Med Phys. 2012 May;39(5):2578-83. doi: 10.1118/1.3702775.
A time-varying magnetic field can cause unpleasant peripheral nerve stimulation (PNS) when the maximum excursion of the magnetic field (ΔB) is above a frequency-dependent threshold level [P. Mansfield and P. R. Harvey, Magn. Reson. Med. 29, 746-758 (1993)]. Clinical and research magnetic resonance imaging (MRI) gradient systems have been designed to avoid such bioeffects by adhering to regulations and guidelines established on the basis of clinical trials. Those trials, generally employing sinusoidal waveforms, tested human responses to magnetic fields at frequencies between 0.5 and 10 kHz [W. Irnich and F. Schmitt, Magn. Reson. Med. 33, 619-623 (1995), T. F. Budinger et al., J. Comput. Assist. Tomogr. 15, 909-914 (1991), and D. J. Schaefer et al., J. Magn. Reson. Imaging 12, 20-29 (2000)]. PNS thresholds for frequencies higher than 10 kHz had been extrapolated, using physiological models [J. P. Reilly et al., IEEE Trans. Biomed. Eng. BME-32(12), 1001-1011 (1985)]. The present study provides experimental data on human PNS thresholds to oscillating magnetic field stimulation from 2 to 183 kHz. Sinusoidal waveforms were employed for several reasons: (1) to facilitate comparison with earlier reports that used sine waves, (2) because prior designers of fast gradient hardware for generalized waveforms (e.g., including trapezoidal pulses) have employed quarter-sine-wave resonant circuits to reduce the rise- and fall-times of pulse waveforms, and (3) because sinusoids are often used in fast pulse sequences (e.g., spiral scans) [S. Nowak, U.S. patent 5,245,287 (14 September 1993) and K. F. King and D. J. Schaefer, J. Magn. Reson. Imaging 12, 164-170 (2000)].
An IRB-approved prospective clinical trial was performed, involving 26 adults, in which one wrist was exposed to decaying sinusoidal magnetic field pulses at frequencies from 2 to 183 kHz and amplitudes up to 0.4 T. Sham exposures (i.e., with no magnetic fields) were applied to all subjects.
For 0.4 T pulses at 2, 25, 59, 101, and 183 kHz, stimulation was reported by 22 (84.6%), 24 (92.3%), 15 (57.7%), 2 (7.7%), and 1 (3.8%) subjects, respectively.
The probability of PNS due to brief biphasic time-varying sinusoidal magnetic fields with magnetic excursions up to 0.4 T is shown to decrease significantly at and above 101 kHz. This phenomenon may have particular uses in dynamic scenarios (e.g., cardiac imaging) and in studying processes with short decay times (e.g., electron paramagnetic resonance imaging, bone and solids imaging). The study suggests the possibility of new designs for human and preclinical MRI systems that may be useful in clinical practice and scientific research.
当磁场的最大偏移(ΔB)超过频率相关的阈值水平时,时变磁场会引起不愉快的周围神经刺激(PNS)[P. Mansfield 和 P. R. Harvey,Magn. Reson. Med. 29,746-758(1993)]。临床和研究磁共振成像(MRI)梯度系统通过遵守基于临床试验制定的规定和指南来避免这种生物效应。这些试验通常采用正弦波波形,测试了人体对 0.5 至 10 kHz 之间磁场的反应[W. Irnich 和 F. Schmitt,Magn. Reson. Med. 33,619-623(1995),T. F. Budinger 等人,J. Comput. Assist. Tomogr. 15,909-914(1991)和 D. J. Schaefer 等人,J. Magn. Reson. Imaging 12,20-29(2000)]。使用生理模型推断了 10 kHz 以上频率的 PNS 阈值[J. P. Reilly 等人,IEEE Trans. Biomed. Eng. BME-32(12),1001-1011(1985)]。本研究提供了人体 PNS 阈值的实验数据,用于频率为 2 至 183 kHz 的振荡磁场刺激。采用正弦波有几个原因:(1)便于与使用正弦波的早期报告进行比较,(2)因为通用波形(例如包括梯形脉冲)的快速梯度硬件的先前设计者已经采用四分之一正弦波谐振电路来减少脉冲波形的上升和下降时间,以及(3)因为正弦波常用于快速脉冲序列(例如螺旋扫描)[S. Nowak,美国专利 5245287(1993 年 9 月 14 日)和 K. F. King 和 D. J. Schaefer,J. Magn. Reson. Imaging 12,164-170(2000)]。
进行了一项经过机构审查委员会批准的前瞻性临床试验,涉及 26 名成年人,其中一只手腕暴露于频率为 2 至 183 kHz 且幅度高达 0.4 T 的衰减正弦磁场脉冲中。所有受试者均接受了所有磁场的假暴露(即没有磁场)。
在 0.4 T 脉冲下,2、25、59、101 和 183 kHz 的刺激分别被 22(84.6%)、24(92.3%)、15(57.7%)、2(7.7%)和 1(3.8%)个受试者报告。
用最大偏移为 0.4 T 的短暂双相时变正弦磁场进行刺激时,人体 PNS 的概率显著降低频率为 101 kHz 及以上。这种现象在动态情况下(例如心脏成像)和研究具有短衰减时间的过程(例如电子顺磁共振成像,骨骼和固体成像)中可能具有特殊用途。该研究提出了新的人体和临床前 MRI 系统设计的可能性,这可能在临床实践和科学研究中有用。