Tommasino C, Beretta L, Cozzi S, Paolillo G, Torri G
Cattedra di Anestesiologia e Rianimazione, Università degli Studi di Milano.
Minerva Anestesiol. 1991 Jan-Feb;57(1-2):7-11.
Magnetic resonance imaging (MRI) has presented to anesthesiologists as unique challenge in patient monitoring because of its construction and principles of operation. Ferromagnetic materials within or near the scanner can distort the magnetic field, and monitoring wires act as antennae and this may result in image degradation. Nevertheless, monitoring is mandatory during MRI, especially in a child sedated or in general anesthesia. A monitoring system, made up of commercially available components, was assessed, and its effects on MR (1.5 tesla unit) image quality system determined. Variables monitored included: electrocardiogram and heart rate, (Sirecust 404, ECG cable set MR; Siemens, Enlanger, West Germany); blood pressure via automated sphygmomanometry (Press Mate BP-8800; Colin, Komaki, Japan); and continuous arterial saturation via pulse oximetry (Nellcor 100 E; Nellcor, Inc., Haywood, California). Fluid infusion rate was controlled by means of a plastic deliver (Dial-a-flo; Abbott Labs., Chicago, Illinois). Body temperature was maintained with a heat insulator blanket (Thermadrape, OR Concepts, Inc., Dallas, Texas). The monitoring technique described did not interfere with MRI function or produce image degradation.
由于其构造和工作原理,磁共振成像(MRI)给麻醉医生在患者监测方面带来了独特的挑战。扫描器内部或附近的铁磁材料会使磁场发生畸变,而监测导线充当天线,这可能导致图像质量下降。然而,在MRI检查期间进行监测是必不可少的,尤其是在儿童镇静或全身麻醉的情况下。对一个由市售组件组成的监测系统进行了评估,并确定了其对1.5特斯拉单位MR图像质量系统的影响。监测的变量包括:心电图和心率(Sirecust 404,MR心电图电缆套件;西门子公司,德国恩朗根);通过自动血压计测量血压(Press Mate BP - 8800;日本科林公司,小牧);以及通过脉搏血氧饱和度仪持续监测动脉血氧饱和度(Nellcor 100 E;美国内尔科公司,加利福尼亚州海伍德)。输液速度通过塑料输液器(Dial - a - flo;美国雅培实验室公司,伊利诺伊州芝加哥)控制。使用隔热毯(Thermadrape,OR Concepts公司,得克萨斯州达拉斯)维持体温。所描述的监测技术不会干扰MRI功能或导致图像质量下降。