Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France.
Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, 75013 Paris, France.
Diagn Interv Imaging. 2020 Sep;101(9):507-517. doi: 10.1016/j.diii.2020.02.003. Epub 2020 Feb 21.
Magnetic resonance imaging (MRI) has become the reference imaging for the management of a large number of diseases. The number of MR examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). A CEID was considered an absolute contraindication for MRI for years. The progressive replacement of conventional pacemakers and defibrillators by MR-conditional CEIDs and recent data on the safety of MRI in patients with "MR-nonconditional" CEIDs have progressively increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with "MR-conditional" devices because these devices are not "MR-safe". A specific programing of the device in "MR-mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) describes the effect and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional nonguaranteed" and MR-nonconditional devices.
磁共振成像(MRI)已成为许多疾病管理的参考成像方法。每年接受心脏电子植入式设备(CEID)的患者数量都在增加,同时接受 MRI 检查的患者数量也在增加。多年来,CEID 一直被认为是 MRI 的绝对禁忌证。传统起搏器和除颤器逐渐被 MR 兼容的 CEID 取代,以及最近关于“MR 非条件”CEID 患者 MRI 安全性的数据,逐渐增加了对 CEID 患者进行 MRI 的需求。然而,即使是“MR 兼容”设备,CEID 携带者进行 MRI 也存在一些风险,因为这些设备并非“MR 安全”。对所有携带 CEID 的患者进行“MR 模式”下的设备特定编程和 MRI 期间的监测仍然是强制性的。应在每个进行此类检查的机构中建立基于机构协议的标准化患者工作流程。法国心脏病学会起搏和电生理学工作组以及法国心血管诊断和介入成像学会(SFICV)联合发表的这份立场文件描述了 MRI 在 CEID 携带者中的作用和相关风险。我们针对“MR 兼容”、“MR 兼容但不保证”和“MR 非兼容”设备提出了患者工作流程、监测和 CEID 编程的建议。