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

AI Article Synopsis

  • The study investigates the use of augmented reality navigation combined with 1.5T MRI for guiding paravertebral sympathetic nerve injections, highlighting its advantages like high contrast resolution and lack of ionizing radiation.
  • Conducted on 12 human cadavers, 23 injections were performed with MRI-conditional needles, focusing on parameters such as accuracy, time taken, and potential complications.
  • Results showed that the augmented reality navigation achieved 100% targeting accuracy with minimal needle error and no damage to surrounding structures, indicating its effectiveness for precise nerve injection procedures.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411005PMC
http://dx.doi.org/10.5152/dir.2017.16323DOI Listing

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