Magnetic resonance imaging in individuals with cardiovascular implantable electronic devices
Magnetic resonance imaging in individuals with cardiovascular implantable electronic devices
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DOI：
10.1093/europace/eun021
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发表时间：
2008-03-01
期刊：
影响因子：
6.1
通讯作者：
Sommer, Torsten
中科院分区：
文献类型：
--
作者：
Roguin, Ariel;Schwitter, Juerg;Sommer, Torsten
磁共振(MR)成像具有无与伦比的软组织成像能力。然而，起搏器和植入型心律转复除颤器(ICD)等设备的存在，历来被认为是磁共振成像的禁忌症。我们总结了设备与MR环境相互作用的潜在危害，并提供了关于体外和体内实验的最新信息，表明某些起搏器和ICD系统确实可能是MR安全的。最近关于数百名接受磁共振扫描安全检查的植入起搏器和ICD患者的报告表明，在特定条件下，拥有这些植入系统的个人可以从磁共振成像中受益。我们认为，在个案的基础上，磁共振成像的诊断益处超过了对一些起搏器和ICD患者的推测风险。因此，对于一些患者来说，考虑到这种强大的成像方式的诊断优势，在特定的、特征性的扫描和监测条件下进行MR成像所带来的风险可能是可以接受的。这可能对目前的影像实践有重大的临床意义。提出了一种在这些个体中进行磁共振成像的策略。
Magnetic resonance (MR) imaging has unparalleled soft-tissue imaging capabilities. The presence of devices such as pacemakers and implantable cardioverter-defibrillators (ICDs), however, was historically considered a contraindication to MR imaging. We summarize the potential hazards of the device-MR environment interaction, and present updated information regarding in vitro and in vivo experiments suggesting that certain pacemaker and ICD systems may indeed be MR-safe. Recent reports on several hundred patients with implantable pacemakers and ICDs who underwent MR scan safety indicate that, under certain conditions, individuals with these implanted systems may benefit from MR imaging. We believe that, on a case-by-case basis, the diagnostic benefit from MR imaging outweighs the presumed risks for some pacemaker and ICD patients. Thus for some patients, the risks presented by MR imaging under specific, characterized scanning and monitoring conditions may be acceptable given the diagnostic benefit of this powerful imaging modality. This may have major clinical implications on current imaging practice. A strategy for the performance of MR imaging in these individuals is proposed.