Topics in magnetic resonance imaging : TMRI
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Magnetic resonance (MR)-guided spine injections describe techniques for selective spine injection procedures, in which MR imaging is used to visualize spinal targets and needle placement, monitor the injected drugs, and detect spread to potentially confounding nearby structures. The introduction of clinical high-field wide-bore MR imaging systems has increased the practicability and availability of MR-guided spine injections. ⋯ Magnetic resonance imaging guidance provides excellent osseous and soft-tissue detail of spinal structures and is well suited to avoid radiation exposure. In this article, we discuss the technical background of interventional MR imaging, review the literature, and illustrate interventional MR imaging techniques of commonly performed spinal injection procedures, including sacroiliac joint injections, lumbar facet joint injections, selective spinal nerve root infiltration, and percutaneous drug delivery to the lumbar sympathetic nerves.
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Top Magn Reson Imaging · Aug 2011
ReviewMagnetic resonance-guided interventions of large and small joints.
Magnetic resonance (MR)-guided interventions of large and small joints are feasible and safe procedures offering several advantages compared with standard guiding techniques. Nevertheless, MR-guided interventions are not routinely performed in daily practice apart from a few centers. Accurate injections are crucial for clinical outcome in diagnostic arthrography as well as therapeutic joint injections. ⋯ Thus, a tailored approach such as a posterior technique for suspected anterior lesions in shoulder MR arthrography is possible. In this article, we describe the advantages and limitations of MR guidance in joint interventions with focus on shoulder and hip interventions. We review the requirements for needle material and MR sequences, discuss several different techniques developed to date, and present current results in clinical outcome.
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Top Magn Reson Imaging · Apr 2011
ReviewMagnetic resonance imaging of spondyloarthritis: spine and SI joints.
Magnetic resonance imaging (MRI) has been recently introduced as a classification criterion for spondyloarthropathies in the Assessment of Spondylarthritis International Society criteria. Therefore, it plays an increasingly important role in the diagnostic workup of spondyloarthropathies. In this article, we will review the MRI imaging features of axial spondyloarthritis from sacroiliitis to spine abnormalities; we will explain the rationale for MRI imaging, the evidence for whole body MRI, and we will approach the use of MRI for monitoring treatment response.
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The technology of musculoskeletal magnetic resonance imaging is advancing at a dramatic rate. Magnetic resonance imaging is now done at medium and higher field strengths with more specialized surface coils and with more variable pulse sequences and postprocessing techniques than ever before. ⋯ Substantial technical advances have considerable clinical challenges in musculoskeletal radiology such as postoperative patient imaging, cartilage mapping, and molecular imaging. In this review, we consider technical advances in hardware and software of musculoskeletal magnetic resonance imaging along with their clinical applications.
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Determining the cause of acute pelvic pain in the female patient is often a clinical challenge. Diagnostic imaging can be invaluable in this situation. Ectopic pregnancy, pelvic inflammatory disease, and hemorrhagic ovarian cysts are the most commonly diagnosed gynecologic conditions presenting with acute pelvic pain. ⋯ Other causes to consider include endometriosis, and postpartum causes such as endometritis, or ovarian vein thrombosis. Finally, nongynecologic conditions may overlap in their presentation of acute pelvic pain and should also be considered. The most important of these is acute appendicitis.