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Published on: August 7, 2018
Magnetic resonance imaging-guided lumbar nerve root infiltrations: optimization of an in-house protocol
Max Scheffler1, Pauline Coralie Guillemin2, Orane Lorton2
1Division of Radiology, Geneva University Hospitals, Ch. du Pont-Bochet 3, 1226, Thonex, Switzerland. max.scheffler@hcuge.ch.
Background:
For the treatment of radicular pain, nerve root infiltrations can be performed under MRI guidance in select, typically younger, patients where repeated CT exams are not desirable due to associated radiation risk, or potential allergic reactions to iodinated contrast medium.
Methods:
Fifteen 3 T MRI-guided nerve root infiltrations were performed in 12 patients with a dedicated surface coil combined with the standard spine coil, using a breathhold PD sequence. The needle artifact on the MR images and the distance between the needle tip and the infiltrated nerve root were measured.
Results:
The distance between the needle tip and the nerve root was 2.1 ± 1.4 mm. The visual artifact width, perpendicular to the needle long axis, was 2.1 ± 0.7 mm. No adverse events were reported.
Conclusion:
This technical note describes the optimization of the procedure in a 3 T magnetic field, including reported procedure time and an assessment of targeting precision.
Insights
MRI-guided nerve root infiltrations offer a safe alternative to CT scans for radicular pain treatment in younger patients. This study demonstrates precise targeting with minimal artifact, reporting no adverse events.
Area of Science:
- Radiology
- Interventional Radiology
- Pain Management
Background:
- Nerve root infiltrations are used for radicular pain treatment.
- MRI guidance is an alternative to CT, avoiding radiation and contrast allergies.
- This is particularly relevant for younger patients requiring repeated procedures.
Purpose of the Study:
- To describe the optimization of 3 Tesla (3T) MRI-guided nerve root infiltrations.
- To assess the targeting precision and procedure time.
- To evaluate the safety and feasibility of the technique.
Main Methods:
- Fifteen 3T MRI-guided nerve root infiltrations were performed in 12 patients.
- A dedicated surface coil and standard spine coil were used with a breathhold PD sequence.
- Needle artifact and distance to the nerve root were measured.
Main Results:
- The mean distance between the needle tip and nerve root was 2.1 ± 1.4 mm.
- The mean visual artifact width was 2.1 ± 0.7 mm.
- No adverse events were reported during the procedures.
Conclusions:
- 3T MRI-guided nerve root infiltrations are feasible and precise for radicular pain treatment.
- The technique offers a safe alternative to CT, minimizing radiation exposure.
- Further optimization of the procedure in a 3T magnetic field enhances targeting accuracy.
