Cardiac magnetic resonance imaging at 1.5 T in patients with cardiac rhythm devices
Cardiac magnetic resonance imaging at 1.5 T in patients with cardiac rhythm devices
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DOI：
10.1093/europace/euq501
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发表时间：
2011-04-01
期刊：
影响因子：
6.1
通讯作者：
Salvador, Antonio
中科院分区：
文献类型：
--
作者：
Buendia, Francisco;Cano, Oscar;Salvador, Antonio
目的最近的研究表明，可以对选定的心律设备患者安全地进行非心脏磁共振成像（MRI）扫描。然而，很少有人知道在这种情况下进行特定的心脏MRI的安全性。我们试图确定心脏MRI的可行性与起搏器（PMs）或植入式心律转复除颤器（ICDs）的患者。方法和rsesults 38例患者共进行了39（8 ICD和31 PM）心脏MRI检查在1.5 T使用常规协议没有特定的吸收率（SAR）的限制。9例PM依赖患者入选。在MRI之前和之后立即询问所有器械。扫描期间，起搏模式被程控为PM依赖患者的异步模式，而ICD被程控为仅监测模式。心脏MRI后，所有器械均正常工作。MRI之前和之后即刻获得的器械参数比较显示，起搏阈值、电极导线阻抗、电池状态或感知信号振幅无显著变化。未报告临床事件或患者投诉。39次扫描中有11次（28.2%）出现明显的成像伪影。这些伪影在ICD中的发生率（8/8，100%）明显高于PM（3/31，9.7%）（P < 0.001）。在92.3%的情况下，诊断问题得到了回答，只有三个明显的伪影防止充分的诊断在三个ICD patient.Conclusions我们的研究结果表明，心脏MRI可以安全地进行在适当选择的患者密切监测扫描过程中没有限制的峰值SAR水平使用几种预防措施。图像伪影在ICD患者中更常见。
Aims Recent studies suggest that non-cardiac magnetic resonance imaging (MRI) scanning can be performed safely in selected cardiac rhythm device patients. However, little is known about the safety of performing specific cardiac MRI in this setting. We sought to determine the feasibility of cardiac MRI in patients with pacemakers (PMs) or implantable cardioverter-defibrillators (ICDs).Methods and rsesults Thirty-eight patients underwent a total of 39 (8 ICDs and 31 PM) cardiac MRI examinations at 1.5 T using usual protocols without specific absorption rate (SAR) restrictions. Nine PM-dependent patients were included. All devices were interrogated before and immediately after MRI. During the scan, pacing mode was programmed to asynchronous for PM-dependent patients whereas ICDs were programmed to a monitor-only mode. All devices were functioning appropriately after cardiac MRI. Comparison of device parameters obtained before and immediately after MRI revealed no significant changes in pacing threshold, lead impedance, battery status, or sensing signal amplitude. Neither clinical events nor patient complaints were reported. Significant imaging artefacts were present on 11 of 39 scans (28.2%). These artefacts were significantly more frequent in ICDs (8 of 8, 100%) vs. PMs (3 of 31, 9.7%) (P < 0.001). Diagnostic questions were answered in 92.3% of the cases, with just three pronounced artefacts preventing an adequate diagnosis in three ICD patients.Conclusions Our results suggest that cardiac MRI may be performed safely in appropriately selected patients with close monitoring during the scan without limitation of peak SAR level using several precautionary measures. Image artefacts were more frequent in ICD patients.