Kim Bo Gyung, Kim Jin Won, Park Jeong Jin, Kim Sung Huhn, Kim Hee Nam, Choi Jae Young
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, South Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.
JAMA Otolaryngol Head Neck Surg. 2015 Jan;141(1):45-52. doi: 10.1001/jamaoto.2014.2926.
Patients with cochlear implants (CIs) should be fully informed before undergoing magnetic resonance imaging (MRI) about the possibility of discomfort or pain. Prior to an MRI scan, patients need to fully understand not only the potential complications but also the potential discomfort that they may experience during the scan.
To assess the adverse events during MRI in patients with CIs and to investigate the safety and diagnostic efficiency of MRI in patients with CIs with internal magnets.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of the medical records of 18 patients with CIs undergoing MRI between September 2003 and February 2014 at a single tertiary referral center.
Sixteen patients underwent MRI in a 1.5-T scanner, and 2 patients underwent MRI in a 3.0-T scanner. Twelve brain MRI scans were performed, and 18 MRI scans were performed in areas outside the brain.
Discomfort or pain, adverse events, and auditory performance after MRI were evaluated using medical records or interviews.
Thirteen of 18 patients completed their MRI scans (25 of 30 scans). Five patients with head bandages were unable to complete their MRI scans owing to pain; one of these patients experienced magnet displacement, and another underwent surgery for magnet removal and reinsertion. Finally, 1 patient experienced polarity reversal of the magnet. Artifacts induced by the CI internal magnet compromised the diagnosis of ipsilateral brain lesions under 1.5-T MRI. Auditory performance in the CI recipients who had major events was unaffected.
Even with protective head bandages, 1.5-T MRI in patients with CIs led to a variety of adverse events, including discomfort or pain and displacement of the internal magnet. Therefore, sedation and careful head positioning may be appropriate for some patients with CIs who undergo MRI, and these patients should be carefully monitored to decrease the likelihood of such adverse effects.
人工耳蜗植入（CI）患者在接受磁共振成像（MRI）检查前，应充分了解可能出现不适或疼痛的情况。在进行MRI扫描前，患者不仅需要充分了解潜在并发症，还需了解扫描过程中可能经历的潜在不适。
评估CI患者MRI检查期间的不良事件，并调查MRI对带有内部磁体的CI患者的安全性和诊断效率。
设计、地点和参与者：对2003年9月至2014年2月在一家三级转诊中心接受MRI检查的18例CI患者的病历进行回顾性研究。
16例患者在1.5-T扫描仪中进行MRI检查，2例患者在3.0-T扫描仪中进行MRI检查。进行了12次脑部MRI扫描，18次脑部以外区域的MRI扫描。
通过病历或访谈评估MRI检查后的不适或疼痛、不良事件及听觉性能。
18例患者中有13例完成了MRI扫描（30次扫描中的25次）。5例头部包扎的患者因疼痛无法完成MRI扫描；其中1例患者磁体移位，另1例接受了磁体取出和重新植入手术。最后，1例患者磁体发生极性反转。CI内部磁体引起的伪影影响了1.5-T MRI下同侧脑部病变的诊断。发生重大事件的CI受者的听觉性能未受影响。
即使使用保护性头部绷带，CI患者进行1.5-T MRI检查仍会导致多种不良事件，包括不适或疼痛以及内部磁体移位。因此，对于一些接受MRI检查的CI患者，镇静和仔细的头部定位可能是合适的，并且应对这些患者进行密切监测，以降低此类不良反应的发生可能性。
