植入式循环记录仪患者的心血管磁共振成像
Cardiovascular Magnetic Resonance Imaging in Patients with an Implantable Loop Recorder.
作者信息
Blaschke Florian, Lacour Philipp, Walter Thula, Wutzler Alexander, Huemer Martin, Parwani Abdul, Attanasio Philipp, Boldt Leif-Hendrik, Markowski Marcus, Denecke Timm, Haverkamp Wilhelm
机构信息
Department of Cardiology, Campus Virchow-Klinikum, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
Department of Radiology, Campus Virchow-Klinikum, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
出版信息
Ann Noninvasive Electrocardiol. 2016 May;21(3):319-324. doi: 10.1111/anec.12333. Epub 2015 Dec 24.
BACKGROUND
Implantable loop recorders (ILRs) allow continuous cardiac monitoring for 3-6 years and are a valuable tool for the investigation of syncopal episodes, palpitations, and atrial fibrillations as well as risk stratification after myocardial infarction. Although magnetic resonance imaging (MRI) in patients with ILRs has been shown to be safe, the impact of ILRs on cardiac MRI image quality has not been investigated yet. Thus, we tested the diagnostic value of cardiac MRI in patients with various types of ILRs.
METHODS
Two patients with an ILR and a clinical indication to assess myocardial burden of scarring and fibrosis or stress-induced myocardial ischemia underwent cardiac MRI. Device interrogation was performed prior to, immediately after, and 3 months after cardiac MRI.
RESULTS
The post-MRI follow-ups revealed no change in programmed ILR parameters, sensing fidelity, and battery parameters. However, ILRs caused significant, uninterpretable hyperintensity artifacts in cardiac MRI.
CONCLUSIONS
Further clinical studies are warranted to investigate whether modified MRI techniques are helpful to eliminate imaging artifacts.
背景
植入式循环记录仪（ILR）可进行3至6年的连续心脏监测，是用于调查晕厥发作、心悸和心房颤动以及心肌梗死后风险分层的重要工具。尽管已证明ILR患者进行磁共振成像（MRI）是安全的，但ILR对心脏MRI图像质量的影响尚未得到研究。因此，我们测试了心脏MRI在不同类型ILR患者中的诊断价值。
方法
两名有ILR且有临床指征评估心肌瘢痕和纤维化负担或应激性心肌缺血的患者接受了心脏MRI检查。在心脏MRI检查前、检查后立即以及检查后3个月进行设备询问。
结果
MRI检查后的随访显示，ILR的程控参数、感知保真度和电池参数没有变化。然而，ILR在心脏MRI中引起了明显的、无法解释的高强度伪影。
结论
有必要进行进一步的临床研究，以调查改良的MRI技术是否有助于消除成像伪影。
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