Neurostimulation system used for deep brain stimulation (DBS): MR safety issues and implications of failing to follow safety recommendations
Neurostimulation system used for deep brain stimulation (DBS): MR safety issues and implications of failing to follow safety recommendations
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DOI：
10.1097/01.rli.0000124940.02340.ab
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发表时间：
2004-05-01
影响因子：
6.7
通讯作者：
Shellock, FG
中科院分区：
文献类型：
--
作者：
Rezai, AR;Phillips, M;Shellock, FG
在使用神经刺激系统进行脑深部刺激的患者中使用磁共振成像（MRI）需要极其小心，在没有经验证据表明可以安全进行手术的情况下，任何人都不应接受MR检查。对带有神经刺激器的患者进行MR的风险包括与发热、磁场相互作用、感应电流和这些器械的功能中断相关的风险。MRI必须严格遵循特定神经刺激系统关于脉冲发生器、电极导线、电极、器械操作条件、这些组件的定位以及MR系统条件的确切安全建议。正如最近发生的2起事故所强调的那样，未能严格遵循安全建议（例如，仅使用带有发送/接收头射频线圈的1.5 T MR系统;将比吸收率限制为0.4 W/kg;等）可能对患者造成严重的、暂时的或永久性的伤害，包括可能出现暂时性肌张力障碍、瘫痪、昏迷甚至死亡。
The use of magnetic resonance imaging (MRI) in patients with neurostimulation systems used for deep brain stimulation requires the utmost care, and no individual should undergo an MR examination in the absence of empirical evidence that the procedure can be performed safely. The risks of performing MR] in patients with neurostimulators include those associated with heating, magnetic field interactions, induced currents, and the functional disruption of these devices. The exact safety recommendations for the particular neurostimulation system with regard to the pulse generator, leads, electrodes, operational conditions for the device, the positioning of these components, and the MR system conditions must be carefully followed for MRI. As highlighted by 2 recent accidents, the failure to strictly follow safety recommendations (eg, use a 1.5-T MR system with a send/receive head radiofrequency coil only; limit the specific absorption rate to 0.4 W/kg; etc.) may result in serious, temporary, or permanent injury to the patient including the possibility of transient dystonia, paralysis, coma, or even death.