Section for image guided intervention and surgery
Since 2002 there has been close collaboration between the departments of radiology and plastic surgery at the University Hospital of North-Noway (UNN). Professor and plastic surgeon Louis de Weerd has been a member of the research group since 2014. The collaboration has resulted in many scientific publications on new surgical techniques such as tissue transfer using involving perforator flaps after cancer surgery and trauma, fat transplantation in the treatment of recalcitrant fistula, new techniques for abdominal wall reconstructions in cases of advanced hernias and new methods for the surgical treatment of newborns with myelomeningocele. New techniques have been tested in collaboration with the departments of gastroenterological surgery and neurosurgery and imaging techniques have a central role in this research.
The departments of radiology and plastic surgery have been cooperating in the treatment of neurogenic pain since 2008. A new technique has been developed for ultrasound-guided injection of botulinum toxin for patients with anterior cutaneous nerve entrapment syndrome (ACNES). Traditionally this syndrome has been treated with surgery, which is effective in approximately 50% of the patients. Botulinum toxin A (BTA) is effective in the treatment of neurogenic pain. However, it is a challenge to localize the affected nerve for precise injection of the drug in proximity of the nerve compression. Based on the research on thermography and perforator flaps, the MIRS has developed a new ultrasound-guided technique using color Doppler to visualize the vessels accompanying the nerves through the muscle and subcutaneous tissue towards the skin. The technique allows for precise positioning of the syringe needle for effective treatment of ACNES. The technique has also been used on several other pain syndromes with promising results. The research group has developed a new technique for the treatment of Raynaud’s phenomenon and disease involving sympathetic block with BTA around the radial artery. It is known from the literature that 8-9 injections of BTA in the hand is effective to treat vasospasm. However, this technique is painful for the patients. With this new technique only one injection is performed at each wrist, which involves very little pain. Several research projects are planned on ultrasound-guided intervention, three of these are included in a PhD project.
Before the Medical Imaging and Research Group (MIRG) was established there had been close collaboration for several years between the departments of radiology and plastic surgery in the development of dynamic infrared thermography (DIRT) as a new imaging technique. For more than a decade Professor James Mercer has been responsible for the thermography laboratory, recently in a position as Professor Emeritus. DIRT is a unique modality not offered by any other European departments of radiology. The scientific research on DIRT in Tromsø has produced several PhD- and Master degrees. The MIRG has a leading role on the use of DIRT in reconstructive surgery, the group has provided at scientific basis for the clinical use of DIRT in the planning of surgery as well as intra- and postoperatively in perforator flap surgery.