Magnetic resonance imaging-guided lumbar nerve root infiltrations: optimization of an in-house protocol

BMC Med Imaging. 2021 Jul 12;21(1):110. doi: 10.1186/s12880-021-00641-0.

Abstract

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.

Keywords: MRI guidance; Nerve root infiltration; Radicular pain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dexamethasone / administration & dosage
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Injections, Spinal / methods*
  • Low Back Pain / drug therapy
  • Lumbar Vertebrae / diagnostic imaging*
  • Lumbar Vertebrae / innervation
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Radiculopathy / drug therapy*
  • Ropivacaine / administration & dosage
  • Sciatic Nerve / diagnostic imaging
  • Spinal Nerve Roots / diagnostic imaging*

Substances

  • Glucocorticoids
  • Ropivacaine
  • Dexamethasone