MR-guided discography using an open 1 Tesla MRI system.
OBJECTIVE
To evaluate the feasibility of MR-guided discography using an open 1 Tesla MRI system.


METHODS
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.


RESULTS
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.


CONCLUSIONS
MR-guided discography is accurate and safe. Multiplanar dynamic imaging facilitates the puncture of discs and provides high-quality MR discograms.
Department of Radiology, Charité, Humboldt-University Medical School, Charitéplatz 1, 10117 Berlin, Germany. florian.streitparth@charite.de
Florian
F
Streitparth
T
T
Hartwig
B
B
Schnackenburg
P
P
Strube
M
M
Putzier
S
S
Chopra
M
M
De Bucourt
B
B
Hamm
U
U
Teichgräber
D000328:Adult; D015992:Body Mass Index; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain; D011446:Prospective Studies; D015203:Reproducibility of Results
D003287:Contrast Media