Ono Maki, Suzuki Makoto, Isobe Mitsuaki
Kameda General Hospital, 929 Higashi-cho, Kamogawa City, Chiba 296-8602, Japan.
Tokyo Medical and Dental University, 1-5-45 Bunkyo-ku, Yushima, Tokyo 113-8510, Japan.
J Arrhythm. 2017 Oct;33(5):455-458. doi: 10.1016/j.joa.2017.01.002. Epub 2017 Feb 9.
The feasibility, safety, and potential demand of emergent magnetic resonance imaging (MRI) of patients with a cardiac implantable electronic device (CIED) in emergency situations are unknown.
We retrospectively compared emergent and scheduled MRI orders for patients with CIEDs at Kameda General Hospital, a tertiary hospital in Japan, from October 2012 to September 2016.
We identified 11 emergent MRI orders via the emergency room and 38 scheduled MRI orders. Although the baseline characteristics were similar between the two groups, brain scanning was predominant in emergent scanning (=0.002). The reasons for MRI and physicians who ordered it were also significantly different between the two groups (<0.001, =0.03, respectively). Among the emergent orders via the emergency room, 10 out of 11 were brain scans. Nine out of 10 patients underwent successful emergent brain MRI. The time from arrival at the emergency room to MRI was 144±29 min, and the time from the MRI order made by the cardiologist to its actual performance was 60±10 min. Four out of 9 patients had a diagnosis of acute stroke confirmed by emergent MRI, and two had emergent thrombolysis with a complete neurological recovery. All emergent scanning was conducted safely with no complications.
Our study found the potential demand of brain MRI of patients with CIEDs in emergency situations compared with scheduled scanning, which was shown to be feasible and safe for the diagnosis and treatment of an acute stroke.
在紧急情况下，心脏植入式电子设备（CIED）患者进行紧急磁共振成像（MRI）的可行性、安全性及潜在需求尚不清楚。
我们回顾性比较了2012年10月至2016年9月期间日本三级医院龟田综合医院CIED患者的紧急和常规MRI检查订单。
我们通过急诊室确定了11份紧急MRI检查订单和38份常规MRI检查订单。尽管两组的基线特征相似，但紧急扫描中脑部扫描占主导（=0.002）。两组之间MRI的原因及开具订单的医生也存在显著差异（分别为<0.001，=0.03）。在通过急诊室的紧急订单中，11份中有10份是脑部扫描。10名患者中有9名成功进行了紧急脑部MRI检查。从到达急诊室到进行MRI检查的时间为144±29分钟，从心脏病专家下达MRI检查订单到实际进行检查的时间为60±10分钟。9名患者中有4名经紧急MRI检查确诊为急性中风，2名接受了紧急溶栓治疗，神经功能完全恢复。所有紧急扫描均安全进行，无并发症发生。
我们的研究发现，与常规扫描相比，CIED患者在紧急情况下对脑部MRI有潜在需求，这对于急性中风的诊断和治疗是可行且安全的。
