Akbar M, Aschoff A, Georgi J C, Nennig E, Heiland S, Abel R, Stippich C
Stiftung Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany.
Rofo. 2010 Jul;182(7):594-602. doi: 10.1055/s-0028-1109882. Epub 2009 Dec 2.
Considering the rapidly increasing number of clinical high-field MR imagers and the lack of data regarding interference with magnetically adjustable cerebrospinal fluid (CSF) shunt valves, valve safety was assessed with regard to magnetic field interactions: imaging artifacts, heating, magnetic forces, and functional changes in a phantom study at 3.0 Tesla using explanted devices as a realistic model for in vivo conditions.
Sixteen explanted Codman-Medos and Sophy-SU8 shunt valves, all in perfect working order, were selected and exposed to a 3.0 T static magnetic field. Valve-induced imaging artifacts and signal drop-outs and the heating experiments were evaluated using standard diagnostic MR sequences with different SAR values. Translational attraction for the adjustable valves was assessed using the deflection angle method. To test adjustability and function, the spherical phantom containing the valve was placed in the isocenter of the MR scanner and exposed to a static magnetic field of 3.0 T for 0.25 to 12 hours (repeated exposure 1-12 times), including typical entrance and move-out procedures.
The diameters of imaging artifacts ranged from 10-70 mm and were most prominent on T2*w sequences. There was no relevant MR-imaging-related heating. Magnetic forces were not critical. Reproducible adjustment failures occurred in 6 valves.
Until suggestions can be made concerning the exposure of hydrocephalic patients to 3.0 T-MRI, further testing is necessary.
鉴于临床高场强磁共振成像仪数量迅速增加,且缺乏关于对可磁调节脑脊液(CSF)分流阀干扰的数据,在一项体模研究中,使用植入设备作为体内情况的真实模型,在3.0特斯拉磁场下,从成像伪影、加热、磁力和功能变化等方面评估了阀门安全性。
选择16个植入的Codman-Medos和Sophy-SU8分流阀,均处于完美工作状态,使其暴露于3.0 T静磁场中。使用具有不同比吸收率(SAR)值的标准诊断磁共振序列评估阀门引起的成像伪影、信号丢失和加热实验。使用偏转角方法评估可调节阀门的平移吸引力。为测试可调节性和功能,将包含阀门的球形体模置于磁共振扫描仪的等中心,使其暴露于3.0 T静磁场中0.25至12小时(重复暴露1至12次),包括典型的进入和移出程序。
成像伪影直径范围为10 - 70毫米,在T2*加权序列上最为明显。没有与磁共振成像相关的显著加热现象。磁力不构成关键问题。6个阀门出现了可重复的调节故障。
在能就脑积水患者接受3.0 T磁共振成像检查提出建议之前,有必要进行进一步测试。