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MRI环境中的生理记录(PRiME):MRI兼容的血流动力学记录系统

Physiological Recording in the MRI Environment (PRiME): MRI-Compatible Hemodynamic Recording System.

作者信息

Kakareka John W, Faranesh Anthony Z, Pursley Randall H, Campbell-Washburn Adrienne, Herzka Daniel A, Rogers Toby, Kanter Josh, Ratnayaka Kanishka, Lederman Robert J, Pohida Thomas J

机构信息

National Institutes of HealthBethesdaMD20892USA.

FitbitSan FranciscoCA94105USA.

出版信息

IEEE J Transl Eng Health Med. 2018 Mar 1;6:4100112. doi: 10.1109/JTEHM.2018.2807813. eCollection 2018.

Abstract

Hemodynamic recording during interventional cardiovascular procedures is essential for procedural guidance, monitoring patient status, and collection of diagnostic information. Recent advances have made interventions guided by magnetic resonance imaging (MRI) possible and attractive in certain clinical scenarios. However, in the MRI environment, electromagnetic interference (EMI) can cause severe distortions and artifacts in acquired hemodynamic waveforms. The primary aim of this paper was to develop and validate a system to minimize EMI on electrocardiogram (ECG) and invasive blood pressure (IBP) signals. A system was developed which incorporated commercial MRI compatible ECG leads and pressure transducers, custom electronics, user interface, and adaptive signal processing. Measurements were made on pediatric patients (N = 6) during MRI-guided catheterization. Real-time interactive scanning, which is known to produce significant EMI due to fast gradient switching and varying imaging plane orientations, was selected for testing. The effectiveness of the adaptive algorithms was determined by measuring the reduction of noise peaks, amplitude of noise peaks, and false QRS triggers. During real-time gradient-intensive imaging sequences, peak noise amplitude was reduced by 80% and false QRS triggers were reduced to a median of 0. There was no detectable interference on the IBP channels. A hemodynamic recording system front-end was successfully developed and deployed, which enabled high-fidelity recording of ECG and IBP during MRI scanning. The schematics and assembly instructions are publicly available to facilitate implementation at other institutions. Researchers and clinicians are provided a critical tool in investigating and implementing MRI guided interventional cardiovascular procedures.

摘要

介入性心血管手术过程中的血流动力学记录对于手术指导、监测患者状态以及收集诊断信息至关重要。最近的进展使得在某些临床场景中,由磁共振成像(MRI)引导的介入手术成为可能且具有吸引力。然而,在MRI环境中,电磁干扰(EMI)会在采集的血流动力学波形中导致严重的失真和伪影。本文的主要目的是开发并验证一种系统,以最小化心电图(ECG)和有创血压(IBP)信号上的EMI。开发了一种系统,该系统集成了与MRI兼容的商用ECG导联和压力传感器、定制电子设备、用户界面以及自适应信号处理。在MRI引导的导管插入术中对儿科患者(N = 6)进行了测量。选择了实时交互式扫描进行测试,已知这种扫描由于快速梯度切换和成像平面方向变化会产生显著的EMI。通过测量噪声峰值的降低、噪声峰值幅度以及错误QRS触发来确定自适应算法的有效性。在实时梯度密集型成像序列期间,峰值噪声幅度降低了80%,错误QRS触发减少到中位数为0。在IBP通道上没有检测到干扰。成功开发并部署了一种血流动力学记录系统前端,能够在MRI扫描期间对ECG和IBP进行高保真记录。原理图和组装说明已公开提供,以方便其他机构实施。为研究人员和临床医生提供了一个关键工具,用于研究和实施MRI引导的介入性心血管手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3852/5849467/3298f306b4e0/kakar5abcd-2807813.jpg

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