MR-guided Neurolytic Celiac Plexus Ablation: An Evaluation of Effect and Injection Spread Pattern in Cancer Patients with Celiac Tumor Infiltration

作者：Akural Etem; Ojala Risto O; Jarvimaki Voitto; Kariniemi Juho; Tervonen Osmo A; Sequeiros Roberto Blanco^*

来源：CardioVascular and Interventional Radiology, 2013, 36(2): 472-478.

DOI：10.1007/s00270-012-0417-x

• Interventional MRI
• Optical tracking
• Low field
• Celiac plexus
• Ablation
• Block

The purpose of this study was to evaluate the feasibility, the initial accuracy, and the effects of the MR-guided neurolytic celiac plexus ablation as a method to treat cancer-induced chronic abdominal pain. %26lt;br%26gt;Thirteen celiac plexus ablations were performed for 12 patients. A 0.23-T open MRI scanner with optical navigation was used for procedural guidance. As an adjunct to the MR-guided needle positioning, the needle location was confirmed with saline injection and consequent MR imaging (STIR sequence). The spread of the ablative injection material (alcohol-lidocaine mix) was observed by repeating this sequence after the therapeutic injection. Pain scores from seven patients (eight ablations) were used to assess the therapy effect. %26lt;br%26gt;MR guidance allowed adequate needle positioning and visualization of injection material in all cases. The rest pain scores significantly decreased from 4 (median) at baseline to 1 (median) at 2 weeks (p %26lt; 0.05). Average and worst pain experienced during the past week were significantly lower at the 2-week time point compared with the baseline (p %26lt; 0.05). However, the intervention did not result in reduction of opioid use at 2 weeks. %26lt;br%26gt;MR guidance is an accurate and safe method for celiac plexus ablation with positive therapeutic effect.

• 出版日期2013-4