Teitelbaum G P, Lin M C, Watanabe A T, Norfray J F, Young T I, Bradley W G
Department of Radiology, Georgetown University Hospital, Washington, DC 20007.
AJNR Am J Neuroradiol. 1990 Mar-Apr;11(2):267-72.
Metallic extracranial carotid vascular clamps of the Selverstone, Crutchfield, Poppen-Blaylock, Salibi, Kindt, and tantalum varieties have been placed for treatment of large, giant, or inoperable intracranial aneurysms. To ascertain what adverse effect, if any, MR imaging would have on these clamps, magnetic deflection at 1.5 T was measured for various carotid clamps. Marked magnetic deflection (and torque) was displayed by stainless steel Poppen-Blaylock clamps. Relatively mild magnetic deflection was displayed by the stainless steel Selverstone, Salibi, Crutchfield, and Kindt clamps. Three patients with previously placed carotid clamps (two Selverstone, one Salibi) and one patient with a nonferromagnetic tantalum carotid clip had cranial or cervical MR studies at field strengths ranging from 0.35 to 0.60 T. No patient experienced any discomfort or neurologic sequelae as a result of MR imaging. Although the ferromagnetic clamps created severe "black-hole" artifacts and image distortion within the cervical and facial regions, no significant image degradation was apparent during spin-echo imaging of the brain. The tantalum clip created a far smaller MR artifact than did ferromagnetic clamps and allowed effective spin-echo and gradient-echo imaging in the cervical region. Our findings indicate that most patients with carotid vascular clamps (and nonferromagnetic clips) can probably be imaged safely with MR.
已使用塞尔弗斯通、克拉奇菲尔德、波彭 - 布莱洛克、萨利比、金特等型号的金属颅外颈动脉血管夹以及钽制血管夹来治疗大型、巨型或无法手术的颅内动脉瘤。为确定磁共振成像（MR成像）对这些血管夹是否会产生不良影响，我们对各种颈动脉血管夹在1.5T磁场下的磁偏转进行了测量。不锈钢材质的波彭 - 布莱洛克血管夹显示出明显的磁偏转（以及扭矩）。不锈钢材质的塞尔弗斯通、萨利比、克拉奇菲尔德和金特血管夹显示出相对较轻的磁偏转。三名先前已植入颈动脉血管夹的患者（两名塞尔弗斯通血管夹，一名萨利比血管夹）以及一名使用非铁磁性钽制颈动脉夹的患者，在0.35至0.60T的场强下进行了头颅或颈部MR检查。没有患者因MR成像而出现任何不适或神经后遗症。尽管铁磁性血管夹在颈部和面部区域产生了严重的“黑洞”伪影和图像失真，但在脑部的自旋回波成像过程中，没有明显的图像质量下降。钽制血管夹产生的MR伪影比铁磁性血管夹小得多，并且在颈部区域能够进行有效的自旋回波和梯度回波成像。我们的研究结果表明，大多数植入颈动脉血管夹（以及非铁磁性血管夹）的患者可能可以安全地进行MR成像。
