CardioVascular and Interventional Radiology

, Volume 36, Issue 3, pp 748–755 | Cite as

Saline as the Sole Contrast Agent for Successful MRI-guided Epidural Injections

  • Martin DeliEmail author
  • Jan Fritz
  • Serban Mateiescu
  • Martin Busch
  • John A. Carrino
  • Jan Becker
  • Marietta Garmer
  • Dietrich Grönemeyer
Clinical Investigation



To assess the performance of sterile saline solution as the sole contrast agent for percutaneous magnetic resonance imaging (MRI)-guided epidural injections at 1.5 T.


A retrospective analysis of two different techniques of MRI-guided epidural injections was performed with either gadolinium-enhanced saline solution or sterile saline solution for documentation of the epidural location of the needle tip. T1-weighted spoiled gradient echo (FLASH) images or T2-weighted single-shot turbo spin echo (HASTE) images visualized the test injectants. Methods were compared by technical success rate, image quality, table time, and rate of complications.


105 MRI-guided epidural injections (12 of 105 with gadolinium-enhanced saline solution and 93 of 105 with sterile saline solution) were performed successfully and without complications. Visualization of sterile saline solution and gadolinium-enhanced saline solution was sufficient, good, or excellent in all 105 interventions. For either test injectant, quantitative image analysis demonstrated comparable high contrast-to-noise ratios of test injectants to adjacent body substances with reliable statistical significance levels (p < 0.001). The mean table time was 22 ± 9 min in the gadolinium-enhanced saline solution group and 22 ± 8 min in the saline solution group (p = 0.75).


Sterile saline is suitable as the sole contrast agent for successful and safe percutaneous MRI-guided epidural drug delivery at 1.5 T.


MRI/MRA Nonvascular interventions Pain Spine/nervous system 



We thank Silke Lange for her support in the statistical data analysis and Aliki Papathanassiou for her support as a second rater in the interrater reliability test of the qualitative assessment.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Martin Deli
    • 1
    Email author
  • Jan Fritz
    • 2
  • Serban Mateiescu
    • 1
  • Martin Busch
    • 1
  • John A. Carrino
    • 2
  • Jan Becker
    • 1
  • Marietta Garmer
    • 1
  • Dietrich Grönemeyer
    • 1
  1. 1.Department of Radiology and Microtherapy, Groenemeyer Institute for Microtherapy (GIMT)University of Witten/HerdeckeBochumGermany
  2. 2.Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA

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