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人工耳蜗植入与磁共振成像:100 余例置磁后检查经验

Cochlear Implants and Magnetic Resonance Imaging: Experience With Over 100 Studies Performed With Magnets in Place.

机构信息

Department of Otorhinolaryngology.

Department of Radiology, Mayo Clinic, Rochester, Minnesota.

出版信息

Otol Neurotol. 2021 Jan;42(1):51-58. doi: 10.1097/MAO.0000000000002866.

Abstract

OBJECTIVE

To evaluate adverse events and feasibility of performing 1.5-T MRI in patients with cochlear implants (CI) and auditory brainstem implants (ABI).

SETTING

Single tertiary academic referral center.

PATIENTS

CI and ABI recipients undergoing 1.5-T MRI without internal magnet removal.

INTERVENTION(S): MRI after tight headwrap application.

MAIN OUTCOME MEASURES

Adverse events, patient tolerance.

RESULTS

A total of 131 MR studies in 79 patients were performed, with a total of 157 study ears. Sixty-one patients (77%) had unilateral devices. Four patients (5%) underwent MRI with ABI magnets in place. Sixteen patients (20%) had MRI-compatible devices that did not require a head wrap. There were no instances of device stimulation, device malfunction, or excessive heating of the receiver-stimulator package. Magnet tilt requiring manual repositioning occurred during seven studies (4.5%) and magnet displacement requiring operative intervention occurred during seven studies (4.5%). Significant pain where imaging had to be discontinued occurred during three episodes (2%). No adverse events were noted among patients who underwent MRI with an MRI-compatible magnet.

CONCLUSIONS

MRI with CI or ABI magnets in place is associated with a low prevalence of adverse events when performed in a controlled setting. Many partial magnet displacements can be corrected with firm manual pressure. Devices with magnets that align with the field within their housing were not associated with any adverse events and do not require immobilization of the magnet during the scan. These may be valuable in patients with known or anticipated need for MRI.

摘要

目的

评估在植入人工耳蜗(CI)和听觉脑干植入物(ABI)的患者中进行 1.5-T MRI 的不良事件和可行性。

地点

单一体位三级学术转诊中心。

患者

植入 CI 和 ABI 且未移除内置磁铁的患者行 1.5-T MRI。

干预措施

MRI 后紧裹头套。

主要观察指标

不良事件,患者耐受性。

结果

79 例患者共进行了 131 项 MRI 研究,共计 157 只研究耳。61 例患者(77%)单侧设备。4 例患者(5%)在 ABI 磁铁在位的情况下进行 MRI。16 例患者(20%)有 MRI 兼容设备,无需头套。无设备刺激、设备故障或接收器刺激器包过热的情况。在 7 项研究中(4.5%)出现磁铁倾斜,需要手动复位;在 7 项研究中(4.5%)出现磁铁移位,需要手术干预。在 3 次(2%)出现因成像必须中断而产生显著疼痛的情况。在进行 MRI 兼容磁铁 MRI 的患者中未观察到不良事件。

结论

在控制环境下,在植入 CI 或 ABI 磁铁的情况下进行 MRI,不良事件的发生率较低。许多部分磁铁移位可以通过牢固的手动压力来纠正。磁铁与外壳内的磁场对齐的设备不会产生任何不良事件,在扫描期间不需要固定磁铁。这些对于已知或预期需要 MRI 的患者可能很有价值。

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