rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-2-31-37rentrad-16Research ArticleСтатьиМАЛОИНВАЗИВНЫЕ ВМЕШАТЕЛЬСТВА ПОД КОНТРОЛЕМ МАГНИТНО-РЕЗОНАНСНОЙ ТОМОГРАФИИ В УТОЧНЯЮЩЕЙ ДИАГНОСТИКЕ ОПУХОЛЕЙ МАЛОГО ТАЗАMINI-INVASIVE INTERVENTIONS UNDER MAGNETIC RESONANCE GUIDANCE IN THE CLARIFYING DIAGNOSIS OF SMALL PELVIC TUMORSНеледовД. В.NeledovD. V.

к. м. н., с. н. с. отделения магнитно-резонансной томографии

ул. Королева, 4, Обнинск, 249036

MD, PhD, Senior Researcher of Department MRI

ul. Koroleva, 4, Obninsk, 249036

dmitriy_neledov@mail.ruШавладзеЗ. Н.ShavladzeZ. N.

к. м. н, заведующий отделением магнитно-резонансной томографии

ул. Королева, 4, Обнинск, 249036

MD, PhD, Head of Department MRI

ul. Koroleva, 4, Obninsk, 249036

БерезовскаяТ. П.BerezovskayaT. P.

д. м. н., профессор, г. н. с. отделения магнитно-резонансной томографии 

ул. Королева, 4, Обнинск, 249036

MD, PhD, DSc, Professor, Chief Researcher of Department MRI 

ul. Koroleva, 4, Obninsk, 249036

ФГБУ «Медицинский радиологический научный центр» Министерства здравоохранения РФРоссияMedical Radiological Research Center, Ministry of Health of the RFRussian Federation201427022016023137Copyright © Неледов Д.В., Шавладзе З.Н., Березовская Т.П., 20162016Неледов Д.В., Шавладзе З.Н., Березовская Т.П.Neledov D.V., Shavladze Z.N., Berezovskaya T.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/16

Цель исследования – отработать методику и оценить возможности применения малоинвазивных диагностических вмешательств под контролем магнитно-резонансной томографии (МРТ) в сложных анатомических ситуациях при патологических изменениях в области малого таза неясного характера.

Материал и методы

Материал и методы. Выполнено 10 интервенционных вмешательств в малом тазу под контролем МРТ. Показаниями к проведению биопсии костных структур под контролем МРТ явились плохая визуализация костных изменений или их отсутствие при рентгенологическом исследовании, в том числе при компьютерной томографии. Биопсия органов и мягких тканей малого таза проводилась в ситуациях сложного расположения патологических изменений рядом с критическими органами, крупными сосудистыми и невральными структурами. Все интервенционные вмешательства выполнены на высокопольном магнитно-резонансном томографе. Биопсия осуществлялась поэтапно методом «свободной руки» под контролем Т2-взвешенных изображений в аксиальной и сагиттальной плоскостях.

Результаты

Результаты. Во всех случаях был получен информативный гистологический материал. Осложнений не наблюдалось.

Заключение

Заключение. Только благодаря выполнению прицельной биопсии под контролем МРТ у исследуемых 10 больных с неясным характером изменений в малом тазу стало возможным верифицировать диагноз на основании морфологического заключения и своевременно определить тактику ведения.

Objective

Objective: to perfect and estimate the possibilities of using a mini-invasive diagnostic procedure under magnetic resonance (MR) guidance in the complex anatomic situations in cases of pathological small pelvic changes of unknown origin.

Material and methods

Material and methods. Ten small pelvic interventions were made under MR guidance. The indications for bone biopsy under MR guidance were poor visualization of bone changes or their absence during radiography, including computed tomography. Small pelvic organ and soft tissue biopsies were carried out in the situations of complex location of pathological changes adjacent to critical organs, large vascular and neural structures. All interventions were done using a high-field MR scanner. Freehand biopsy was performed in a stepwise fashion under axial and sagittal T2-weighted image control.

Results

Results. Informative histological material was obtained in 100% of cases. No complications were observed.

Conclusions

Conclusions. It became possible to verify the diagnosis based on morphological findings and to timely determine management tactics only by target biopsy under MR guidance in these 10 patients with small pelvic changes of unknown origin.

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The authors declare that there are no conflicts of interest present.