From the *Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg; †Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen; ‡Department of Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, University Hospital, Essen; §Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig; ∥Department of High-Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen; ¶Department of Biomedical Magnetic Resonance, University of Tüingen; #Special Lab Non-Invasive Brain Imaging, Leibniz Institute for Neurobiology, Magdeburg; **Research Center Jülich, Institute of Neuroscience and Medicine, Jülich; and ††Department of Neurology, RWTH Aachen University, Aachen, Germany.
Invest Radiol. 2014 May;49(5):249-59. doi: 10.1097/RLI.0000000000000035.
The aims of this study were to investigate the subjective discomfort and sensory side effects during ultrahigh field (UHF) magnetic resonance imaging (MRI) examinations in a large-scale study and to evaluate differences between magnetic resonance (MR) sites.
Four MR sites with a 7-T MR system and 2 MR sites with a 9.4-T MR system participated in this multicenter study with a total number of 3457 completed questionnaires on causes of discomfort and sensations during the examination. For a pooled retrospective analysis of the results from the partially different questionnaires, all data were adapted to an answer option with a 4-point scale (0 = no discomfort/side effect, 3 = very unpleasant/very strong sensation). To differentiate effects evoked by the low-frequency time-varying magnetic fields due to movement through the static magnetic field, most questionnaires separated the manifestation of sensory side effects during movement on the patient table from manifestation while lying still in the isocenter.
In general, a high acceptance of UHF examinations was found, where in 82% of the completed questionnaires, the subjects stated the examination to be at least tolerable. Although in 7.6% of the questionnaires, subjects felt discomfort during the examination, only 0.9% of the image acquisitions had to be terminated prematurely. No adverse events occurred in any of the examinations. Only 1% of the subjects were unwilling to undergo further UHF MRI examinations. Examination duration was the most complained cause of discomfort, followed by acoustic noise and lying still. All magnetic-field-related sensations were more pronounced when moving the patient table versus the isocenter position (19%/2% of the subjects felt unpleasant vertigo during the moving/stationary state). In general, vertigo was the most often stated sensory side effect and was more pronounced at 9.4 T compared with 7 T. However, the results varied substantially among the different sites.
The high levels of subjective acceptance found in this study lead to the conclusion that UHF MRI would be tolerated as a diagnostic tool in clinical practice. For more consistent data ascertainment, we propose a standardized questionnaire for subjective perception monitoring.
本研究旨在通过一项大规模研究,调查超高场(UHF)磁共振成像(MRI)检查过程中的主观不适和感觉副作用,并评估不同磁共振(MR)部位之间的差异。
四个使用 7T MR 系统的 MR 部位和两个使用 9.4T MR 系统的 MR 部位参与了这项多中心研究,共完成了 3457 份关于检查过程中不适和感觉原因的问卷。为了对部分不同问卷的结果进行汇总回顾性分析,所有数据均被改编为 4 分制(0=无不适/无副作用,3=非常不适/非常强烈的感觉)。为了区分因穿过静磁场而产生的低频时变磁场引起的效应,大多数问卷将患者在检查床上移动时的感觉副作用表现与躺在等中心位置时的表现区分开来。
总的来说,UHF 检查的接受度很高,在 82%的完成问卷中,受试者表示检查至少是可以忍受的。尽管在 7.6%的问卷中,受试者在检查过程中感到不适,但只有 0.9%的图像采集需要提前终止。在任何检查中均未发生不良事件。只有 1%的受试者不愿意进行进一步的 UHF MRI 检查。检查持续时间是引起不适的最主要原因,其次是噪音和静止不动。与躺在等中心位置相比,当移动患者检查床时,所有与磁场相关的感觉都更为明显(19%/2%的受试者在移动/静止状态时感到不愉快的眩晕)。总的来说,眩晕是最常被报告的感觉副作用,在 9.4T 时比在 7T 时更为明显。然而,不同部位之间的结果存在很大差异。
本研究中发现的高水平主观接受度表明,UHF MRI 将被容忍为临床实践中的诊断工具。为了更一致地获取数据,我们建议使用标准化问卷进行主观感知监测。