Aissani Sarra, Laistler Elmar, Felblinger Jacques
IADI, U947, INSERM, Université de Lorraine, CHRU de Nancy Brabois, Bâtiment Recherche, Rue du Morvan, 54511, Nancy, Frankreich.
Zentrum für Medizinische Physik und Biomedizinische Technik, Medizinische Universität Wien, Wien, Österreich.
Radiologe. 2019 Oct;59(10):869-874. doi: 10.1007/s00117-019-0540-7.
Increasing numbers of patients with active implantable medical devices (AIMDs) require magnetic resonance (MR) examinations. The manufacturers are continuing to improve the MR compatibility of their AIMDs. To this end, a variety of measurement methods and numerical simulations are used to evaluate the risks associated with magnetic resonance imaging (MRI).
In this article, test methods used to investigate interactions between AIMDs with radio frequency fields and time-varying magnetic gradient fields are reviewed.
A literature review of known test methods for radio frequency and gradient field exposure of AIMDs with leads, in particular for neurostimulators, cochlear implants, and implanted infusion pumps, is presented. The state of the art and promising methods are discussed.
ISO/TS 10974 describes the design of high frequency and gradient injection setups to test conductive materials. A large number of sensor designs have been published to measure the induced voltages and currents through radio frequency and gradient fields and for monitoring AIMDs during MR examinations in in vitro tests.
The test methods should be planned to be as conservative as possible to cover the worst case scenario. However, in vitro measurements and computer simulation are far from being able to cover all possible configurations in their complexity and uniqueness. For safer MR examinations, current research recommends in vivo testing prior to MR, parallel radiofrequency transmission techniques, and new sequences with reduced energy input in the presence of AIMDs.
越来越多植入有源医疗器械(AIMD)的患者需要进行磁共振(MR)检查。制造商们不断提高其AIMD的MR兼容性。为此,人们使用了各种测量方法和数值模拟来评估与磁共振成像(MRI)相关的风险。
本文综述了用于研究AIMD与射频场和时变磁梯度场之间相互作用的测试方法。
对已知的针对带有导线的AIMD,特别是神经刺激器、人工耳蜗和植入式输液泵进行射频和梯度场暴露的测试方法进行文献综述,并讨论了其现状和有前景的方法。
ISO/TS 10974描述了用于测试导电材料的高频和梯度注入装置的设计。已经发表了大量传感器设计,用于在体外测试中通过射频和梯度场测量感应电压和电流以及在MR检查期间监测AIMD。
测试方法的规划应尽可能保守,以涵盖最坏的情况。然而,体外测量和计算机模拟远不能涵盖所有可能配置的复杂性和独特性。为了进行更安全的MR检查,当前研究建议在进行MR检查之前进行体内测试、并行射频传输技术以及在存在AIMD的情况下减少能量输入的新序列。