Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China.
J Interv Card Electrophysiol. 2021 Sep;61(3):545-550. doi: 10.1007/s10840-020-00854-3. Epub 2020 Aug 17.
Magnetic resonance imaging (MRI) at 3.0 T is becoming more common, but there is a lack of sufficient evidence on the safety of a 3.0 T scan in patients with pacemakers. This study aimed to investigate the safety and practical concerns of 3.0 T scans for patients with MR-conditional pacemakers.
Twenty consecutive patients were enrolled. A standardized protocol was developed by cardiologists, pacemaker engineers, and radiologists. Pacemaker interrogation was performed immediately before and after the scan. Scan-related adverse events were documented, and imaging quality was graded as level 1 to 4 by radiologists.
Twenty-three MRI scans of different body regions (brain = 13, lumbar spine = 4, cervical spine = 2, and heart = 4) were performed, and the average time of a scan was 25 ± 11 min. No significant changes in sensing amplitude (atrial 3.1 ± 1.1 mV vs. 2.9 ± 1.2 mV, P = 0.71; ventricular 9.3 ± 3.5 mV vs. 10.2 ± 3.4 mV, P = 0.46), lead impedances (atrial 647 ± 146 Ω vs. 627 ± 151 Ω, P = 0.7; ventricular: 780 ± 247 Ω vs.711 ± 226 Ω, P = 0.36), or pacing threshold (atrial 0.6 ± 0.2 V/0.4 ms vs. 0.6 ± 0.2 V/0.4 ms, P = 0.71; ventricular 0.7 ± 0.3 V/0.4 ms vs. 0.7 ± 0.2 V/0.4 ms, P = 0.85) were observed pre- and postscan. No adverse events were detected. Image quality review showed grade 1 quality in 16 patients and grade 2 quality in 4 patients with artifacts of pulse generators and leads in cardiac MRI scan and no impact on diagnostic value.
Our initial data indicated that 3.0 T scanning might be feasible under a standardized protocol with good diagnostic imaging quality irrespective of body region in patients with MR-conditional pacemakers.
3.0T 磁共振成像（MRI）越来越普及，但对于带有起搏器的患者进行 3.0T 扫描的安全性仍缺乏足够的证据。本研究旨在探讨具有磁共振兼容性起搏器的患者进行 3.0T 扫描的安全性和实际问题。
连续纳入 20 例患者。由心脏病专家、起搏器工程师和放射科医生制定了标准化方案。在扫描前后进行起搏器询问。记录与扫描相关的不良事件，并由放射科医生将图像质量评为 1 到 4 级。
共进行了 23 次不同部位的 MRI 扫描（大脑=13 次，腰椎=4 次，颈椎=2 次，心脏=4 次），平均扫描时间为 25±11 分钟。感知幅度（心房 3.1±1.1mV 与 2.9±1.2mV，P=0.71；心室 9.3±3.5mV 与 10.2±3.4mV，P=0.46）、导联阻抗（心房 647±146Ω 与 627±151Ω，P=0.7；心室：780±247Ω 与 711±226Ω，P=0.36）或起搏阈值（心房 0.6±0.2V/0.4ms 与 0.6±0.2V/0.4ms，P=0.71；心室 0.7±0.3V/0.4ms 与 0.7±0.2V/0.4ms，P=0.85）在扫描前后均无显著变化。未发现不良事件。图像质量评估显示，16 例患者的图像质量为 1 级，4 例患者的图像质量为 2 级，存在脉冲发生器和导联伪影，但不影响诊断价值。
我们的初步数据表明，在具有磁共振兼容性起搏器的患者中，使用标准化方案进行 3.0T 扫描可能是可行的，无论扫描部位如何，都能获得良好的诊断成像质量。
