caa a22 4500 605509492 CHVBK 20210128100641.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10877-014-9576-4 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9576-4 Real-time two-dimensional and three-dimensional echocardiographic imaging of the thoracic spinal cord: a possible new window into the central neuraxis [Elektronische Daten] [Neil Feinglass, Steven Clendenen, Timothy Shine, Archer Martin, Roy Greengrass] Transesophageal echocardiography of the spine has been difficult to perform, and high-quality images have been difficult to obtain with earlier available technology. New capabilities in hardware and software reconstruction may allow more reliable clinical data to be obtained. We describe an initial successful attempt to image the adult spinal canal, its contents, and in situ instrumentation. This report is a retrospective review of two patients in whom transesophageal echocardiography (TEE) was used to image the thoracic spine. The thoracic spine was identified and imaged with real-time 2-D and 3-D technology with location of the thoracic aorta and slight insertion and withdrawal of the TEE probe until the intervertebral discs alignment was optimized. Images of the spinal cord anatomy and its vascular supply, as well as indwelling epidural catheters were easily identified. 2-D and 3-D imaging was performed and images were recorded in digital imaging and communications in medicine format. 3-D reconstruction of images was possible with instantaneous 3-D imaging from multiple 2-D electrocardiogram-gated image acquisitions using the Phillips TEE IE-33 imaging platform. The central neuraxial cavity, including the spinal cord and the spinal nerve roots, was easily visualized, and motion of the cord was seen in a phasic pattern (with respiratory variation); cerebrospinal fluid surrounding the spinal cord was documented. The epidural space and local anesthetic drug administration through the epidural catheter were visualized, with the epidural catheter seen lying adjacent to the epidural tissue as a bright hyperechoic line. Pulsed-wave Doppler determined a biphasic pattern of blood flow in the anterior spinal artery through pulse mapping of the anatomic area. New, advanced imaging hardware and software generate clinically useful imaging of the thoracic spine in 2-D and 3-D using TEE. We believe this technology holds promise for future diagnostic and therapeutic interventions in the operating room that were previously unavailable. Springer Science+Business Media New York, 2014 Transesophageal echocardiography nationallicence 3-D transesophageal echocardiography nationallicence Cardiothoracic anesthesiology nationallicence Spinal cord monitoring nationallicence Neurophysiological monitoring nationallicence Feinglass Neil Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut Clendenen Steven Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut Shine Timothy Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut Martin Archer Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut Greengrass Roy Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/1(2015-02-01), 121-125 1387-1307 29:1<121 2015 29 10877 https://doi.org/10.1007/s10877-014-9576-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9576-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Feinglass Neil Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Clendenen Steven Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Shine Timothy Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Martin Archer Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Greengrass Roy Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Road S, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/1(2015-02-01), 121-125 1387-1307 29:1<121 2015 29 10877