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磁共振成像对植入深部脑刺激系统患者的影响。

Effects of magnetic resonance imaging in patients with implanted deep brain stimulation systems.

机构信息

Department of Neurology and Neurosurgery, Magnetic Resonance Imaging Unit, University Hospital of Grenoble, INSERM U836, Grenoble Neuroscience Institute, Joseph Fourier University, Grenoble, France.

出版信息

J Neurosurg. 2010 Dec;113(6):1242-5. doi: 10.3171/2010.1.JNS09951. Epub 2010 Feb 26.

DOI:10.3171/2010.1.JNS09951
PMID:20187699
Abstract

OBJECT

The aim of this study was to study the effects of MR imaging on the electrical settings of deep brain stimulation (DBS) systems and their clinical consequences.

METHODS

The authors studied the effects of 1.5-T MR imaging on the electrical settings of implanted DBS systems, including 1 or more monopolar or quadripolar leads, extension leads, and single- or dual-channel implantable pulse generators (IPGs). The IPG was switched off during the procedure and the voltage was set to 0. The impedances were checked before and after MR imaging.

RESULTS

Five hundred seventy patients were treated with DBS for movement disorders and underwent brain MR imaging after lead implantation and before IPG implantation. None of the patients experienced any adverse events. Thirty-one of these patients underwent 61 additional MR imaging sessions after the entire DBS system had been implanted. The authors report neither local cutaneous nor neurological disorders during or after the MR imaging session. No change in the IPG settings occurred when the magnet reed switch function remained disabled during the procedure.

CONCLUSIONS

This study demonstrates that 1.5-T MR imaging can be performed safely with continuous monitoring in patients with a DBS system. The ability to disable the magnet reed switch function of the IPG prevents any change in the electrical settings and thus any side effects. The increasing number of DBS indications and the widespread use of MR imaging indicates the need for defining safety guidelines for the use of MR imaging in patients with implanted neurostimulators.

摘要

目的

本研究旨在研究磁共振成像(MRI)对深部脑刺激(DBS)系统电设置的影响及其临床后果。

方法

作者研究了 1.5T MRI 对植入的 DBS 系统的电设置的影响,包括 1 个或多个单极或四极导联、延长导联以及单通道或双通道可植入脉冲发生器(IPG)。在手术过程中关闭 IPG,并将电压设置为 0。在 MRI 前后检查阻抗。

结果

570 例运动障碍患者接受 DBS 治疗,并在植入导联后和植入 IPG 前进行脑部 MRI 检查。所有患者均未发生任何不良事件。其中 31 例患者在整个 DBS 系统植入后接受了 61 次额外的 MRI 检查。作者报告在 MRI 检查过程中和检查后,患者既没有出现局部皮肤也没有出现神经方面的疾病。在手术过程中保持磁簧开关功能禁用的情况下,IPG 设置没有发生变化。

结论

本研究表明,在 DBS 系统患者中,可以进行安全的 1.5T MRI 检查,并进行连续监测。能够禁用 IPG 的磁簧开关功能可防止电设置发生任何变化,从而避免任何副作用。随着 DBS 适应证数量的增加和 MRI 的广泛应用,需要为植入神经刺激器患者制定使用 MRI 的安全指南。

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