Clinical applications of interventional magnetic resonance imaging in pain therapy of the spine

Abstract

Objectifs The purpose of this presentation is to show the spectrum of interventional MR imaging procedures in spinal pain therapy and to demonstrate the application of MR-Fluoroscopy. Materiels et methodes The introduction of new MR-Scanners with a larger bore and a shorter magnet (Magnetom ESPREE, Siemens, Erlangen, Germany) and the development of MR-compatible instruments lead to new therapeutic possibilities for interventional radiologists. Resultats General concepts are illustrated in reference to procedures including lumbar sympatholysis, facet joint blockade, sacroiliac joint infiltration and periradicular infiltration. The ability of pre-and procedural MR imaging provides the physicist with exclusive information for evaluation of the region of interest and for planning of the procedure. The development of ultra-fast acquisition techniques and display of MR images enables near real-time imaging (MR-Fluoroscopy or step-by-step) for continuous action control even in low-field MR-Scanners. Conclusion Pain therapy in an interventional MR-unit is a safe and feasible procedure without irradiation. Multiplanar imaging for exact positioning of the instrument and the use of fluoroscopy to save time are the main advantages of the MR guidance. Performing the diagnosis and the therapy in the same session is another potential advantage.