3-Tesla High-Field Magnetic Resonance Neurography for Guiding Nerve Blocks and Its Role in Pain Management

Fritz, Jan; Dellon, A. Lee; Williams, Eric H.; Belzberg, Allan J.; Carrino, John A.

doi:10.1016/j.mric.2015.05.010

Cited by 34 publications

(20 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, adding quantitative measurements to mere nerve visualization during high-resolution MRN might further enhance guidance of interventional nerve blocks and perineural injections. So far, promising results have already been achieved for qualitative MRN, but investigations on combined qualitative and quantitative high-resolution 3D MRN for this purpose have not yet been carried out [17].…”

Section: Discussionmentioning

confidence: 99%

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

View full text Add to dashboard Cite

Purpose Isotropic high-resolution three-dimensional (3D) magnetic resonance neurography (MRN) is increasingly used to depict even small and highly oblique nerves of the lumbosacral plexus (LSP). The present study introduces a T2 mapping sequence (T2-prepared 3D turbo spin echo) that is B1-insensitive and enables quantitative assessment of LSP nerves. Methods In this study 15 healthy subjects (mean age 28.5 ± 3.8 years) underwent 3 T MRN of the LSP area three times. The T2 values were calculated offline on a voxel-by-voxel basis and measured at three segments (preganglionic, ganglionic, postganglionic) of three LSP nerves (S1, L5, L4) by two independent investigators (experienced and novice). Normative data for the different nerves were extracted and intraclass correlation coefficients (ICCs) were calculated to assess reproducibility and interobserver reliability of T2 measurements. Results The T2 mapping showed excellent reproducibility with ICCs ranging between 0.99 (S1 preganglionic) and 0.89 (L5 postganglionic). Interobserver reliability was less robust with ICCs ranging between 0.78 (S1 preganglionic) and 0.44 (L5 postganglionic) for S1 and L5. A mean T2 value of 74.6 ± 4.7 ms was registered for preganglionic segments, 84.7 ± 4.1 ms for ganglionic and 65.4 ± 2.5 ms for postganglionic segments, respectively. There was a statistically significant variation of T2 values across the nerve (preganglionic vs ganglionic vs postganglionic) for S1, L5, and L4. Conclusion Our approach enables isotropic high-resolution and B1-insensitive T2 mapping of LSP nerves with excellent reproducibility. It might reflect a robust and clinically useful method for future diagnostics of LSP pathologies.

show abstract

Section: Discussionmentioning

confidence: 99%

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Aside from the limited availability of the above used open MRI scanners, because they are no longer commercially available, primary differences to the closed bore 1.5 T MRI scanner used in the present study are related to the lower field strength, which results in less homogeneity, lower MRI signal, limited image quality and longer imaging times. The augmented reality system used in the present study was able to overcome the barrier of patient access inherent to the closed bore magnet design, which may also be used with modern 3.0 T MRI scanners (31,32).…”

Section: Discussionmentioning

confidence: 99%

1.5 T augmented reality navigated interventional MRI: paravertebral sympathetic plexus injections

Marker

Thainual

Ungi

et al. 2017

Diagn Interv Radiol

Self Cite

View full text Add to dashboard Cite

“…The protocol included three-dimensional intermediate-weighted and T2-weighted high-resolution turbo spin echo pulse sequences without and with fat suppression [16, 17]. …”

Section: Methodsmentioning

confidence: 99%

Sacrotuberous Ligament Healing following Surgical Division during Transgluteal Pudendal Nerve Decompression: A 3-Tesla MR Neurography Study

Fritz

Dellon

2016

PLoS ONE

Self Cite

View full text Add to dashboard Cite

Pelvic pain due to chronic pudendal nerve (PN) compression, when treated surgically, is approached with a transgluteal division of the sacrotuberous ligament (STL). Controversy exists as to whether the STL heals spontaneously or requires grafting. Therefore, the aim of this study was to determine how surgically divided and unrepaired STL heal. A retrospective evaluation of 10 patients who had high spatial resolution 3-Tesla magnetic resonance imaging (3T MRI) exams of the pelvis was done using an IRB-approved protocol. Each patient was referred for residual pelvic pain after a transgluteal STL division for chronic pudendal nerve pain. Of the 10 patients, 8 had the STL divided and not repaired, while 2 had the STL divided and reconstructed with an allograft tendon. Of the 8 that were left unrepaired, 6 had bilateral surgery. Outcome variables included STL integrity and thickness. Normative data for the STL were obtained through a control group of 20 subjects. STL integrity and thickness were measured directly on 3 T MR Neurography images, by two independent Radiologists. The integrity and thickness of the post-surgical STL was evaluated 39 months (range, 9–55) after surgery. Comparison was made with the native contra-lateral STL in those who had unilateral STL division, and with normal, non-divided STL of subjects of the control group. The normal STL measured 3 mm (minimum and maximum of absolute STL thickness, 2–3 mm). All post-operative STL were found to be continuous regardless of the surgical technique used. Measured at level of Alcock’s canal in the same plane as the obturator internus tendon posterior to the ischium, the mean anteroposterior STL diameter was 5 mm (range, 4–5 mm) in the group of prior STL division without repair and 8 mm (range, 8–9 mm) in the group with the STL reconstructed with grafts (p<0.05). The group of healed STLs were significantly thicker than the normal STL (p<0.05). We conclude that a surgically divided STL will heal spontaneously and will be significantly thicker after healing.

show abstract

3-Tesla High-Field Magnetic Resonance Neurography for Guiding Nerve Blocks and Its Role in Pain Management

Cited by 34 publications

References 65 publications

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

1.5 T augmented reality navigated interventional MRI: paravertebral sympathetic plexus injections

Sacrotuberous Ligament Healing following Surgical Division during Transgluteal Pudendal Nerve Decompression: A 3-Tesla MR Neurography Study

Contact Info

Product

Resources

About