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Utility and efficacy of navigation system use in interventional radiology

Open Journal of Clinical Diagnostics 2013年第3期3卷 128-132页

作者： jatin kaicker Sriharsha Athreya Department of Medical Imaging McMaster University Hamilton Canada

Background: To ensure precision and accuracy during interventional radiologic (IR) procedures, navigation systems are utilized. There are four main categories of guidance systems that can be used to assist in IR procedures: optical system, electromagnetic (EM) tracking, Cone Bean Computer Tomography (CBCT) and Magnetic Navigation system. Objective: The purpose of this report is to examine some current medical literature to present an impression as to the state of navigation system use in interventional radiology. Methods: Three health databases were selected: Pubmed, Embase and OVID Medline, with the search terms “Interventional Radiology” and “Navigation System” being used. All included studies were presented in English. Studies were excluded if they did not pertain to navigation systems in interventional radiology, were in a language other than English, presented an abstract only or solely discussed interventional cardiology. Results: General themes emerged within the literature for the advantages of navigation system use including benefits to interventional radiologic procedures, increased patient accuracy and reduced procedure time and the potential for reduction in costs. Increased radiation exposure, problems accounting for respiratory motion and sterility remain issues for navigation system use. Conclusion: With potential to better standardize treatment using navigation systems, patients can have access to up-to-date technology for treatment. To ensure the highest standard of care, navigation systems should be used by interventional radiologists only. As indications and clinical efficacy are frequently being defined for navigation system use in interventional radiology, continual review of the published literature and large clinical trials for each system should be pursued.

关键词： Interventional Radiology Navigation System Electromagnetic tracking Cone Bean Computer Tomography

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Efficacy of high resolution computed tomography for detection of early healing in scaphoid fractures

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Open Journal of Clinical Diagnostics 2012年第3期2卷 51-55页

作者： Michael Di Ianni jatin kaicker Ke Wu Hema Choudur Department of Medical Imaging McMaster University Hamilton Canada

Background: While plain radiography is commonly used to assess scaphoid fracture, this imaging modality may not accurately demonstrate early bone healing. This investigation evaluates the utility of 64-slice CT in the detection of early fracture healing compared to plain radiographs and magnetic resonance imaging (MRI). Methods: Outpatients attending follow-up visits for scaphoid fractures at Hamilton General Hospital were included in this investigation. Inclusion criteria included outpatients over age of 18 who consented to attend a follow-up visit for the scaphoid fracture at 6 weeks for X-Ray, 64-slice CT and MRI scan to monitor fracture healing. Assessment of healing was independently interpreted by two radiologists specialized in musculoskeletal imaging. A total of 7 adult outpatients were accrued, with each case classified as healing, not healing, or equivocal for plain radiography and 64-slice CT scan. Results: For plain radiographs, the level of interrater agreement for evidence of healing was 57% (4/7) cases. When comparing this to CT scans, there was no discrepancy between radiologists as 100% (7/7) were found to have evidence of healing. The 64-slice CT scan demonstrated evidence of early trabecular continuity in all cases, including radiographs that were interpreted as equivocal. Conclusion: This study can be considered a pilot project for the efficacy of 64-slice CT in the assessment of early healing of scaphoid fractures. For clinicians, the multiplanar reconstruction images allows for more accurate assessment of fractures than plain radiography. CT scans are able to penetrate through bony callus that may obscure visualization of healing in plain radiography, demonstrate trabecular continuity better than plain radiographs, are readily accessible and provide faster imaging acquisition. The observations from this study may have implications in terms of duration and type of casting applied, timing of strengthening exercises, and avoiding unnecessary surge

关键词： Wrist Fracture Scaphoid Bone Fracture Scaphoid Bone Fracture Healing 64-Slice CT Scans Trabecular Continuity

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Pseudoband formation: Missed ATFL tears on MR imaging

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Open Journal of Clinical Diagnostics 2013年第3期3卷 137-141页

作者： Vajid Khan jatin kaicker James Namburi Pawel Stefanksi Bradley Petrisor Hema Choudur Department of Medical Imaging McMaster University Hamilton Canada Department of Orthopedic Surgery McMaster University Hamilton Canada

Background: The anterior talofibular ligament (ATFL) is the ligament most commonly injured during ankle sprains. Objective: The purpose of this investigation was to assess the sensitivity of Magnetic Resonance (MR) imaging for ATFL with open surgery, Brostrom-Gould surgical interventional considered the gold standard. Methods: A retrospective chart review using Operating Room (OR) and MR reports from April 2008-November 2009 led to a review of 137 charts, with 15 cases meeting the inclusion criteria. Results: The sensitivity for ATFL tears irrespective of extent of the tear was 93%. For full thickness ATFL tears, 10 were found to be positive on MR but 13 on OR with a sensitivity of 77%. Of the three missed cases, 2 were described as sprain injuries and the other normal using MRI. Conclusion: The recommendations for MR assessment of ankle injury include use of dedicated sequences and understanding the “pseudoband” concept. The two full thickness and two partial thickness tears on OR described as sprain injuries on MRI had a band of inflammatory granulation tissue. This tissue accounted for the appearance of the thick continuous band at MRI, the pseudoband. This study reaffirms the usefulness of MR in determining ATFL tears, aiding surgical decision making.

关键词： ATFL Tear Brostrom-Gould Surgery Pseudoband

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