Bailey William, Robinson Leslie
MRI, Leighton Hospital, Middlewich Road, Cheshire CW1 4QJ, UK.
Radiography Department, University of Salford, Frederick Road, Salford, Greater Manchester M6 6PU, UK.
Radiography (Lond). 2007 Feb;13(1):72-80. doi: 10.1016/j.radi.2005.09.006. Epub 2005 Dec 1.
Magnetic resonance imaging of patients with a metallic Intra-Orbital Foreign Body (IOFB) may be hazardous. Much controversy exists with regard to the optimum initial screening protocol to be undertaken which will ensure patients with metallic IOFBs do not enter the MR controlled area. Once a patient has been screened as 'at risk', further variations in practice exist with regard to optimum imaging modality and radiographic technique to rule out the FB. This is due to a paucity of empirical research which is diverse in approach and conclusion. MR radiographers are developing their role and, as advanced practitioners, will find themselves increasingly involved in decision-making with regard to patient safety. Although it may feel a comfortable option to request a radiograph on all patients who pose a dilemma, MR radiographers need to be able to defend such a course of action through a thorough understanding of the financial and dose implications as discussed in the literature. This review will highlight some of the arguments both for and against screening patients for metallic IOFB and consider the radiographic screening options for 'at risk' patients.
对患有金属眶内异物(IOFB)的患者进行磁共振成像可能具有危险性。关于应采用何种最佳初始筛查方案存在诸多争议,该方案需确保患有金属IOFB的患者不会进入磁共振控制区域。一旦患者被筛查为“有风险”,在排除异物的最佳成像方式和放射技术方面,实际操作中还存在进一步的差异。这是由于实证研究匮乏,且研究方法和结论各不相同。磁共振放射技师正在拓展其角色,作为高级从业者,他们会发现自己越来越多地参与到关乎患者安全的决策中。尽管对所有存在两难情况的患者都要求进行X光检查可能是个稳妥的选择,但磁共振放射技师需要通过透彻理解文献中讨论的财务和剂量影响,来捍卫这一行动方案。本综述将强调支持和反对对患者进行金属IOFB筛查的一些观点,并考虑针对“有风险”患者的放射学筛查选项。