Department of Cardiology, The Heart Hospital, part of University College London Hospitals NHS Trust, London, UK.
J Cardiovasc Magn Reson. 2011 May 3;13(1):26. doi: 10.1186/1532-429X-13-26.
Cardiovascular implantable electronic devices represent important limitations to magnetic resonance imaging (MRI). Recently, MRI-conditional dual chamber pacemakers and leads have become available. We describe a case of a patient with neuro-sarcoidosis presenting with diplopia and hydrocephalus requiring an MRI-conditional programmable ventriculo-peritoneal shunt, who developed complete heart block. In view of the ongoing need for neuro-imaging, MRI-conditional dual chamber pacemaker and leads were implanted. Cardiac and brain MRI were requested to guide immunosupression. Overall the scans demonstrated stable neurological disease, but confirmed cardiac sarcoid, with oedema on T2 weighted images suggesting active disease and extensive sub-endocardial late gadolinium enhancement, including the basal septum. This case illustrates why sarcoid patients who develop bradyarrhythmias should ideally have an MRI-conditional pacing system.
心血管植入式电子设备对磁共振成像（MRI）有重要限制。最近，出现了可用于 MRI 的双腔起搏器和导线。我们描述了一例患有神经结节病的患者，表现为复视和脑积水，需要 MRI 条件下可程控的脑室-腹腔分流管，该患者出现完全性心脏阻滞。鉴于持续需要神经影像学检查，因此植入了可用于 MRI 的双腔起搏器和导线。要求进行心脏和脑部 MRI 以指导免疫抑制治疗。总的来说，扫描结果显示神经系统疾病稳定，但证实了心脏结节病，T2 加权图像上有水肿提示活动性疾病和广泛的心内膜下晚期钆增强，包括基底间隔。这个病例说明了为什么发生心动过缓的结节病患者理想情况下应配备有 MRI 条件的起搏系统。
