Computergestütztes Navigationssystem für CT-gesteuerte Interventionen: Ergebnisse am Phantom und im klinischen Einsatz

mentioning

confidence: 99%

Accuracy and Feasibility of Frameless Stereotactic and Robot-Assisted CT-Based Puncture in Interventional Radiology: a Comparative Phantom Study

Stoffner

Augschöll²,

Widmann

et al. 2009

“…Sie kön-nen zum Teil ambulant durchgeführt werden, sind kosteneffektiv und haben sowohl bei Patienten als auch bei zuweisenden Ärzten aufgrund der minimalen Invasivität eine breite Akzeptanz [14,16]. Besondere Situationen wie schwer erreichbare Zielregionen, agitierte und nicht kooperative Patienten oder eng benachbarte vitale Strukturen können ein zielsicheres Vorführen großlumiger Bestecke deutlich erschweren [17]. In solchen Situationen ist das Sondieren der Zielregion mittels einer feinen Nadel wie der 20G-Seldinger-Nadel mit anschließendem sekundärem Einbringen des eigentlichen Interventionsbestecks eine Alternative zu den gängigen Punktionstechniken wie der Trokar-Technik oder der üblichen Seldinger-Technik.…”

Section: Diskussionunclassified

Evaluierung einer neuen Seldinger-Nadel für computertomografisch gesteuerte Interventionen: Erste Erfahrungen

Plumhans

Mahnken²,

Iwa³

et al. 2008

“…Although rare, severe complications, such as cervical spinal marrow infarct and vertebral artery dissections, have been reported in cervical spine interventions [8 -12]. Therefore, guidance via fluoroscopy or computed tomography (CT) fluoroscopy has been used to increase treatment safety [13,14]. Both methods have a high bone-soft tissue contrast and with almost realtime image availability they allow quick and safe anatomically exact placement of the injection cannula while protecting adjacent sensitive structures.…”

mentioning

confidence: 99%

MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison

Maurer

Froeling

Röttgen

et al. 2013

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40?mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12???36?min.) for MRI-guided infiltration and 19.7?min. (range: 5???54?min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. Citation Format: ??Maurer MH, Froeling V, R?ttgen R et?al. MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison. Fortschr R?ntgenstr 2014; 186: 559???566