MR-guided lumbar sympathicolysis

Abstract

The aim of this study was to demonstrate the feasibility of MR-guided lumbar sympathicolysis (LSL) in a non-selected patient population. One hundred one MR-guided LSL procedures were performed in 89 patients according to Haaga's technique using a horizontally open clinical MR system (0.2 T) and non-ferromagnetic 20-G cannulas (neurolysis, n=93; blockade, n=8). Only gradient-recalled sequences in either single or multislice mode [fast imaging with steady-state precession (FISP) and fast low-angle shot] were applied for anatomical survey and needle guiding. Bupivacaine injection was monitored with MR fluoroscopically. Fluid distribution was subsequently documented in a CT scan in 65 patients. Ninety-one LSL procedures could be successfully completed. Ten patients were not treated using MR due to patient inconvenience, severe motion artifacts ( n=4 each), excessive spondylophytes, and retroperitoneal hematoma ( n=1 each). One case of ureteral necrosis occurred. Motion artifacts were rated less severe in single-slice FISP sequences and in obese patients. An average of 3.48 sequence measurements were required for definitive needle placement. Average table time was 32.3 min. An MR-guided LSL is feasible and can be performed with acceptable safety and time effort. It can be recommended for repeated sympathetic blockades in younger patients to avoid cumulative irradiation associated with CT guidance.

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

“…Currently there are limited clinical studies regarding the efficacy of MRI-guided sympathetic interventional therapy (10,29,30). König et al (10) assessed clinical outcomes of low-field MRI-guided paravertebral lumbar sympathetic neurolysis.…”

“…König et al (10) assessed clinical outcomes of low-field MRI-guided paravertebral lumbar sympathetic neurolysis. The authors performed 101 MRI-guided procedures in 89 patients using a dedicated, horizontally open 0.2 T MRI scanner.…”

Aktuelle Therapie der fokalen Hyperhidrose

“…Die Studienlage ist hierbei schlechter als bei der ETS. Neuerdings wird auch die magnetresonanztomographisch-(MRT-)gesteuerte Sympathikolyse propagiert [21]. Weder für die axilläre, palmare oder plantare HyperhidAbb.…”

Evaluation of MR imaging guided steroid injection of the sacroiliac joints for the treatment of children with refractory enthesitis-related arthritis

“…In contrast to X-ray fluoroscopy and computed tomography, interventional MRI allows for image guidance without health risks from exposure to ionizing radiation [11][12][13][14][15][16][17][18][19][20][21][22]. To the best of our knowledge, no prior reports have been published assessing interventional MR imaging of the sacroiliac joints in children.…”