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

Area of Science:

• Interventional radiology
• Medical imaging
• Anatomy

Background:

• Interventional magnetic resonance imaging (MRI) offers high contrast resolution and avoids ionizing radiation, making it suitable for sensitive procedures.
• Paravertebral sympathetic nerve plexus injections are important for pain management and other therapeutic interventions.

Purpose of the Study:

• To assess the feasibility and technical performance of MRI-guided paravertebral sympathetic injections.
• To evaluate the utility of augmented reality (AR) navigation combined with a 1.5 Tesla (T) MRI scanner for these procedures.

Main Methods:

• Prospective planning and execution of 23 bilateral paravertebral sympathetic plexus injections in human cadavers.
• Utilized a 1.5 T MRI scanner with an AR navigation system and MRI-conditional needles.
• Injected Gadolinium-DTPA-enhanced saline and assessed outcomes including needle tip accuracy, non-target punctures, fluid distribution, and procedure length.

Main Results:

• Achieved 100% success rate (46 of 46 targets) in targeting the paravertebral space and performing perineural injections.
• Mean needle tip error was 3.9±1.7 mm, with no punctures of critical non-target structures.
• Mean procedure length was 33±12 minutes, demonstrating efficient workflow.

Conclusions:

• 1.5 T augmented reality-navigated interventional MRI provides accurate imaging guidance for perineural injections.
• This technique is effective for thoracic, lumbar, and hypogastric sympathetic plexus targets.
• The study confirms the feasibility and technical success of this advanced imaging approach.