Evidence map›Paper›PMID 26791162›Full record

ArticleSkeletal radiology2016

MR-guided perineural injection of the ganglion impar: technical considerations and feasibility.

David R Marker, Paweena U-Thainual, Tamas Ungi, Aaron J Flammang, Gabor Fichtinger, Iulian I Iordachita, John A Carrino, Jan Fritz

Abstract read
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In one paragraph

Article in Skeletal radiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.7field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 19 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

David R MarkerRussell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 North Caroline Street, JHOC 3140A, Baltimore, MD, 21287, USA.
Paweena U-ThainualDepartment of Mechanical and Materials Engineering, Queen's University, 99 University Avenue, Kingston, ON, Canada.
Tamas UngiSchool of Computing, Queen's University, 557 Goodwin Hall, Queen's University, Kingston, ON, Canada.
Aaron J FlammangSiemens Corporate Research, Center for Applied Medical Imaging, Baltimore, MD, USA.
Gabor FichtingerSchool of Computing, Queen's University, 557 Goodwin Hall, Queen's University, Kingston, ON, Canada.
Iulian I IordachitaDepartment of Mechanical Engineering and Laboratory for Computational Sensing and Robotics, Johns Hopkins University, 3400 N. Charles St., Hackerman 112, Baltimore, MD, 21218, USA.
John A CarrinoRussell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 North Caroline Street, JHOC 3140A, Baltimore, MD, 21287, USA.
Jan FritzRussell H. Morgan Department of Radiology and Radiological Science, Musculoskeletal Radiology, Johns Hopkins University School of Medicine, 601 North Caroline Street, JHOC 3140A, Baltimore, MD, 21287, USA. jfritz9@jhmi.edu.
Johns Hopkins University · USQueen's University · CAJohns Hopkins Medicine · USSiemens (United States) · US

Funding

Image Overlay for MRI-Guided Needle InsertionsR01CA118371 · NCI · JOHNS HOPKINS UNIVERSITY · PI CARRINO, JOHN ANTHONY · 2007 to 2010
$1.4M
NCI NIH HHS 1 R01 CA118371-01A2
6 · The paper itself

Abstract

objectivePerineural ganglion impar injections are used in the management of pelvic pain syndromes; however, there is no consensus regarding the optimal image guidance. Magnetic resonance imaging (MRI) provides high soft tissue contrast and the potential to directly visualize and target the ganglion. The purpose of this study was to assess the feasibility of MR-guided percutaneous perineural ganglion impar injections. MATERIALS AND

methodsSix MR-guided ganglion impar injections were performed in six human cadavers. Procedures were performed with a clinical 1.5-Tesla MRI system through a far lateral transgluteus approach. Ganglion impar visibility, distance from the sacrococcygeal joint, number of intermittent MRI control steps required to place the needle, target error between the intended and final needle tip location, inadvertent punctures of non-targeted vulnerable structures, injectant distribution, and procedure time were determined.

resultsThe ganglion impar was seen on MRI in 4/6 (66 %) of cases and located 0.8 mm cephalad to 16.3 mm caudad (average 1.2 mm caudad) to the midpoint of the sacrococcygeal joint. Needle placement required an average of three MRI control steps (range, 2-6). The average target error was 2.2 ± 2.1 mm. In 6/6 cases (100 %), there was appropriate periganglionic distribution and filling of the presacrococcygeal space. No punctures of non-targeted structures occurred. The median procedure time was 20 min (range, 12-29 min).

conclusionInterventional MRI can visualize and directly target the ganglion impar for accurate needle placement and successful periganglionic injection with the additional benefit of no ionizing radiation exposure to patient and staff. Our results support clinical evaluation.

Indexed as

AgedAutonomic Nerve BlockCadaverFeasibility StudiesFemaleGanglia, SympatheticHumansImage EnhancementMagnetic Resonance Imaging, InterventionalMiddle AgedPelvic PainReproducibility of ResultsSensitivity and SpecificityGanglion imparInterventional MRINerve blockNerve injectionPelvic pain

Identifiers

PMID26791162
OpenAlexW2297041219

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.