A Magnetic Resonance Imaging-Conditional External Cardiac Defibrillator for Resuscitation Within the Magnetic Resonance Imaging Scanner Bore.
A Magnetic Resonance Imaging-Conditional External Cardiac Defibrillator for Resuscitation Within the Magnetic Resonance Imaging Scanner Bore.
复制标题
磁共振成像条件外部心脏除颤器，用于在磁共振成像扫描仪孔内复苏。
DOI：
10.1161/circimaging.116.005091
复制
发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Halperin HA
中科院分区：
文献类型：
--
作者：
Schmidt EJ;Watkins RD;Zviman MM;Guttman MA;Wang W;Halperin HA
在进行CPR和除颤之前，在MRI扫描仪内经历心脏骤停的受试者目前从孔中移除，然后从MRI套件中移除，这可能增加死亡风险。这使得许多高风险（急性缺血、急性卒中）患者无法接受MRI成像和MRI引导的介入治疗。MRI特定条件安全心脏除颤器应能够在连接除颤垫和发生器开启的情况下进行扫描，从而在心脏事件发生后的MRI秒内应用除颤。MRI条件性体外除颤器可提高患者对MRI程序的接受度。通过在发生器和市售一次性表面垫之间添加新型射频（RF）滤波器，使市售体外除颤器达到1.5 T MRI条件性。RF滤波器减少了进入MRI扫描仪的辐射，并防止了成像期间电缆/表面垫加热，同时保留了除颤器的所有监测和输送功能。使用高比吸收率序列对人类志愿者进行成像，以验证MRI图像质量（IQ）和无发热。对猪进行电原纤化（N = 4），然后在MRI孔的外部和内部进行除颤。发生器处于监测模式并分别使用电池或交流电源运行时，MRI IQ降低0.8或1.6 dB。商业表面垫没有产生深于皮肤表面以下6mm的伪影。射频致热符合FDA指南。MRI孔内外除颤完全成功。原型MRI条件性除颤系统在MRI中成功除颤，而不会降低图像质量或增加除颤所需的时间。它可以提高患者对MRI程序的接受度。
Subjects undergoing cardiac arrest within an MRI scanner are currently removed from the bore and then from the MRI suite, prior to delivery of CPR and defibrillation, potentially increasing risk of mortality. This precludes many higher-risk (acute-ischemic, acute-stroke) patients from undergoing MRI imaging and MRI-guided intervention. An MRI-conditional cardiac defibrillator should enable scanning with defibrillation pads attached and the generator ON, enabling application of defibrillation within the MRI seconds after a cardiac event. An MRI-conditional external defibrillator may improve patient acceptance for MRI procedures. A commercial external defibrillator was rendered 1.5 Tesla MRI-conditional by addition of novel Radio-Frequency (RF) filters between the generator and commercial disposable surface-pads. The RF filters reduced emission into the MRI scanner, and prevented cable/surface-pad heating during imaging, while preserving all the defibrillator’s monitoring and delivery functions. Human volunteers were imaged using high Specific-Absorption-Rate sequences to validate MRI image quality (IQ) and lack of heating. Swine were electrically fibrillated (N=4) and thereafter defibrillated both outside and inside the MRI bore. MRI IQ was reduced by 0.8 or 1.6 dB, with the generator in monitoring mode and operating on battery or AC power, respectively. Commercial surface-pads did not create artifacts deeper than 6mm below the skin surface. RF heating was within FDA guidelines. Defibrillation was completely successful inside and outside the MRI bore. A prototype MRI-conditional defibrillation system successfully defibrillated in the MRI without degrading image quality, or increasing the time needed for defibrillation. It can increase patient acceptance for MRI procedures.