Nerve root infiltration of the first sacral root with MRI guidance

Ojala, Risto; Vahala, Erkki; Karppinen, Jaro; Klemola, Rauli; Sequeiros, Roberto Blanco; Vaara, Teuvo; Tervonen, Osmo

doi:10.1002/1522-2586(200010)12:4<556::aid-jmri6>3.0.co;2-c

Cited by 42 publications

(25 citation statements)

References 24 publications

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“…1). The details of the optical tracking system have been previously reported [24,25]. During the biopsy, the needle was guided with graphic overlay information provided by optical tracking, as well as instrument generated susceptibility (Fig.…”

Section: Methodsmentioning

confidence: 99%

MRI-guided abdominal biopsy in a 0.23-T open-configuration MRI system

et al. 2004

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The purpose of this study was to test the hypothesis that when ultrasound (US) guidance is not feasible, abdominal biopsies can be performed safely and accurately under magnetic resonance imaging (MRI) guidance in a low-field environment. MRI-guided abdominal biopsy was performed on 31 consecutive patients, in whom US-guided abdominal biopsy was not possible because the lesion was not visualized in US (n=27) or an US-guided procedure was not considered safe (n=4). The locations of the lesions were liver (n=14), pancreas (n=6), lymph node (n=4), retroperitoneal mass (n=3), adrenal gland (n=3) and spleen (n=1). The average size of the lesion was 2.2 cm (range 1-4 cm) in maximum diameter. All procedures were done by using a 0.23-T open-configuration C-arm-shaped MRI scanner with interventional optical tracking equipment and software. Fine-needle aspiration (FNA) biopsy was performed on all 31 patients; 18 patients underwent both FNA biopsy and cutting needle core biopsy. Procedures were evaluated for diagnostic sensitivity, specificity and accuracy as well as procedure time and complications. The FNA biopsy specimens were adequate for interpretation in 27 (87%) of 31 cases. Two of these proved to be false-negative findings during follow-up or subsequent biopsy. The final diagnosis was malignant in 15 and benign in 16 patients. The sensitivity, specificity and accuracy of FNA biopsy were 71, 100 and 81%, respectively. Of the 18 core-needle biopsies, one was determined false-negative owing to nonrepresentativeness. The sensitivity, specificity and accuracy of histological samples were 90, 100 and 94%, respectively. The needle time was 19 min on average and the mean room time was 1 h 48 min. No immediate or late complications occurred. MRI-guided abdominal biopsy can be performed safely and accurately in a low-field environment in patients for whom an US-guided procedure is not feasible.

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Section: Methodsmentioning

confidence: 99%

MRI-guided abdominal biopsy in a 0.23-T open-configuration MRI system

et al. 2004

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“…Various spine interventions have been successfully performed at open MR scanners [9][10][11][12]. However, MR fluoroscopy guidance [6,7,10,11] for Electronic supplementary material The online version of this article (doi:10.1007/ s00330-008-0890-4) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

Real-time MR fluoroscopy-navigated lumbar facet joint injections: feasibility and technical properties

et al. 2008

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We prospectively evaluated the feasibility and technical properties of a dedicated interventional magnetic resonance (MR) imaging protocol for near-real-time MR fluoroscopy-guided bilateral lumbar facet joint injections. A total of 44 facet joint injections were performed in 22 patients using a C-shaped open 0.2-T MR imaging system (Magnetom Concerto, Siemens Medical Solutions, Erlangen, Germany). A T1/T2-weighted fast-imaging-with-steady-precession (FISP) sequence with an end-to-end latency of 1.2 s facilitated sufficient near real-time MR imaging guidance in all cases. A T1-weighted two dimensional fast-low-angle-shot (FLASH2D) MR sequence identified final needle tip location. Different angles of the needle path had only minimal influence on the appearance of the needle artifact produced by both sequences, resulting in a symmetrical needle tip artifact. The joint cavity was successfully punctured in 79.5% (35/44) of joints, which was followed by intra-articular fluid accumulation in 75% (33/44). Inaccessible joints demonstrated a significantly (p=0.044) higher number of posterior osteophytes (66.7%, 6/9 joints) compared to accessible joints (26%, 9/35 joints). No complications occurred. Table time showed significant shortening over time with average table time of 33 (21-68.5) min. We conclude that MR fluoroscopy-navigated lumbar facet joint injections are feasible and safe.

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“…Periradicular nerve root infiltration under fluoroscopic, CT fluoroscopic, and sonographic guidance has proven to be a safe and effective therapy method for treating patients in whom conservative treatment of cervical discomfort and cervical radicular pain syndrome is not sufficient [4, 32 -34]. Therapy guidance via MRI was also able to be subsequently clinically established [22,35]. In our study, the technical success rate was 100 %.…”

Section: Discussionmentioning

confidence: 54%

“…Finally the duration of the intervention also depends on the experience of the interventionalist [20]. Therefore, the average intervention duration for the first five patients in a patient collective of Ojala et al [35] was 34 minutes, while the average time for the last five patients was only 23 minutes. Two radiologists with MRI-guided intervention experience performed the infiltrations in our study.…”

Section: Discussionmentioning

confidence: 99%

MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison

Maurer

Froeling

Röttgen

et al. 2013

Fortschr Röntgenstr

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Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40?mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12???36?min.) for MRI-guided infiltration and 19.7?min. (range: 5???54?min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. Citation Format: ??Maurer MH, Froeling V, R?ttgen R et?al. MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison. Fortschr R?ntgenstr 2014; 186: 559???566

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Nerve root infiltration of the first sacral root with MRI guidance

Cited by 42 publications

References 24 publications

MRI-guided abdominal biopsy in a 0.23-T open-configuration MRI system

MRI-guided abdominal biopsy in a 0.23-T open-configuration MRI system

Real-time MR fluoroscopy-navigated lumbar facet joint injections: feasibility and technical properties

MRI-Guided and CT-Guided Cervical Nerve Root Infiltration Therapy: A Cost Comparison

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