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Cardiovasc Intervent Radiol ; 36(2): 472-8, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22588275

RESUMO

OBJECTIVE: 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. METHODS: 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. RESULTS: 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 < 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 < 0.05). However, the intervention did not result in reduction of opioid use at 2 weeks. CONCLUSIONS: MR guidance is an accurate and safe method for celiac plexus ablation with positive therapeutic effect.


Assuntos
Dor Abdominal/etiologia , Dor Abdominal/cirurgia , Ablação por Cateter/métodos , Plexo Celíaco/patologia , Neoplasias da Vesícula Biliar/complicações , Imagem por Ressonância Magnética Intervencionista , Manejo da Dor/métodos , Neoplasias Pancreáticas/complicações , Idoso , Idoso de 80 Anos ou mais , Anestésicos Locais/administração & dosagem , Etanol/administração & dosagem , Feminino , Humanos , Injeções , Lidocaína/administração & dosagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Agulhas , Invasividade Neoplásica , Medição da Dor , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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