Actual-time ultrasound-MRI fusion picture digital navigation for finding intraspinal tumour in a pregnant girl.
Eur Backbone J. 2018 Jan 30;:
Authors: Liu TJ, Shen F, Zhang C, Huang PT, Zhu YJ
BACKGROUND: Customary fluoroscopic steering (C-arm fluoroscopy) has been routinely used for intraoperative localization of spinal stage for surgical removing of intraspinal tumour, whereas it’s not appropriate for chosen sufferers, e.g. pregnant ladies, who must keep away from radiation publicity. Fusion imaging of real-time ultrasound (US) and magnetic resonance imaging (MRI) is a radiation-free method which has been reported to have good localization accuracy in managing a number of situations.
CLINICAL PRESENTATION: A 37-year-old pregnant affected person, offered with a progressively aggravating decrease again ache for 20 days and was incapable of mendacity supine with decrease extremities swelling for 1 week, was referred to our hospital in her 18th week of gestation. Lumbar MRI recognized an L1 stage intraspinal lesion, and surgical procedure was deliberate. To keep away from the ionizing radiation generated by fluoroscopy, quantity navigation method (VNT) primarily based fusion imaging of US and MRI was used to localize the intraspinal lesion, which was eliminated fully by way of minimally invasive interlaminar method. Pathological examination confirmed the prognosis of ependymoma of the conus medullaris. Her signs had been largely relieved after the operation, and a wholesome child was delivered on the 40th week of being pregnant.
CONCLUSION: We offered the primary case of utilizing VNT primarily based fusion imaging of real-time US/MRI to information the surgical resection of an intraspinal tumour. Future research with bigger affected person quantity is required to validate this system as an alternative choice to fluoroscopy in sufferers who must keep away from radiation publicity.
PMID: 29380148 [PubMed – as supplied by publisher]