Neurorehabilitation Department, Fondazione Ospedale San Camillo IRCCS, Venezia, Italia.
J Spinal Cord Med. 2020 Sep;43(5):710-713. doi: 10.1080/10790268.2018.1519997. Epub 2018 Sep 12.
Magnetic Resonance Imaging (MRI) is an essential diagnostic tool for neuroimaging tissues such as the spinal cord. Unfortunately, the use of MRI may be limited in ventilated patients, who cannot maintain the supine position in spontaneous breathing for the whole duration of the exam (i.e. neuro-muscular patients with diaphragm involvement). The use of MRI-compatible ventilator during MRI could be a solution but they are not universally available. Furthermore, their performances are not up to those of the conventional ones and they are not always compatible with Non Invasive Ventilation (NIV). This case report describes an easy and low-cost solution to ventilate a patient non-invasively during the MRI procedure. The patient in this case was a 45-yr-old man, wheelchair-dependent and chronically ventilated in NIV with a forced vital capacity in supine position of 370 ml (10% of predicted normal), affected by Arnold-Chiari Syndrome, and in need of a MRI diagnostic control. The technique proposed, that does not affect the MRI images quality, consists in ventilating the patient using a simple nonmetallic Ventilation Bag, operated by a Respiratory Therapist. This has been proven a useful and economical solution for ventilatory support during MRI for a respiratory-dependent patient with Arnold-Chiari Syndrome.
磁共振成像(MRI)是神经影像学组织(如脊髓)的重要诊断工具。不幸的是,对于不能在整个检查过程中保持仰卧位自主呼吸的通气患者(即膈肌受累的神经肌肉患者),可能会限制 MRI 的使用。在 MRI 期间使用与 MRI 兼容的呼吸机可能是一种解决方案,但它们并非普遍可用。此外,它们的性能不如传统呼吸机,并且并不总是与无创通气(NIV)兼容。本病例报告描述了一种在 MRI 过程中对患者进行无创通气的简便且低成本的解决方案。该病例患者为 45 岁男性,因 Arnold-Chiari 综合征需接受 MRI 诊断性检查,无法离开轮椅,且长期在 NIV 下通气,仰卧位时的用力肺活量为 370ml(预测正常的 10%)。该患者使用了一种由呼吸治疗师操作的简单非金属通气袋进行通气,该方法不会影响 MRI 图像质量。对于患有 Arnold-Chiari 综合征的依赖通气的患者,该方法在 MRI 期间提供通气支持,是一种有用且经济的解决方案。