European radiology
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The quality of magnetic resonance (MR) angiography could be substantially improved over the past several years based on the introduction and application of parallel imaging, new sequence techniques, such as, e.g., centric k-space trajectories, dedicated contrast agents, and clinical high-field scanners. All of these techniques have played an important role to improve image resolution or decrease acquisition time for the dedicated examination of a single vascular territory. ⋯ The present review article describes the technical innovations with a focus on parallel imaging at high field strength and the impact on whole-body MR angiography. The clinical value of advanced whole-body MR angiography techniques is illustrated by characteristic cases.
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We prospectively evaluated the feasibility and technical properties of a dedicated interventional magnetic resonance (MR) imaging protocol for near-real-time MR fluoroscopy-guided bilateral lumbar facet joint injections. A total of 44 facet joint injections were performed in 22 patients using a C-shaped open 0.2-T MR imaging system (Magnetom Concerto, Siemens Medical Solutions, Erlangen, Germany). A T1/T2-weighted fast-imaging-with-steady-precession (FISP) sequence with an end-to-end latency of 1.2 s facilitated sufficient near real-time MR imaging guidance in all cases. ⋯ No complications occurred. Table time showed significant shortening over time with average table time of 33 (21-68.5) min. We conclude that MR fluoroscopy-navigated lumbar facet joint injections are feasible and safe.
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Ultrasound-guided, intraneural chemical nerve block was performed to control intractable limb spasticity and its feasibility was evaluated. Twenty-nine patients showing spastic limb were controlled by 53 intraneural injections of chemical agents, either lidocaine or phenol. The main targets were the sciatic, tibial and musculocutaneous nerves. ⋯ The average effective duration was 9.1+/-19.6 days in the lidocaine injection group and was 164.5+/-169.4 days in the permanent blocking group with phenol injection. The ultrasound-guided intraneural injection technique was convincing. Intraneural injection of phenol achieved long-lasting improvement of spasticity.