Verma Atul, Ha Andrew C T, Dennie Carole, Essebag Vidal, Exner Derek V, Khan Naeem, Lane Chris, Leipsic Jonathan, Philippon Francois, Sampaio Marcos, Schieda Nicola, Seifer Colette, Berthiaume Alain, Campbell Debra, Chakraborty Santanu
Southlake Regional Health Centre, Newmarket, Ontario, Canada.
University Health Network, Toronto, Ontario, Canada.
Can Assoc Radiol J. 2014 Nov;65(4):290-300. doi: 10.1016/j.carj.2014.08.001. Epub 2014 Oct 24.
Magnetic resonance imaging (MRI) has historically been considered contraindicated for individuals with cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable defibrillators. Magnetic resonance scanners produce magnetic fields that can interact negatively with the metallic components of CIEDs. However, as CIED technology has advanced, newer MRI conditional devices have been developed that are now in clinical use and these systems have had demonstrated safety in the MRI environment. Despite the supportive data of such CIED systems, physicians remain reluctant to perform MRI scanning of conditional devices. This joint statement by the Canadian Heart Rhythm Society and the Canadian Association of Radiologists describes a collaborative process by which CIED specialists and clinics can work with radiology departments and specialists to safely perform MRI in patients with MRI conditional CIED systems. The steps required for patient and scanning preparation and the roles and responsibilities of the CIED and radiology departments are outlined. We also briefly outline the risks and a process by which patients with nonconditional CIEDs might also receive MRI in highly specialized centres. This document supports MRI in patients with MRI conditional CIEDs and offers recommendations on how this can be implemented safely and effectively.
磁共振成像(MRI)在历史上一直被认为不适用于患有心脏植入式电子设备(CIED)的个体,如起搏器和植入式除颤器。磁共振扫描仪会产生磁场,该磁场可能会与CIED的金属部件产生负面相互作用。然而,随着CIED技术的进步,现已开发出更新的适用于MRI的设备并已投入临床使用,并且这些系统在MRI环境中已被证明是安全的。尽管有关于此类CIED系统的支持性数据,但医生们仍然不愿意对适用于MRI的设备进行MRI扫描。加拿大心律学会和加拿大放射学家协会的这份联合声明描述了一个协作过程,通过该过程,CIED专家和诊所可以与放射科及专家合作,为使用适用于MRI的CIED系统的患者安全地进行MRI检查。文中概述了患者和扫描准备所需的步骤以及CIED和放射科的角色与职责。我们还简要概述了风险以及无条件CIED患者在高度专业化中心接受MRI检查的流程。本文件支持为使用适用于MRI的CIED患者进行MRI检查,并就如何安全有效地实施提供了建议。