Holtmann L, Hans S, Kaster F, Müller V, Lang S, Göricke S, Lang-Roth R, Arweiler-Harbeck D
Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.
Cochlear Implants Int. 2021 Jul;22(4):195-202. doi: 10.1080/14670100.2021.1872906. Epub 2021 Feb 12.
Although modern cochlear implants (CIs) are approved for magnetic resonance imaging (MRIs) adverse events still occur with unacceptable frequency. Methods: In this retrospective study, magnet displacement due to MRIs was analysed. Relevant factors e.g. symptoms during MRI, diagnostics, surgical intervention following the diagnosis and possible subsequent damage were assessed.
16 patients were enclosed. All patients complained about pain while the scan was conducted. Computed tomography (CT) scans of the temporal bone or X-rays of the skull were performed to confirm diagnosis. Artefacts on CT scans delayed immediate diagnosis in some cases.
Despite various studies demonstrating the range of adverse events related to CIs following MRI, little information is available on diagnosis and radiologic recognition of magnet dislocation. In patients complaining about pain following an MRI scan an X-ray of the head should be performed immediately. Most adverse events occur in radiological centres without expertise in cochlear implants.
Comprehensive training of patients, surgeons and radiologists is the most efficient tool to prevent damage to the CI and the patient. X-ray of the skull is suggested to be used as the method of choice in imaging.
尽管现代人工耳蜗（CI）已获磁共振成像（MRI）批准，但不良事件仍以不可接受的频率发生。方法：在这项回顾性研究中，分析了MRI导致的磁体移位情况。评估了相关因素，如MRI期间的症状、诊断、诊断后的手术干预以及可能的后续损伤。
纳入16例患者。所有患者在扫描过程中均主诉疼痛。进行了颞骨计算机断层扫描（CT）或颅骨X线检查以确诊。CT扫描上的伪影在某些情况下延迟了即时诊断。
尽管有各种研究表明了与MRI后人工耳蜗相关的不良事件范围，但关于磁体脱位的诊断和放射学识别的信息却很少。对于MRI扫描后主诉疼痛的患者，应立即进行头部X线检查。大多数不良事件发生在没有人工耳蜗专业知识的放射中心。
对患者、外科医生和放射科医生进行全面培训是预防人工耳蜗和患者受损的最有效工具。建议将颅骨X线检查用作成像的首选方法。
