MR-trackable intramyrocardial injection catheter

被引:52
作者
Karmarkar, PV
Kraitchman, DL
Izbudak, I
Hofmann, LV
Amado, LC
Fritzges, D
Young, R
Pittenger, M
Bulte, JWM
Atalar, E
机构
[1] Johns Hopkins Univ, Dept Radiol, Sch Med, Baltimore, MD 21025 USA
[2] Johns Hopkins Univ, Sch Med, Div Cardiol, Dept Med, Baltimore, MD USA
[3] Osiris Therapeut Inc, Baltimore, MD USA
[4] Bilkent Univ, Dept Elect Engn, Ankara, Turkey
关键词
interventional MRI; intramyocardial injection catheter; labeled stem cells; intramyocardial injections; catheter tracking; cardiac MRI; iron oxide MR contrast agent;
D O I
10.1002/mrm.20086
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
There is growing interest in delivering cellular agents to infarcted myocardium to prevent postinfarction left ventricular remodeling. MRI can be effectively used to differentiate infarcted from healthy myocardium. MR-guided delivery of cellular agents/therapeutics is appealing because the therapeutics can be precisely targeted to the desired location within the infarct. In this study, a steerable intramyocardial injection catheter that can be actively tracked under MRI was developed and tested. The components of the catheter were arranged to form a loopless RF antenna receiver coil that enabled active tracking. Feasibility studies were performed in canine and porcine myocardial infarction models. Myocardial delayed-enhancement (MDE) imaging identified the infarcted myocardium, and real-time MRI was used to guide left ventricular catheterization from a carotid artery approach. The distal 35 cm of the catheter was seen under MRI with a bright signal at the distal tip of the catheter. The catheter was steered into position, the distal tip was apposed against the infarct, the needle was advanced, and a bolus of MR contrast agent and tissue marker dye was injected intramyocardially, as confirmed by imaging and postmortem histology. A pilot study involving intramyocardial delivery of magnetically labeled stem cells demonstrated the utility of the active injection catheter system. (C) 2004 Wiley-Liss, Inc.
引用
收藏
页码:1163 / 1172
页数:10
相关论文
共 29 条
[1]  
Ackerman JL., 1986, Proceedings of the 5th Annual Meeting of ISMRM, P1131
[2]   Cardiac cell transplantation: Closer to bedside [J].
Al-Radi, OO ;
Rao, V ;
Li, RK ;
Yau, T ;
Weisel, RD .
ANNALS OF THORACIC SURGERY, 2003, 75 (02) :S674-S677
[3]   High resolution intravascular MRI and MRS by using a catheter receiver coil [J].
Atalar, E ;
Bottomley, PA ;
Ocali, O ;
Correia, LCL ;
Kelemen, MD ;
Lima, JAC ;
Zerhouni, EA .
MAGNETIC RESONANCE IN MEDICINE, 1996, 36 (04) :596-605
[4]   Nonfluoroscopic, in vivo navigation and mapping technology [J].
BenHaim, SA ;
Osadchy, D ;
Schuster, I ;
Gepstein, L ;
Hayam, G ;
Josephson, ME .
NATURE MEDICINE, 1996, 2 (12) :1393-1395
[5]   Magnetic resonance fluoroscopy allows targeted delivery of mesenchymal stem cells to infarct borders in swine [J].
Dick, AJ ;
Guttman, MA ;
Raman, VK ;
Peters, DC ;
Pessanha, BSS ;
Hill, JM ;
Smith, S ;
Scott, G ;
McVeigh, ER ;
Lederman, RJ .
CIRCULATION, 2003, 108 (23) :2899-2904
[6]   REAL-TIME POSITION MONITORING OF INVASIVE DEVICES USING MAGNETIC-RESONANCE [J].
DUMOULIN, CL ;
SOUZA, SP ;
DARROW, RD .
MAGNETIC RESONANCE IN MEDICINE, 1993, 29 (03) :411-415
[7]   Clinically applicable labeling of mammalian and stem cells by combining; Superparamagnetic iron oxides and transfection agents [J].
Frank, JA ;
Miller, BR ;
Arbab, AS ;
Zywicke, HA ;
Jordan, EK ;
Lewis, BK ;
Bryant, LH ;
Bulte, JWM .
RADIOLOGY, 2003, 228 (02) :480-487
[8]   INTRAVASCULAR (CATHETER) NMR RECEIVER PROBE - PRELIMINARY DESIGN ANALYSIS AND APPLICATION TO CANINE ILIOFEMORAL IMAGING [J].
HURST, GC ;
HUA, JM ;
DUERK, JL ;
COHEN, AM .
MAGNETIC RESONANCE IN MEDICINE, 1992, 24 (02) :343-357
[9]   The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. [J].
Kim, RJ ;
Wu, E ;
Rafael, A ;
Chen, EL ;
Parker, MA ;
Simonetti, O ;
Klocke, FJ ;
Bonow, RO ;
Judd, RM .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (20) :1445-1453
[10]   Evaluation of myocardial viability by MRI [J].
Kim, RJ ;
Hillenbrand, HB ;
Judd, RM .
HERZ, 2000, 25 (04) :417-430