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MR-guided PRT of left L5 nerve root

Case Study
Retzlaff, Sebastian, Dr. 360 MRT Praxis für offene Kernspintomografie • Germany

Patient history

36-year-old female with acute pain and dysaesthesia in left L5 dermatome, slight weakness in left M. extensor hallucis longus. Conservative treatment over 3 weeks without success.

MR examination

MR-guided PRT was done on Panorama HFO with ST Multi Purpose L coil using T1wTSE for needle visibility and fast fluoroscopic imaging, TR 600 ms, TE 10 ms, slice thickness 5.0 mm, in-plane resolution 0.89 x 2.53 mm, TSE factor 36, scan time 3.0 seconds, NSA 1, and CLEAR for image homogeneity. The in-room monitor shows the needle position. Interactive software allows fast and interactive navigation of the needle device.

Diagnostic images

 <center> T2w TSE </center> <center> B-TFE </center>
T2w TSE
B-TFE

Fast fluoroscopic imaging

MR results

Diagnostic lumbar spine MRI showed a left mediolateral disc prolapse in L4/5 with nerve root compression L5 left.

Fast fluoroscopic images show the position of needle tip and the surrounding bony and soft tissue structures at the level L5/S1. The needle is well visible thanks to the circumscribed distortion of magnetic field homogeneity by the needle. Periradicular pain therapy with MR guidance provides a truly visible nerve root without ionizing radiation.

Clinical impact of MR-guided PRT

The use of the Panorama HFO with ST Multiple Purpose L coil using T1wTSE for needle visibility and fast fluoroscopic imaging allows us to really see the nerve root and to have an excellent control of the needle tip. Periradicular pain therapy with MR guidance provides a truly visible nerve root without ionizing radiation.

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Oct 9, 2012

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Case Study
Panorama HFO
Body, interventional, Interventional, Lumbar spine, MR fluoroscopy, MR-guided interventions, ST multi porpose L coil
 

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