European radiology
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To investigate the influence of age, sex and spinal level on perfusion parameters of normal lumbar bone marrow with dynamic contrast-enhanced MRI (DCE MRI). Sixty-seven subjects referred for evaluation of low back pain or sciatica underwent DCE MRI of the lumbar spine. After subtraction of dynamic images, a region of interest (ROI) was placed on each lumbar vertebral body of all subjects, and time intensity curves were generated. ⋯ All perfusion parameters, except for washout (WOUT), showed a mild linear correlation with age. Time to maximum slope (TMSP) and time to peak (TTPK) showed the same correlation with sex (0.22
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Mitochondrial disorders are a heterogeneous group of disorders affecting energy metabolism that can present at any age with a wide variety of clinical symptoms. We investigated brain magnetic resonance (MR) findings in 40 children with defects of the mitochondrial respiratory chain (MRC) complex and correlated them with the type of MRC defects. Enrolled were 40 children with MRC defects in biochemical enzyme assay of the muscle specimen. ⋯ Children with MRC defects showed various neuroradiologic features on brain MR imaging that resulted from a complex genetic background and a heterogeneous phenotype. Rapid progression of atrophy involving all structures of the brain with variable involvement of deep gray and white matter are the most frequent MR findings in children with MRC defects in both classical syndromes of mitochondrial disorder and nonspecific mitochondrial encephalomyopathies. The type of biochemical defect in the MRC complex enzyme did not correlate with brain MR findings in child patients.
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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.