[MR-Guided pain therapy: principles and clinical applications]

Area of Science:

• Radiology
• Interventional Pain Management
• Medical Imaging

Background:

• Percutaneous interventions for pain therapy traditionally rely on X-ray fluoroscopy and CT.
• Advancements in MR-compatible needles enable interventions under MR imaging guidance.
• Open MR configurations offer advantages for interventional procedures.

Purpose of the Study:

• To review the general concepts and applications of interventional MR imaging.
• To illustrate MR-guided spinal pain therapy procedures.
• To highlight the benefits of MR imaging in interventional pain management.

Main Methods:

• Utilizing multiplanar MR imaging for pre- and intra-procedural anatomical and pathological evaluation.
• Employing passive needle visualization techniques for spinal MR interventions.
• Optimizing needle artifact through adjustments in sequence type, spatial orientation, and echo time.
• Implementing fast acquisition techniques for near real-time MR fluoroscopy and interactive needle navigation.

Main Results:

• MR-guided interventions provide comprehensive anatomical and pathological information without contrast agents.
• Passive needle visualization is a reliable method for spinal MR interventions.
• MR fluoroscopy allows for continuous monitoring and interactive needle navigation comparable to X-ray and CT fluoroscopy.
• Interventional MR imaging is suitable for children and serial injection therapies due to non-ionizing radiation.

Conclusions:

• Interventional MR imaging offers a safe and effective alternative for percutaneous pain therapy, particularly for spinal procedures.
• MR guidance enhances procedural planning, monitoring, and accuracy.
• The technique is advantageous for specific patient populations and therapeutic approaches, minimizing radiation exposure.