Department of Radiology, Charité, Humboldt-University Medical School, Charitéplatz 1, 10117 Berlin, Germany.
Eur Radiol. 2011 May;21(5):1043-9. doi: 10.1007/s00330-010-2011-4. Epub 2010 Nov 30.
To evaluate the feasibility of MR-guided discography using an open 1 Tesla MRI system.
48 disc segments of 41 patients scheduled for intradiscal thermal treatment, total disc replacement or spondylodesis were examined. A 1.0-T open MRI was used for instrument guidance and imaging. After primary disc puncture under guidance of interactive PDw TSE imaging, 1-2 ml of gadolinium contrast saline mixture was injected into the disc. The occurrence of memory pain during injection was recorded. Axial and sagittal T1w TSE images with and without fat saturation were obtained. All MRI discograms were analysed by two readers, who were blinded to the clinical findings.
Overall, the placement of the puncture needle in the targeted disc was accurate under real-time MR guidance. Injections were technically successful in all cases. No major complications occurred. The mean procedure time was 17 min (range 13-34 min). Image quality of contrast-enhanced MR discograms was excellent when using an optimized gadolinium contrast saline mixture of 1:600. Memory pain was detected in 16 out of 48 affected segments.
MR-guided discography is accurate and safe. Multiplanar dynamic imaging facilitates the puncture of discs and provides high-quality MR discograms.
评估使用开放式 1 特斯拉 MRI 系统进行磁共振引导下椎间盘造影的可行性。
对 41 例拟行椎间盘内热治疗、全椎间盘置换或脊柱融合术的患者的 48 个椎间盘节段进行了检查。采用 1.0-T 开放式 MRI 进行器械引导和成像。在交互式 PDw TSE 成像引导下进行初步椎间盘穿刺后，向椎间盘内注射 1-2 毫升钆造影盐水混合物。记录注射过程中记忆痛的发生情况。获得有和没有脂肪饱和的轴向和矢状 T1w TSE 图像。两位读者对所有 MRI 椎间盘造影进行了分析，他们对临床结果不知情。
总体而言，在实时 MR 引导下，穿刺针准确地置于目标椎间盘内。在所有病例中，注射均技术成功，无重大并发症发生。平均手术时间为 17 分钟（范围 13-34 分钟）。使用优化的 1:600 钆造影盐水混合物，增强磁共振椎间盘造影的图像质量极佳。在 48 个受影响的节段中，有 16 个出现了记忆痛。
磁共振引导下椎间盘造影术准确、安全。多平面动态成像有助于椎间盘穿刺，并提供高质量的磁共振椎间盘造影。
