Department of Radiology, Humboldt University of Berlin, Berlin, Germany.
Invest Radiol. 2013 Jun;48(6):471-6. doi: 10.1097/RLI.0b013e31828362be.
The objective of this study was to evaluate the accuracy, safety, and efficacy of magnetic resonance (MR)-guided periradicular nerve root injection therapy using an open 1.0-T magnetic resonance imaging (MRI) system with fast dynamic imaging.
Between April 2008 and November 2011, a total of 249 MR-guided periradicular nerve root injections were performed in 141 patients experiencing lumbosacral radicular pain. All interventions were performed in an open 1.0-T MRI system. An interactive proton-density-weighted fast spin-echo sequence was used for real-time guidance. An in-room monitor, a wireless MR mouse for operator-controlled multiplanar imaging, a flexible surface coil, and an MR-compatible 20-G needle were used. Informed consent was obtained from all patients. Clinical outcome was evaluated through clinical follow-up and a questionnaire before injection therapy (baseline) and 6 months after using a numeric visual analog scale.
All procedures were technically successful. No major complications occurred. At 6 months, of the 103 patients (197 injections; 57 men, 46 women; mean age, 49.5 years; range, 20-80) who enrolled in the outcome analysis, 14.6% reported complete remission of radicular pain; 53.4%, significant relief of pain; 22.3%, mild relief; and 9.7%, no relief of pain. We found a significant decrease of the visual analog scale score from the preintervention compared with the follow-up after 6 months (P < 0.001). No significant difference in the outcome was observed between the patients with degenerative foraminal stenoses and the patients with herniated disks.
Magnetic resonance fluoroscopy-guided periradicular injection therapy for the lumbosacral spine under open 1.0-T MRI guidance is accurate, safe, and efficient in the symptomatic treatment of radicular pain. This technique may be a promising alternative to fluoroscopy- or computed tomography-guided spinal injections in the lumbosacral region, especially for young patients and patients undergoing serial therapeutic regimens.
本研究旨在评估使用开放式 1.0T 磁共振成像（MRI）系统和快速动态成像进行磁共振（MR）引导下经皮神经根周围注射治疗的准确性、安全性和疗效。
2008 年 4 月至 2011 年 11 月，对 141 例经历腰骶神经根痛的患者共进行了 249 例 MR 引导下经皮神经根周围注射。所有介入均在开放式 1.0T MRI 系统中进行。使用交互式质子密度加权快速自旋回波序列进行实时引导。使用室内监视器、供操作者控制多平面成像的无线 MR 鼠标、柔性表面线圈和兼容 MR 的 20-G 针进行操作。所有患者均获得知情同意。通过临床随访和注射治疗前（基线）和 6 个月后的问卷调查评估临床结果，使用数字视觉模拟量表进行评估。
所有程序均技术成功。未发生重大并发症。在纳入结局分析的 103 例患者（197 次注射；57 例男性，46 例女性；平均年龄 49.5 岁；范围 20-80 岁）中，14.6%报告神经根痛完全缓解；53.4%报告疼痛显著缓解；22.3%报告轻度缓解；9.7%报告疼痛无缓解。我们发现与 6 个月后的随访相比，视觉模拟量表评分在干预前显著降低（P<0.001）。在退行性椎间孔狭窄患者和椎间盘突出患者之间，结局无显著差异。
开放式 1.0T MRI 引导下经皮神经根周围注射治疗腰骶脊柱是准确、安全和有效的，可有效治疗神经根痛症状。该技术可能是腰骶部透视或 CT 引导下脊柱注射的有前途的替代方法，特别是对于年轻患者和接受连续治疗方案的患者。
