Reducing RF-related heating of cardiac pacemaker leads in MRI: Implementation and experimental verification of practical design changes
Reducing RF-related heating of cardiac pacemaker leads in MRI: Implementation and experimental verification of practical design changes
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DOI：
10.1002/mrm.24197
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发表时间：
2012-11-01
影响因子：
3.3
通讯作者：
Quick, Harald H.
中科院分区：
文献类型：
--
作者：
Nordbeck, Peter;Fidler, Florian;Quick, Harald H.
在植入了导电医疗器械（例如心脏起搏器和相关电极导线）的患者中进行磁共振成像时，存在严重的安全性问题，因为过去曾发生过严重事件。在本研究中，系统地开发和评价了几种改变植入物电极导线设计的方法，以提高植入式医疗器械在磁共振成像环境中的安全性。然后在1.5 T下，在功能电极导线原型中系统研究了每项设计变更对射频致热的单独影响。通过对传统起搏器电极导线设计进行三项基本变更可成功减少射频致热：（1）增加电极导线头端面积，（2）增加电极导线导体电阻，（3）增加外部电极导线绝缘电导率。研究结果表明，可以减少磁共振成像中的射频能量拾取，因此，根据安全的设计策略，通过专用结构变更可以提高患者安全性。将所描述的改变结合到植入式医疗器械（例如起搏器导线）中可用于在相应患者组中执行磁共振成像时帮助实现有利的风险受益比。Magn Reson Med，2012年。(c)2012 Wiley Periodicals，Inc.
There are serious concerns regarding safety when performing magnetic resonance imaging in patients with implanted conductive medical devices, such as cardiac pacemakers, and associated leads, as severe incidents have occurred in the past. In this study, several approaches for altering an implant's lead design were systematically developed and evaluated to enhance the safety of implanted medical devices in a magnetic resonance imaging environment. The individual impact of each design change on radiofrequency heating was then systematically investigated in functional lead prototypes at 1.5 T. Radiofrequency-induced heating could be successfully reduced by three basic changes in conventional pacemaker lead design: (1) increasing the lead tip area, (2) increasing the lead conductor resistance, and (3) increasing outer lead insulation conductivity. The findings show that radiofrequency energy pickup in magnetic resonance imaging can be reduced and, therefore, patient safety can be improved with dedicated construction changes according to a safe by design strategy. Incorporation of the described alterations into implantable medical devices such as pacemaker leads can be used to help achieve favorable risk-benefit-ratios when performing magnetic resonance imaging in the respective patient group. Magn Reson Med, 2012. (c) 2012 Wiley Periodicals, Inc.