E-ISSN: 1305-3612
    1.5 T augmented reality navigated interventional MRI: paravertebral sympathetic plexus injections
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    Interventional Radiology - Original Article
    VOLUME: 23 ISSUE: 3
    P: 227-232
    May 2017

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

    Diagn Interv Radiol 2017;23(3):227-232
    DOI: 10.5152/dir.2017.16323
    David R. Marker 1
    Paweena U-Thainual 2
    Tamas Ungi 3
    Aaron J. Flammang 4
    Gabor Fichtinger 3
    Iulian I. Iordachita 5
    John A. Carrino 1
    Jan Fritz 1
    1. Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    2. Department of Mechanical and Materials Engineering, Queen’s University, Kingston, Ontario, Canada
    3. School of Computing, Queen’s University, Kingston, Ontario, Canada
    4. Siemens Corporate Research, Center for Applied Medical Imaging, Baltimore, Maryland, USA
    5. Department of Mechanical Engineering and Laboratory for Computational Sensing and Robotics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    No information available.
    No information available
    Received Date: 22.06.2016
    Accepted Date: 03.01.2017
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    ABSTRACT

    PURPOSE:

    The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner.

    METHODS:

    A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%), and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1.5 Tesla (T) MRI scanner and augmented reality navigation system. MRI-conditional needles were used. Gadolinium-DTPA-enhanced saline was injected. Outcome variables included the number of control magnetic resonance images, target error of the needle tip, punctures of critical nontarget structures, distribution of the injected fluid, and procedure length.

    RESULTS:

    Augmented-reality navigated MRI guidance at 1.5 T provided detailed anatomical visualization for successful targeting of the paravertebral space, needle placement, and perineural paravertebral injections in 46 of 46 targets (100%). A mean of 2 images (range, 1–5 images) were required to control needle placement. Changes of the needle trajectory occurred in 9 of 46 targets (20%) and changes of needle advancement occurred in 6 of 46 targets (13%), which were statistically not related to spinal regions (P = 0.728 and P = 0.86, respectively) and cadaver sizes (P = 0.893 and P = 0.859, respectively). The mean error of the needle tip was 3.9±1.7 mm. There were no punctures of critical nontarget structures. The mean procedure length was 33±12 min.

    CONCLUSION:

    1.5 T augmented reality-navigated interventional MRI can provide accurate imaging guidance for perineural injections of the thoracic, lumbar, and hypogastric sympathetic plexus.

    References

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