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Real World Success Stories in Enterprise Imaging | Case #1:  Pediatric Aneurysm

Real World Success Stories in Enterprise Imaging | Case #1: Pediatric Aneurysm

Days like these could have been any day. But on this day, just a week into a massive go-live, our team experienced something truly rewarding, reminding us all why we do what we do.

While providing go-live support, it came to the Visage team’s attention that a pediatric patient presented with multiple aneurysms and needed emergency surgery. The Neuroradiologist approached our team with the critical clinical challenge at hand - emergency pediatric neurosurgery. Not a potential clinical scenario, but a "right here, right now" situation.

Like right now.

Visage 7: Dynamic MRA/MRV Layout

There was no time to perform specialty scans, send out the case to 3D teleradiology, or to wait for lengthy technologist post-processing of the datasets. The patient was being prepped and rushed into surgery, and the Neuroradiologist was developing his surgical plan. He knew his institution had just gone live with Visage 7, and he was curious if Visage 7 could assist with his surgical planning, explaining, “This is what a guy like me needs to know.”

The surgeon, who specializes in neurointerventional techniques, worked with the Visage team to display the MR study in a protocol with side-by-side layouts for MRA (MR Angiography (images timed to maximum intensification of arteries)) and MRV (MR Venography (images timed to maximum intensification of veins)). Visage 7 enabled the interventionalist to virtualize the planning, by literally thinking out loud, walking through the surgery with his eyes, while dynamically interrogating the vessels in the MRA and MRV volumes.

The on-the-fly planning was essentially a verbal ballet: "The first embolization is going to do this. I'm going around and embolizing this thing.…..what I don't want to do is embolize this, … maybe because of this imaging, I need to have a bigger angulation, and if I get this much angulation,, this is the artery here, good."

He then continued, realizing the impact of what he just experienced, "It's really helpful, because these are really risky procedures and they are anxiety provoking, and I'd really like to be able to do this before I do the case. Maybe it'll minimize risk."

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The Visage 7 diagnostic enterprise viewer was the enabler, allowing him to visualize different approaches. He continued to plan, "If that's the artery, when I embolize this, this is the venous pouch, that's going to fill nicely and reflex up, to the other vessel. That, I'm going to really like to see. I'm going to come here and not here, and then catheterize this vessel. What I don't want to do is to contaminate normal veins.”

The physician continued until the rehearsed surgical plan was committed to memory.

All of this was performed on the fly, all from the same ‘seat’ (that also provides interpretation and clinical access for all diagnostic imaging), without any unnecessary workflow impediments or delays. That saved precious time (estimated at tens of minutes), increased the quality and speed of the surgical planning, and allowed the interventionalist to go into surgery with increased confidence.

He continued, "Now that I've seen what Visage can do, I am desperate to leave my old approach behind." Visage quickly established a new dynamic layout linking the MRA and MRV volumes, and saved it to an MR protocol, as well as established a new dynamic layout into a CT protocol to enable the effective reading of more than one CT volume(s). He explained, "To have both the MRA and MRV volume move at the same time, I'll be totally addicted to it. I won't be able to live without it." Visage is also actively considering adding the protocol to our default set of protocols for all Visage customers to take advantage of.

Later the following day, commenting about the contributions of Visage 7 to his surgery, the Neuroradiologist commented, "[Visage 7] was priceless".

This whole experience reinforces that Visage 7 enables the world's best doctors to perform with the ultimate precision and speed, delivering the very best patient care imaginable.

Even one week into go-live.

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