Cardiac MRI in patients with complex CHD following primary or secondary implantation of MRI-conditional pacemaker system
Cardiac MRI in patients with complex CHD following primary or secondary implantation of MRI-conditional pacemaker system
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DOI：
10.1017/s1047951115000190
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发表时间：
2016-02-01
影响因子：
1
通讯作者：
Peters, Bjoern
中科院分区：
文献类型：
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作者：
Al-Wakeel, Nadya;h-Ici, Darach O.;Peters, Bjoern
目的在冠心病患者中，心脏MRI常用于功能和解剖评估。随着最近引进的核磁共振条件起搏器系统，心脏MRI已成为心脏起搏器患者可访问。本临床研究旨在评估冠心病患者和MRI条件起搏器系统的安全性、易感性伪影和心脏MRI图像读取。材料与方法采用1.5 t磁共振成像系统对有条件心脏起搏器和临床需要心脏MRI的冠心病患者进行检查。MRI前后分别检测铅功能。人工制品和图像读数采用四分制进行评估。结果9例冠心病患者共接受11次心脏MRI检查，平均年龄34.0岁，范围19.5 ~ 53.6岁。由于临床适应症，7名患者先前已从常规起搏器系统转换为mri条件起搏器系统。所有MRI检查均完成，无不良反应。MRI后立即进行的设备测试和随访均未发现起搏器和导联功能的改变。临床问题可以在所有患者中得到解决和回答。结论在冠心病患者应用MRI条件起搏器时，可安全进行心脏MRI检查，诊断率高。如果有临床指征的导联和换盒，非mri条件起搏器系统的冠心病患者应考虑完全转换为mri条件起搏器系统。
Objectives In patients with CHD, cardiac MRI is often indicated for functional and anatomical assessment. With the recent introduction of MRI-conditional pacemaker systems, cardiac MRI has become accessible for patients with pacemakers. The present clinical study aims to evaluate safety, susceptibility artefacts, and image reading of cardiac MRI in patients with CHD and MRI-conditional pacemaker systems.Material and methods CHD patients with MRI-conditional pacemaker systems and a clinical need for cardiac MRI were examined with a 1.5-T MRI system. Lead function was tested before and after MRI. Artefacts and image readings were evaluated using a four-point grading scale.Results A total of nine patients with CHD (mean age 34.0 years, range 19.5-53.6 years) received a total of 11 cardiac MRI examinations. Owing to clinical indications, seven patients had previously been converted from conventional to MRI-conditional pacemaker systems. All MRI examinations were completed without adverse effects. Device testing immediately after MRI and at follow-up showed no alteration of pacemaker device and lead function. Clinical questions could be addressed and answered in all patients.Conclusion Cardiac MRI can be performed safely with high certainty of diagnosis in CHD patients with MRI-conditional pacemaker systems. In case of clinically indicated lead and box changing, CHD patients with non-MRI-conditional pacemaker systems should be considered for complete conversion to MRI-conditional systems.