Volume 20, Issue 7 , Pages 879-887, July 2009
MR Imaging–guided Percutaneous Sclerotherapy of Peripheral Venous Malformations with a Clinical 1.5-T Unit: A Pilot Study
Purpose
To evaluate the feasibility of magnetic resonance (MR) imaging–guided percutaneous sclerotherapy of venous malformations (VMs) by using a clinical 1.5-T MR unit and the safety and therapeutic outcome of the performed procedures.
Materials and Methods
This is a prospective pilot study with ethical approval and written informed patient consent. Ten MR imaging–guided percutaneous sclerotherapy treatments were performed in 10 patients (one male and nine female patients; age range, 16–47 years; mean age, 30.3 years) with a VM in the foot and/or ankle (n = 5), calf (n = 2), thigh and/or knee (n = 2), and elbow (n = 1). MR imaging was used for needle insertion guidance and real-time monitoring of the injection process by using three-dimensional fast spoiled gradient-echo MR sequences (repetition time msec/echo time msec = 3.7–5.2/1.1–1.6, flip angle = 35°) and meglumine gadoterate/ethanol solutions as the sclerosing agent. The technical success (ie, absence of technical problems, number of needle position corrections) was systematically evaluated along with safety aspects (ie, absence of complications) and the therapeutic outcome (eg, VM volume decrease, relief of symptoms) during a 1-year follow-up period.
Results
MR imaging–guided sclerotherapy was technically successful in all patients. A mean of 2.5 ± 1.85 (range, 1–6) needle position corrections were needed for correct needle placement. The distribution of the sclerosing agent (mean amount, 10.5 mL; range, 0.8–33.0 mL) was clearly visible with real-time MR monitoring. One patient developed a compartment syndrome, which was managed with surgery. No other complications were observed. VM volumes significantly decreased by 53% (range, 24%–86%; P = .02) 12 weeks after therapy. Nine of the 10 patients (90%) noted an improvement of symptoms.
Conclusions
In this limited preliminary series, 1.5-T MR imaging–guided percutaneous sclerotherapy for the treatment of VMs was feasible with a high degree of technical success, was relatively safe, and had a good therapeutic outcome after 1 year.
Abbreviations: FSE, fast spin echo, GRE, gradient echo, MIP, maximum intensity projection, 3D, three-dimensional, VM, vascular malformation
To access this article, please choose from the options below
None of the authors have identified a conflict of interest.
PII: S1051-0443(09)00332-7
doi:10.1016/j.jvir.2009.03.034
© 2009 SIR. Published by Elsevier Inc. All rights reserved.
Volume 20, Issue 7 , Pages 879-887, July 2009
