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European Radiology

, Volume 20, Issue 2, pp 395–403 | Cite as

Image-guided spinal injection procedures in open high-field MRI with vertical field orientation: feasibility and technical features

  • F. StreitparthEmail author
  • T. Walter
  • U. Wonneberger
  • S. Chopra
  • F. Wichlas
  • M. Wagner
  • K. G. Hermann
  • B. Hamm
  • U. Teichgräber
Interventional

Abstract

Objective

We prospectively evaluated the feasibility and technical features of MR-guided lumbosacral injection procedures in open high-field MRI at 1.0 T.

Methods

In a CuSO4·5H2O phantom and five human cadaveric spines, fluoroscopy sequences (proton-density-weighted turbo spin-echo (PDw TSE), T1w TSE, T2w TSE; balanced steady-state free precession (bSSFP), T1w gradient echo (GE), T2w GE) were evaluated using two MRI-compatible 20-G Chiba-type needles. Artefacts were analysed by varying needle orientation to B0, frequency-encoding direction and slice orientation. Image quality was described using the contrast-to-noise ratio (CNR). Subsequently, a total of 183 MR-guided nerve root (107), facet (53) and sacroiliac joint (23) injections were performed in 53 patients.

Results

In vitro, PDw TSE sequence yielded the best needle–tissue contrasts (CNR = 45, 18, 15, 9, and 8 for needle vs. fat, muscle, root, bone and sclerosis, respectively) and optimal artefact sizes (width and tip shift less than 5 mm). In vivo, PDw TSE sequence was sufficient in all cases. The acquisition time of 2 s facilitated near-real-time MRI guidance. Drug delivery was technically successful in 100% (107/107), 87% (46/53) and 87% (20/23) of nerve root, facet and sacroiliac joint injections, respectively. No major complications occurred. The mean procedure time was 29 min (range 19–67 min).

Conclusion

MR-guided spinal injections in open high-field MRI are feasible and accurate using fast TSE sequence designs.

Keywords

Interventional MRI Open high field Spinal injection therapy Artefacts Low back pain 

Supplementary material

PRT Movie (MOV 317 KB)

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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • F. Streitparth
    • 1
    Email author
  • T. Walter
    • 1
  • U. Wonneberger
    • 1
  • S. Chopra
    • 2
  • F. Wichlas
    • 3
  • M. Wagner
    • 1
  • K. G. Hermann
    • 1
  • B. Hamm
    • 1
  • U. Teichgräber
    • 1
  1. 1.Department of RadiologyCharité, Humboldt-Universität zu BerlinBerlinGermany
  2. 2.Department of General, Visceral, and Transplantation SurgeryCharité-Universitätsmedizin Berlin, Campus Virchow KlinikumBerlinGermany
  3. 3.Center for Musculoskeletal SurgeryCharité-Universitätsmedizin Berlin, Campus Virchow KlinikumBerlinGermany

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