title: Saline as the sole contrast agent for successful MRI-guided epidural injections.
abstract: OBJECTIVE
  To assess the performance of sterile saline solution as the sole contrast agent for percutaneous magnetic resonance imaging (MRI)-guided epidural injections at 1.5 T.
  
  
  METHODS
  A retrospective analysis of two different techniques of MRI-guided epidural injections was performed with either gadolinium-enhanced saline solution or sterile saline solution for documentation of the epidural location of the needle tip. T1-weighted spoiled gradient echo (FLASH) images or T2-weighted single-shot turbo spin echo (HASTE) images visualized the test injectants. Methods were compared by technical success rate, image quality, table time, and rate of complications.
  
  
  RESULTS
  105 MRI-guided epidural injections (12 of 105 with gadolinium-enhanced saline solution and 93 of 105 with sterile saline solution) were performed successfully and without complications. Visualization of sterile saline solution and gadolinium-enhanced saline solution was sufficient, good, or excellent in all 105 interventions. For either test injectant, quantitative image analysis demonstrated comparable high contrast-to-noise ratios of test injectants to adjacent body substances with reliable statistical significance levels (p < 0.001). The mean table time was 22 ± 9 min in the gadolinium-enhanced saline solution group and 22 ± 8 min in the saline solution group (p = 0.75).
  
  
  CONCLUSIONS
  Sterile saline is suitable as the sole contrast agent for successful and safe percutaneous MRI-guided epidural drug delivery at 1.5 T.
authors.affiliation: Department of Radiology and Microtherapy, Groenemeyer Institute for Microtherapy (GIMT), University of Witten/Herdecke, Universitaetsstrasse 142, 44799 Bochum, Germany. martin.deli@web.de
authors.forename: Martin
authors.initials: M
authors.lastname: Deli
authors.forename: Jan
authors.initials: J
authors.lastname: Fritz
authors.forename: Serban
authors.initials: S
authors.lastname: Mateiescu
authors.forename: Martin
authors.initials: M
authors.lastname: Busch
authors.forename: John A
authors.initials: JA
authors.lastname: Carrino
authors.forename: Jan
authors.initials: J
authors.lastname: Becker
authors.forename: Marietta
authors.initials: M
authors.lastname: Garmer
authors.forename: Dietrich
authors.initials: D
authors.lastname: Grönemeyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007268:Injections, Epidural; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008536:Meglumine / Q000008:administration & dosage; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D012965:Sodium Chloride; D008536:Meglumine; D019786:Gadolinium DTPA; C072417:gadoterate meglumine