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AJNR - American Journal of Neuroradiology

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MR-Guided Catheter Navigation of the Intracranial Subarachnoid Space

George Rappard^a, Gregory J. Metzger^f, James L. Fleckenstein^a, Evelyn E. Babcock^c, Paul T. Weatherall^b, Robert E. Replogle^a,d, G. Lee Pride, Jr^a, Susan L. Miller^e, Christina E. Adams^e and Phillip D. Purdy^a,d,e

^a Department of Radiology, Division of Neuroradiology, the University of Texas Southwestern Medical Center at Dallas
^b Department of Radiology, the University of Texas Southwestern Medical Center at Dallas
^c Division of Medical Physics, the University of Texas Southwestern Medical Center at Dallas
^d Department of Neurological Surgery, the University of Texas Southwestern Medical Center at Dallas
^e Mobility Foundation Center, the University of Texas Southwestern Medical Center at Dallas
^f Philips Medical Systems, Best, the Netherlands

View larger version (68K): [in a new window]   FIG 1. SSFP image in human volunteer. The image was produced in 253 milliseconds (four frames per second), with the following parameters: TR/TE, 4.4/2.2/90; flip angle, 192 x 256; section thickness, 10 mm; FOV, 200 mm; 80% reduced FOV; 60% image; and 50% keyhole. Note the paucity of CSF pulsation artifact or magnetic susceptibility effects at the skull base.

View larger version (68K): [in a new window]   FIG 2. A 3F catheter (curved arrow) and 0.014-inch guidewire (straight arrow) are in the pontine cistern. Note that magnetic susceptibility artifact allows adequate visualization of the microguidewire.

View larger version (68K): [in a new window]   FIG 3. The 3F microcatheter (arrow) traverses cerebellopontine angle.

View larger version (70K): [in a new window]   FIG 4. The catheter-guidewire (curved arrows) is advanced through prepontine cistern; it impacts the posterior clinoid process (straight arrows) and buckles in the pontine cistern. The catheter-guidewire is then redirected to suprasellar cistern and advanced to the left sylvian fissure (arrowhead).

View larger version (175K): [in a new window]   FIG 5. A 5F catheter (arrow) contacts the vertebral artery (arrowhead).