Magnetic Resonance Neurography–Guided Nerve Blocks for the Diagnosis and Treatment of Chronic Pelvic Pain Syndrome

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

“…Aside from the limited availability of the above used open MRI scanners, because they are no longer commercially available, primary differences to the closed bore 1.5 T MRI scanner used in the present study are related to the lower field strength, which results in less homogeneity, lower MRI signal, limited image quality and longer imaging times. The augmented reality system used in the present study was able to overcome the barrier of patient access inherent to the closed bore magnet design, which may also be used with modern 3.0 T MRI scanners (31,32).…”

Pudendal Nerve Blockade

“…However, the advantage again lies with excellent tissue resolution to image the target nerve for accurate needle placement and injection. MRI also allows for the visualization of oblique needle paths through the use of multiplanar imaging capabilities [ 64 ]. Studies using MRN for pudendal nerve blockade have been limited to the diagnosis and therapy of chronic pelvic pain syndromes.…”

“…MRN can be especially useful to block the pudendal nerve within Alcock's canal, if clinically indicated [ 64 ]. The sensitivity of MRI at 1.5 T can allow operators to identify if an injection to Alcock's canal occurred inside or outside of the canal.…”

“…If a pudendal nerve blockade is being used to assist in the diagnosis of a pelvic pain syndrome, local anesthetic spread to the posterior femoral cutaneous nerve may lead to false-positive results [ 64 ].…”

3-Tesla High-Field Magnetic Resonance Neurography for Guiding Nerve Blocks and Its Role in Pain Management

“…1 Diagnostic nerve blocks with a local anesthetic are used to prove or disprove that a particular nerve is a substantial contributor to the patient's pain syndrome. 7,8 A nerve block may be used to confirm an MR neurographically abnormal-appearing nerve as the pain generator, to identify the pain-mediating nerves in the setting of multiple MR neurographically abnormalappearing nerves, and to identify a pain-mediating nerve in the case of a normal-appearing MR neurography examination.…”