Magnetic resonance imaging/ultrasound fusion-guided sacroiliac joint corticosteroid injection in patients with axial spondyloarthritis.

Local glucocorticoid injections are used in the treatment of isolated sacroiliitis in patients with spondyloarthritis. Sacroiliac joint injections can be performed intraarticularly or periarticularly. Since the accuracy of blind injections is low, fluoroscopy, magnetic resonance imaging, computed tomography, or ultrasonography guidance are used to increase the accuracy of sacroiliac joint injections. Currently, imaging fusion software is successfully used in sacroiliac joint interventions with three-dimensional anatomic information added to ultrasonography. Herein, we present two cases of sacroiliac joint corticosteroid injections under ultrasonography-magnetic resonance imaging fusion guidance.

Fast three-dimensional time-of-flight magnetic resonance angiography: Should it be used in routine neuroimaging for headaches?

OBJECTIVES: We aimed to evaluate the diagnostic efficacy of fast three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) in the detection of cerebral aneurysms. METHODS: We screened 1589 patients over a 3-year period, who underwent a magnetic resonance imaging for headache. Fast 3D TOF MRA images taken in addition to routine neuroimaging sequences, which were examined by two independent observers to assess cerebral aneurysms. RESULTS: Sixty-nine aneurysms were detected in 63 patients. The locations of the aneurysms were as follows: Middle cerebral artery, 27.5% (n = 19); internal carotid artery, 53.6% (n = 37); anterior cerebral artery, 5.8% (n = 4); posterior cerebral artery, 5.8% (n = 4); anterior communicating artery, 5.8% (n = 4); and ophthalmic artery, 1.4% (n = 1). Thirty-five (50.7%) were 7 mm or less, 23 (33.3%) were 8-10 mm, and 11 (15.9%) were 11 mm or larger. About 88% of pathological cases (n = 61) were saccular and 12 (n = 8) were fusiform type aneurysms. The interobserver compliance was high (K = 0.83) for detecting the aneurysms. CONCLUSION: Considering the mortality and morbidity of subarachnoid hemorrhages, 3D TOF MRA is a successful, non-invasive method for detecting cerebral aneurysms. Results of the present study have shown that adding 3D TOF MRA to the routine brain imaging protocol is a beneficial tool for diagnosis.