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

David R Marker1, Paweena U Thainual, Tamas Ungi

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This study demonstrates that augmented reality-navigated interventional magnetic resonance imaging (MRI) is a feasible technique for precise paravertebral sympathetic plexus injections. The method achieved 100% accuracy in cadavers, offering a safe and effective imaging guidance solution.

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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.