences (3%) in this group. Due to careful video documentation of all procedures, retrospective analysis of operative failure was possible. Working on the complications occurring resulted in a modification of the procedure, leading to a standardization of the operative technique and to a rigorous reduction in the number of complications and recurrences. Conclusions: Video-assisted retrospective failure analysis is consequently an effective method to use to optimize the results of minimal invasive hernia repair.
    Type of Medium: Electronic Resource
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