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Preliminary Clinical Experience (preliminary + clinical_experience)
Selected AbstractsFascia Augmentation of the Vocal Fold: Graft Yield in the Canine and Preliminary Clinical Experience,THE LARYNGOSCOPE, Issue 5 2001Sanford G. Duke MD Abstract Introduction Glottal insufficiency resulting from vocal fold bowing, hypomobility, or scar is frequently treated by injection augmentation. Injection augmentation with fat, collagen, gel foam, polytef, and recently, fascia lata has been previously reported. Variable graft yield and poor host-tissue tolerance have motivated the continued search for an ideal graft substance. Study Design A prospective trial of autologous fascia augmentation of the vocal cord in the human and in an animal model. Methods Autologous fascia injection augmentation (AFIA) was evaluated in 8 canines and 40 patients at our institution between 1998 and 2000. The animal study compared graft yield from AFIA with autologous fat yield. The outcome measure was graft yield calculated from histological examination of larynges 12 weeks after injection augmentation. Clinical trial outcome measures included symptom surveys, acoustical voice analyses, and subjective voice assessments. Mean follow-up was 9 months. Results In the canine larynx, the mean graft yield for AFIA was 33% (range, 5%,84%) compared with autologous lipoinjection (47%; range, 7%,96%;P = .57). Subjective improvement in vocal quality was reported by 95% of patients (38 of 40) after AFIA. Preoperative and postoperative voice analysis data were obtained from 26 patients. Subjective voice rating demonstrated a significant improvement after AFIA (P <.0001). Acoustical parameters of jitter, shimmer, noise-to-harmonic ratio, phonatory range, and degree unvoiced improved significantly (P <.05) in all patients after fascia augmentation. Conclusions Based on the animal study, we concluded that graft yields are excellent but variable for AFIA. The result is similar in variability and overall yield to autologous lipoinjection. Subjective and objective analyses of voice outcomes after AFIA are universally improved. Fascia appears to be an excellent alternative to lipoinjection in properly selected cases of glottic insufficiency. [source] MRI-guided procedures in various regions of the body using a robotic assistance system in a closed-bore scanner: Preliminary clinical experience and limitations,JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2010Michael Moche MD Abstract Purpose: To present the clinical setup and workflow of a robotic assistance system for image-guided interventions in a conventional magnetic resonance imaging (MRI) environment and to report our preliminary clinical experience with percutaneous biopsies in various body regions. Materials and Methods: The MR-compatible, servo-pneumatically driven, robotic device (Innomotion) fits into the 60-cm bore of a standard MR scanner. The needle placement (n = 25) accuracy was estimated by measuring the 3D deviation between needle tip and prescribed target point in a phantom. Percutaneous biopsies in six patients and different body regions were planned by graphically selecting entry and target points on intraoperatively acquired roadmap MR data. Results: For insertion depths between 29 and 95 mm, the average 3D needle deviation was 2.2 ± 0.7 mm (range 0.9,3.8 mm). Patients with a body mass index of up to ,30 kg/m2 fitted into the bore with the device. Clinical work steps and limitations are reported for the various applications. All biopsies were diagnostic and could be completed without any major complications. Median planning and intervention times were 25 (range 20,36) and 44 (36,68) minutes, respectively. Conclusion: Preliminary clinical results in a standard MRI environment suggest that the presented robotic device provides accurate guidance for percutaneous procedures in various body regions. Shorter procedure times may be achievable by optimizing technical and workflow aspects. J. Magn. Reson. Imaging 2010;31:964,974. ©2010 Wiley-Liss, Inc. [source] 3D nongadolinium-enhanced ECG-gated MRA of the distal lower extremities: Preliminary clinical experienceJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2008FRANZCR, Ruth P. Lim MBBS Abstract Purpose To report our initial experience implementing a noncontrast-enhanced electrocardiograph (ECG) gated fast spin echo magnetic resonance angiography (MRA) technique for assessment of the calf arteries. Materials and Methods Noncontrast MRA images of 36 clinical patients examined over a 6-month period were evaluated by two radiologists for length and degree of stenosis of arterial segments. Diagnostic confidence in the technique was also recorded. The reference standard was a consensus reading by both radiologists using the noncontrast technique combined with two gadolinium-enhanced techniques: bolus-chase and time-resolved imaging. Results For stenosis evaluation the noncontrast technique demonstrated accuracy 79.4% (1083/1364), sensitivity 85.4% (437/512), and specificity 75.8% (646/852). The sequence demonstrated high negative predictive value (92.3%, 646/700). The technique had serious artifacts leading to poor diagnostic confidence in 17 patients (47.2%). These included motion (n = 7) and artifacts specific to the sequence, including inaccurate trigger delays (n = 5), linear artifact (n = 7), and vessel blurring (n = 5). When only patients in whom there was satisfactory diagnostic confidence were considered, accuracy, sensitivity, and negative predictive value were 92.2% (661/717), 92.4% (158/171), and 97.5% (503/516), respectively. Conclusion Our results indicate that when technically successful, noncontrast-enhanced MRA using ECG-gated fast spin echo can provide accurate imaging of the calf and pedal arteries. However, further development and optimization are needed to improve the robustness of the technique. J. Magn. Reson. Imaging 2008;28:181,189. © 2008 Wiley-Liss, Inc. [source] Postmortem whole-body magnetic resonance imaging as an adjunct to autopsy: Preliminary clinical experienceJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2001Article first published online: 23 APR 200 [source] MRI-guided procedures in various regions of the body using a robotic assistance system in a closed-bore scanner: Preliminary clinical experience and limitations,JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2010Michael Moche MD Abstract Purpose: To present the clinical setup and workflow of a robotic assistance system for image-guided interventions in a conventional magnetic resonance imaging (MRI) environment and to report our preliminary clinical experience with percutaneous biopsies in various body regions. Materials and Methods: The MR-compatible, servo-pneumatically driven, robotic device (Innomotion) fits into the 60-cm bore of a standard MR scanner. The needle placement (n = 25) accuracy was estimated by measuring the 3D deviation between needle tip and prescribed target point in a phantom. Percutaneous biopsies in six patients and different body regions were planned by graphically selecting entry and target points on intraoperatively acquired roadmap MR data. Results: For insertion depths between 29 and 95 mm, the average 3D needle deviation was 2.2 ± 0.7 mm (range 0.9,3.8 mm). Patients with a body mass index of up to ,30 kg/m2 fitted into the bore with the device. Clinical work steps and limitations are reported for the various applications. All biopsies were diagnostic and could be completed without any major complications. Median planning and intervention times were 25 (range 20,36) and 44 (36,68) minutes, respectively. Conclusion: Preliminary clinical results in a standard MRI environment suggest that the presented robotic device provides accurate guidance for percutaneous procedures in various body regions. Shorter procedure times may be achievable by optimizing technical and workflow aspects. J. Magn. Reson. Imaging 2010;31:964,974. ©2010 Wiley-Liss, Inc. [source] | ||||||||||