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对装有起搏器的患者进行不同身体部位的 3.0T 磁共振成像扫描。

3.0 T magnetic resonance imaging scanning on different body regions in patients with pacemakers.

机构信息

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.

出版信息

J Interv Card Electrophysiol. 2021 Sep;61(3):545-550. doi: 10.1007/s10840-020-00854-3. Epub 2020 Aug 17.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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