In vivo feasibility of real-time MR–US fusion imaging lumbar facet joint injections

Riccardo Sartoris, Davide Orlandi, Angelo Corazza, Luca Maria Sconfienza, Alice Arcidiacono, Silvia Perugin Bernardi, Simone Schiaffino, Giovanni Turtulici, Pietro Caruso, Enzo Silvestri

Research output: Contribution to journalArticlepeer-review


Objectives: Traditionally, facet joint injections (FJI) are performed under fluoroscopic or computed tomography (CT) guidance, mainly due to the deep anatomical location and the presence of bony landmarks. Fusion imaging technology, which couples the ultrasound scan with the corresponding CT or magnetic resonance (MR) image obtained from the diagnostic examination and reformatted in real time according to the ultrasound scanning plane, allows to combine the panoramic view and the elevated anatomical detail of MR or CT with the ease of use of ultrasound without patient exposure to ionizing radiation. Methods: Thirty eight patients (24 females; mean age ± SD: 64 ± 9 years) received MR fusion-assisted ultrasound-guided FJI of 1 ml of a mixture of local anaesthetic and corticosteroid using a ultrasound machine (Logiq E9, GE Healthcare) equipped with a GPS-enhanced fusion imaging technology which couples real-time B-mode images with those of the previous recent diagnostic MR examination. Low-dose CT needle positioning confirmation was performed in the first 28 patients. Patients’ pain was recorded using a visual analogue scale (VAS), at baseline and at 2, 4 and 8 weeks. Results: All fusion imaging-guided injections were performed successfully. Out of 112, 96 FJI had optimal intra-articular needle positioning (accuracy: 85.7%). Patients VAS significantly decreases after the procedure with no differences among who received CT needle positioning control and who did not receive it. No major complications were observed. Conclusions: Ultrasound needle guidance with MR fusion assistance allows for safe and effective injection of degenerative facet joint disease.

Original languageEnglish
Pages (from-to)23-31
Number of pages9
JournalJournal of Ultrasound
Issue number1
Publication statusPublished - Mar 1 2017


  • Facet joint
  • Fusion imaging
  • Injection
  • Magnetic resonance
  • Ultrasound

ASJC Scopus subject areas

  • Internal Medicine
  • Radiology Nuclear Medicine and imaging


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