肝動脈でのroadmap機能における横隔膜位置を用いた呼吸性移動の補正手法の信頼性評価

概要

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Miss-placement of arteries while using the roadmap technique in endovascular interventions for abdominal arteries occurs because of respiration. It has been reported that abdominal arteries move mainly in a superior-inferior direction and that diaphragm position helps to compensate for the miss-placement. We investigated the reliability of a roadmap technique with respiratory motion compensation that used diaphragm positions to cancel out any miss-placement of the hepatic arteries. From three patients, we obtained five pairs of fluoroscopic sequences and digital subtraction angiography (DSA) images. The coordinates of the right hemi-diaphragm and a micro guide-wire tip were noted for every frame of the fluoroscopic sequence along with the coordinates of the right hemi-diaphragm on the DSA image. The micro guide-wire tip coordinates were corrected using the difference of the Y coordinate values from both hemi-diaphragms. The tip positions that were successfully placed on arteries in the DSA image were counted and the success rate calculated. Mean success rates for two cases were over 90%, though that for the other was under 10%. The results indicate that reliability of the roadmap technique with respiratory motion compensation depends on the particular case. However, this method could stabilize the micro guide-wire tip position.