Carrino John A, Blanco Roberto
Division of Musculoskeletal Radiology, Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Semin Musculoskelet Radiol. 2006 Jun;10(2):159-74. doi: 10.1055/s-2006-939033. Epub 2006 Apr 1.
As an imaging modality, magnetic resonance (MR) guidance has great potential to direct diagnostic and therapeutic procedures performed in the musculoskeletal region and influence patient management. MR-guided interventional procedures involving bone, soft tissue, intervertebral discs, and joints are safe and sufficiently effective for use in clinical practice. This article discusses and illustrates the procedural characteristics and techniques when performing MR-guided musculoskeletal interventions. Biopsy procedures are similar to other modalities for bone and soft tissue lesions. MR guidance is advantageous if the lesion is not visible by other modalities and for regions adjacent to hardware and implants, subselective targeting, intra-articular locations, and periarticular cyst aspiration. MR guidance has also been used for a host of spine injections and pain management procedures such as sacroiliac joint injections, discography, transforaminal epidural injection, selective nerve block, sympathetic block, celiac plexus block, and facet joint cryotherapy neurotomies. Future directions of clinical applications include tumor ablation and multimodality procedure suites. MR-guided musculoskeletal procedures will continue to be a growth area particularly for the diagnosis and treatment of bone and soft tissue neoplasia.
作为一种成像方式，磁共振（MR）引导在指导肌肉骨骼区域的诊断和治疗程序以及影响患者管理方面具有巨大潜力。涉及骨骼、软组织、椎间盘和关节的MR引导介入程序在临床实践中使用是安全且足够有效的。本文讨论并阐述了进行MR引导的肌肉骨骼介入时的程序特点和技术。活检程序与用于骨和软组织病变的其他方式类似。如果病变在其他方式下不可见，以及对于与硬件和植入物相邻的区域、亚选择性靶向、关节内位置和关节周围囊肿抽吸，MR引导具有优势。MR引导还已用于一系列脊柱注射和疼痛管理程序，如骶髂关节注射、椎间盘造影、经椎间孔硬膜外注射、选择性神经阻滞、交感神经阻滞、腹腔神经丛阻滞和面关节冷冻神经切断术。临床应用的未来方向包括肿瘤消融和多模态程序套件。MR引导的肌肉骨骼程序将继续成为一个增长领域，特别是对于骨和软组织肿瘤的诊断和治疗。
