Safety of MRI in patients with retained cardiac leads.
Safety of MRI in patients with retained cardiac leads.
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DOI：
10.1002/mrm.29116
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发表时间：
2022-05
影响因子：
3.3
通讯作者：
Golestanirad L
中科院分区：
文献类型：
--
作者：
Nguyen BT;Bhusal B;Rahsepar AA;Fawcett K;Lin S;Marks DS;Passman R;Nieto D;Niemzcura R;Golestanirad L
通过数值模拟和体模实验，评价MRI在保留电极导线碎片（FRL）患者中的安全性。进行了电磁和热模拟，以确定在1.5 T和3 T MRI期间以及在对应于头部、胸部和腹部的成像标志处，10个患者源FRL模型的最差情况射频致热。在植入重建FRL模型的体模中进行射频产热测量，重建FRL模型在数值模拟中产生最高产热。通过保守估计沿FRL长度沿着产生的梯度感应电压在组织中感应的电场，评估非预期组织刺激的可能性。在保守方法下的模拟中，B1 + ≤ 2 µT的RF暴露在1.5 T和3 T下的所有成像标志处均产生43 < 40的累积等效分钟（CEM），表明采集时间（TA）< 10 min时无热损伤。在实验中，当FRL位于最大电场暴露位置时，测得的最大温升在3 T下为2.4°C，在1.5 T下为2.1°C。在所有情况下，梯度感应电压在组织中感应的电场均保持低于心脏组织刺激阈值。仿真和实验结果表明，FRL患者可以安全地扫描在1.5 T和3 T与大多数临床脉冲序列。
To evaluate the safety of MRI in patients with fragmented retained leads (FRLs) through numerical simulation and phantom experiments. Electromagnetic and thermal simulations were performed to determine the worst‐case RF heating of 10 patient‐derived FRL models during MRI at 1.5 T and 3 T and at imaging landmarks corresponding to head, chest, and abdomen. RF heating measurements were performed in phantoms implanted with reconstructed FRL models that produced highest heating in numerical simulations. The potential for unintended tissue stimulation was assessed through a conservative estimation of the electric field induced in the tissue due to gradient‐induced voltages developed along the length of FRLs. In simulations under conservative approach, RF exposure at B1 + ≤ 2 µT generated cumulative equivalent minutes (CEM)43 < 40 at all imaging landmarks at both 1.5 T and 3 T, indicating no thermal damage for acquisition times (TAs) < 10 min. In experiments, the maximum temperature rise when FRLs were positioned at the location of maximum electric field exposure was measured to be 2.4°C at 3 T and 2.1°C at 1.5 T. Electric fields induced in the tissue due to gradient‐induced voltages remained below the threshold for cardiac tissue stimulation in all cases. Simulation and experimental results indicate that patients with FRLs can be scanned safely at both 1.5 T and 3 T with most clinical pulse sequences.
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影响因子：
3.3
作者：
Golestanirad, Laleh;Kazemivalipour, Ehsan;Kirsch, John
通讯作者：
Kirsch, John
影响因子：
4.8
作者：
Austin, Christopher O.;Landolfo, Kevin;Kusumoto, Fred M.
通讯作者：
Kusumoto, Fred M.
影响因子：
3.3
作者：
Klein V;Davids M;Schad LR;Wald LL;Guérin B
通讯作者：
Guérin B
影响因子：
3.3
作者：
Golestanirad L;Rahsepar AA;Kirsch JE;Suwa K;Collins JC;Angelone LM;Keil B;Passman RS;Bonmassar G;Serano P;Krenz P;DeLap J;Carr JC;Wald LL
通讯作者：
Wald LL
影响因子：
4.4
作者：
Cheng, HLM;Plewes, DB
通讯作者：
Plewes, DB