Abstract
Purpose
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.
Methods
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.
Results
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).
Conclusion
Sterile saline is suitable as the sole contrast agent for successful and safe percutaneous MRI-guided epidural drug delivery at 1.5 T.
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Acknowledgments
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.
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The authors declare that they have no conflict of interest.
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The work was performed at the Groenemeyer Institute for Microtherapy (GIMT), Universitaetsstrasse 142, 44799 Bochum, Germany.
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Deli, M., Fritz, J., Mateiescu, S. et al. Saline as the Sole Contrast Agent for Successful MRI-guided Epidural Injections. Cardiovasc Intervent Radiol 36, 748–755 (2013). https://doi.org/10.1007/s00270-012-0489-7
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DOI: https://doi.org/10.1007/s00270-012-0489-7