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Real-time MR fluoroscopy-navigated lumbar facet joint injections: feasibility and technical properties

We prospectively evaluated the feasibility and technical properties of a dedicated interventional magnetic resonance (MR) imaging protocol for near-real-time MR fluoroscopy-guided bilateral lumbar facet joint injections. A total of 44 facet joint injections were performed in 22 patients using a C-shaped open 0.2-T MR imaging system (Magnetom Concerto, Siemens Medical Solutions, Erlangen, Germany). A T1/T2-weighted fast-imaging-with-steady-precession (FISP) sequence with an end-to-end latency of 1.2 s facilitated sufficient near real-time MR imaging guidance in all cases. A T1-weighted two dimensional fast-low-angle-shot (FLASH2D) MR sequence identified final needle tip location. Different angles of the needle path had only minimal influence on the appearance of the needle artifact produced by both sequences, resulting in a symmetrical needle tip artifact. The joint cavity was successfully punctured in 79.5% (35/44) of joints, which was followed by intra-articular fluid accumulation in 75% (33/44). Inaccessible joints demonstrated a significantly (p=0.044) higher number of posterior osteophytes (66.7%, 6/9 joints) compared to accessible joints (26%, 9/35 joints). No complications occurred. Table time showed significant shortening over time with average table time of 33 (21-68.5) min. We conclude that MR fluoroscopy-navigated lumbar facet joint injections are feasible and safe

Keywords : Adult,Artifacts,complications,drug therapy,Feasibility Studies,Female,Germany,Humans,Injections,Intra-Articular,Low Back Pain,Lumbar Vertebrae,Magnetic Resonance Imaging,Interventional,Male,methods,Middle Aged,Prospective Studies,Punctures,Radiology,Statistics,Nonparametric,Treatment Outcome,Zygapophyseal Joint,, Mr,Fluoroscopynavigated,Lumbar,Facet,Joint, biopsychosocial model definition

Date of Publication : 2008 Jul

Authors : Fritz J;Clasen S;Boss A;Thomas C;Konig CW;Claussen CD;Pereira PL;

Organisation : Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tubingen, Germany. jan.fritz@gmx.net

Journal of Publication : Eur Radiol

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/18299836

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