77022 Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation

Name of the Procedure:

Magnetic Resonance Imaging (MRI) Guidance for Parenchymal Tissue Ablation

Summary

Magnetic Resonance Imaging (MRI) guidance for parenchymal tissue ablation is a minimally invasive procedure that uses MRI technology to precisely locate and destroy abnormal tissue within the liver, kidneys, lungs, or other organs. The MRI provides real-time images to guide the ablation process, ensuring accuracy and effectiveness.

Purpose

The procedure is used to treat various conditions such as tumors, cysts, or other abnormal growths within the parenchymal tissue of organs. The goal is to eliminate pathological tissue while preserving surrounding healthy tissue.

Indications

• Tumors or cancerous lesions in the liver, kidneys, lungs, or other organs.
• Benign growths causing symptoms or functional impairment.
• Patients who are not candidates for traditional surgery due to health or age.
• Minimizing damage to surrounding healthy tissue.

Preparation

• Fasting for a specified period before the procedure.
• Adjustments to current medications as directed by your healthcare provider.
• Blood tests and imaging studies (like CT scans or initial MRI) to plan the procedure.

Procedure Description

1. The patient is positioned on the MRI table, and an initial MRI scan is performed to locate the abnormal tissue.
2. The area of interest is sterilized, and local anesthesia or conscious sedation is administered.
3. Using real-time MRI guidance, a needle or probe is inserted through the skin to the target tissue.
4. Thermal energy (radiofrequency, microwave, or laser) or chemical agents are delivered through the needle or probe to ablate the tissue.
5. Continuous MRI imaging monitors the progress to ensure precise ablation.
6. Once the target tissue is ablated, the needle or probe is removed, and a final MRI is performed to confirm successful ablation.

Duration

The procedure typically takes 1 to 3 hours, depending on the complexity and location of the abnormal tissue.

Setting

The procedure is usually performed in a hospital's radiology or specialized MRI suite equipped with advanced imaging technology.

Personnel

• Interventional radiologist or surgeon.
• MRI technician.
• Anesthesiologist or sedation nurse.
• Surgical nurse or assistant.

Risks and Complications

• Common risks: Bleeding, infection at the insertion site, and discomfort.
• Rare risks: Damage to surrounding healthy tissue, incomplete ablation, thermal injury to nearby structures, and allergic reactions to contrast agents.
• Monitoring and management: Continuous intra-procedural monitoring and post-procedural care to identify and manage complications promptly.

Benefits

• Minimally invasive with a shorter recovery time compared to open surgery.
• Precise targeting of abnormal tissue reduces damage to healthy tissue.
• Can be repeated if necessary.

Recovery

• Post-procedure observation for a few hours in the recovery room.
• Instructions on managing pain and caring for the insertion site.
• Avoiding strenuous activities for a few days.
• Follow-up MRI or other imaging to assess the effectiveness of the ablation.
• Potential follow-up appointments to monitor recovery and ensure no recurrence.

Alternatives

• Surgical resection: More invasive with a longer recovery time.
• Cryoablation: Uses extreme cold to destroy tissue, suitable for some patients.
• Radiofrequency or microwave ablation without MRI guidance.
• Chemotherapy or radiation therapy for malignant tumors.

Patient Experience

• During the procedure: Some discomfort or pressure at the insertion site but generally minimized by anesthesia or sedation.
• After the procedure: Mild pain or soreness at the site, which is manageable with pain relief medications.
• Patients may feel anxious due to the MRI environment, but care teams often provide comfort measures to alleviate this.

The use of MRI guidance provides real-time visualization, increasing the procedure's accuracy and outcome, helping patients recover more quickly and effectively.