The Rate of Magnetic Resonance Imaging in Patients with Deep Brain Stimulation
The Rate of Magnetic Resonance Imaging in Patients with Deep Brain Stimulation
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DOI：
10.1159/000444760
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发表时间：
2016-01-01
影响因子：
1.7
通讯作者：
Hargens, Lies
中科院分区：
文献类型：
--
作者：
Falowski, Steven;Safriel, Yak;Hargens, Lies
背景资料：对于植入脑深部电刺激（DBS）植入物的帕金森病（PD）、原发性震颤（ET）和肌张力障碍患者，磁共振成像（MRI）由于潜在的危险相互作用而需要额外的安全性考虑。目的：分析DBS植入患者的倾向匹配队列，以确定需要MRI的可能性。研究方法：在Truven Health MarketScan（R）商业索赔和医疗保险补充数据库（2009-2012）中识别了植入新DBS全系统植入物的患者（n = 576）。确定了诊断为PD、ET或肌张力障碍且未植入DBS的患者（DBS适应症患者：n = 11，216）。DBS适应症患者连续入组4年，并根据共病情况与DBS植入患者的年龄、性别和倾向评分相匹配（分别为n = 4，878和543）。首次MRI时间的Kaplan-Meier生存曲线外推至10年。结果：估计56-57%的DBS适应症患者在植入后5年内需要进行MRI，66-75%的患者在植入后10年内需要进行MRI。植入DBS的患者中，92%的植入后MRI是头部MRI，而对于DBS适应症患者，62%的MRI是身体MRI，可能与初步诊断无关。结论：该分析强调了DBS人群中MRI在头部和全身图像中的预计使用。(C)2016作者（s）由S. Karger AG，巴塞尔
Background: For Parkinson's disease (PD), essential tremor (ET), and dystonia patients with deep brain stimulation (DBS) implants, magnetic resonance imaging (MRI) requires additional safety considerations due to potentially hazardous interactions. Objective: A propensity-matched cohort of DBS-implanted patients was analyzed to determine the likelihood of needing MRI. Methods: Patients with new DBS full-system implants (n = 576) were identified in the Truven Health MarketScan (R) Commercial Claims and Medicare Supplemental Databases (2009-2012). Patients diagnosed with PD, ET, or dystonia and no DBS implant were identified (DBS-indicated patients: n = 11,216). The DBS-indicated patients were continuously enrolled for 4 years and matched for age, gender, and propensity score based on comorbid conditions to DBS-implanted patients (n = 4,878 and 543, respectively). A Kaplan-Meier survival curve of time to first MRI was extrapolated to 10 years. Results: An estimated 56-57% of DBS-indicated patients need an MRI within 5 years and 66-75% within 10 years after implantation. While 92% of DBS-implanted patients' MRI after implantation was of the head, for DBS-indicated patients, 62% of MRIs were of the body, potentially unrelated to the primary diagnosis. Conclusions: This analysis highlights the projected utilization of MRI in the DBS population for head and full-body images. (C) 2016 The Author(s) Published by S. Karger AG, Basel