Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland, USA.
Otol Neurotol. 2010 Oct;31(8):1215-20. doi: 10.1097/MAO.0b013e3181ec1d61.
To assess the safety of 1.5 T magnetic resonance imaging (MRI) in patients with cochlear implants (CIs) with internal magnets.
Retrospective review of CI patients who underwent an MRI at Johns Hopkins.
Sixteen patients with a mean age of 43 ± 22 years with a CI underwent a total of 22 clinically indicated 1.5 T MRI. Devices from 3 major CI manufactures were represented.
Binding of CI with mold material and gauze was performed before MRI. Some patients were also administered a sedative. Intravenous gadolinium contrast was used in all but 1 patient.
Patients were assessed with regard to the ability to complete the MRI, the size of the artifact caused by the device, the ability to make a diagnosis from the studies, the post-MRI CI function, and the magnet's position.
No CI malfunction, displacement, or magnet displacement was observed after MRI. One patient was unable to tolerate the procedure because of pressure at the site of the device. One patient required intravenous sedation to complete the study. The CI generally produced an artifact on brain MRI, with a mean maximal anterior-posterior dimension of 6.6 cm and a lateral dimension of 4.8 cm around the site of the device. The contralateral internal auditory canal was visualized in all patients, and the ipsilateral internal auditory canal was at least party visible in all but 1 patient.
Patients can safely undergo 1.5 T MRI after CI if the device is tightly bound before scanning. Magnet displacement was not observed, and we think the risk to be minimal compared with the risk and inconvenience of removing the magnet before the study.
评估带有内置磁铁的人工耳蜗(CI)患者进行 1.5 T 磁共振成像(MRI)的安全性。
对在约翰霍普金斯医院接受 MRI 的 CI 患者进行回顾性研究。
16 名平均年龄为 43 ± 22 岁的 CI 患者共进行了 22 次临床指征明确的 1.5 T MRI。设备来自 3 家主要的 CI 制造商。
在 MRI 前使用模具材料和纱布将 CI 绑定。一些患者还接受了镇静剂。除 1 名患者外,所有患者均静脉注射钆对比剂。
评估患者完成 MRI 的能力、设备引起的伪影大小、从研究中做出诊断的能力、MRI 后 CI 功能以及磁铁的位置。
MRI 后未观察到 CI 故障、移位或磁铁移位。1 名患者因设备部位的压力而无法耐受该程序。1 名患者需要静脉镇静剂才能完成研究。CI 通常会在脑部 MRI 上产生伪影,设备周围的最大前后径平均值为 6.6 厘米,侧径平均值为 4.8 厘米。所有患者均能观察到对侧内听道,除 1 名患者外,所有患者均至少能部分观察到同侧内听道。
如果在扫描前将设备紧密绑定,患者可以安全地在 CI 后进行 1.5 T MRI。未观察到磁铁移位,我们认为与在研究前移除磁铁的风险和不便相比,风险极小。