CT-Guided Method

  • Hiroyuki UchinoEmail author
  • Yukihiko Ogihara
  • Kiyoshige Ohseto


The advances of the pain techniques have been rapidly grown over the last decade. Pain clinicians use different technique in these procedures. Especially, to use the image guidance for the pain therapeutic procedure is proved by the recent systemic reviews, and the choice of image guidance is depending on the practitioner’s preference with conventional fluoroscopy or computed tomography (CT) which can perform low milliampere technique.

The utility of CT-guided nerve block is well known and has many advantages because of its characteristics that can show the view of vital organ as high resolution and vascular component. It also provides the accurate location of the block needle to prevent the organ and vascular injury to perform the effective neurolytic block.

The goal of this chapter is to provide the basic overview of CT-guided nerve blocks for interventional pain procedures.


Computed tomography Interventional pain Nerve block Neurolytic block 


  1. 1.
    Curatolo M, Bogduk N. Diagnostic and therapeutic nerve blocks. In: Fishman SM, Ballantyne JC, Rathmell JP, editors. Bonica’s management of pain. 4th ed. Philadelphia: Lippincott; 2010. p. 1401–14023.Google Scholar
  2. 2.
    Koizuka S, Nakajima K, Mieda R. CT-guided nerve block: a review of the features of CT fluoroscopic guidance for nerve blocks. J Anesth. 2014;28(1):94–101.CrossRefGoogle Scholar
  3. 3.
    Haaga JR, Reich NE, Havrilla TR, Alfidi RJ. Interventional CT scanning. Radiol Clin N Am. 1977;15(3):449–56.PubMedGoogle Scholar
  4. 4.
    Silverman SG, Tuncali K, Adams DF, Nawfel RD, Zou KH, Judy PF. CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology. 1999;212(3):673–81.CrossRefGoogle Scholar
  5. 5.
    Katada K, Kato R, Anno H, Ogura Y, Koga S, Ida Y, Sato M, Nonomura K. Guidance with real-time CT fluoroscopy: early clinical experience. Radiology. 1996;200(3):851–6.CrossRefGoogle Scholar
  6. 6.
    Granfors PR, Albagli D, Tkaczyk JE, et al. Performance of a flt-panel cardiac detector. In: Medical imaging, vol. 2001. San Diego, CA: Physics of Medical Imaging; 2001. p. 77–86.Google Scholar
  7. 7.
    Sarti M, Brehmer WP, Gay SB. Low-dose techniques in CT-guided interventions. Radiographics. 2012;32(4):1109–19.CrossRefGoogle Scholar
  8. 8.
    Koizuka S, Saito S, Tobe M, Sekimoto K, Obata H, Koyama Y. Technical communication: percutaneous radiofrequency mandibular nerve rhizotomy guided by high-speed real-time computed tomography fluoroscopy. Anesth Analg. 2010;111(3):763–7.CrossRefGoogle Scholar
  9. 9.
    Strobel N, Meissner O, Boese J, Brunner T, Hoheisel BHM, Lauritsch G, Nagel M, Pfister M, Rührnschopf E-P, Scholz B, Schreiber B, Spahn M, Zellerhoff M. Klaus Klingenbeck-Regn. In: Reiser MF, Becker CR, Nikolaou K, Glazer G, editors. 3D imaging with flat-detector C-arm systems. Berlin Heidelberg: Multislice CT Springer; 2009. p. 33–51.Google Scholar
  10. 10.
    Hoang JK, Yoshizumi TT, Toncheva G, Gray L, Gafton AR, Huh BK, Eastwood JD, Lascola CD, Hurwitz LM. Radiation dose exposure for lumbar spine epidural steroid injections: a comparison of conventional fluoroscopy data and CT fluoroscopy techniques. AJR Am J Roentgenol. 2011;197(4):778–82.CrossRefGoogle Scholar
  11. 11.
    Timpone VM, Hirsch JA, Gilligan CJ, Chandra RV. Computed tomography guidance for spinal intervention: basics of technique, pearls, and avoiding pitfalls. Pain Physician. 2013;16(4):369–77.PubMedGoogle Scholar

Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Hiroyuki Uchino
    • 1
    Email author
  • Yukihiko Ogihara
    • 1
  • Kiyoshige Ohseto
    • 1
  1. 1.Department of AnesthesiologyTokyo Medical UniversityTokyoJapan

Personalised recommendations