植入式心脏电子设备患者的磁共振成像
MRI of Patients with Cardiac Implantable Electronic Devices.
作者信息
Martinez Jessica A, Ennis Daniel B
机构信息
Department of Radiological Sciences, University of California, Los Angeles, CA, USA.
Department of Bioengineering, University of California, Los Angeles, CA, USA.
出版信息
Curr Cardiovasc Imaging Rep. 2019 Jul;12(7). doi: 10.1007/s12410-019-9502-8. Epub 2019 May 27.
PURPOSE OF REVIEW
The purpose of this review is to clarify the risks associated with MRI exams for patients with cardiac implantable electronic devices (CIEDs) and to provide information regarding the MRI examination protocol for patients with CIEDs.
RECENT FINDINGS
Several prospective studies evaluated the feasibility of MRI exams for patients with CIEDs and reported no adverse events. These studies suggest that by following a specific MRI examination protocol and monitoring both CIED parameters and the patient's symptoms, an MRI exam can be performed by appropriately trained personnel with an acceptable benefit-to-risk ratio.
SUMMARY
Both MR unsafe and MR conditional CIEDs are commercially available, but there are no MR safe CIEDs. The potential risks faced by patients with CIEDs during an MRI exam are always present and warrant careful monitoring. Three magnetic fields in the MRI scanner interact with the device in ways that can damage the CIED or harm the patient. Due to safety concerns and out of an abundance of caution, the majority of MRI exams for patients with CIEDs are currently denied. However, when following a specific MRI exam protocol, these risks can be mitigated.
综述目的
本综述旨在阐明心脏植入式电子设备（CIED）患者进行MRI检查的相关风险，并提供有关CIED患者MRI检查方案的信息。
最新发现
多项前瞻性研究评估了CIED患者进行MRI检查的可行性，且未报告不良事件。这些研究表明，通过遵循特定的MRI检查方案并监测CIED参数和患者症状，经过适当培训的人员可以进行MRI检查，且效益风险比可接受。
总结
市场上既有MR不安全的CIED，也有MR条件性的CIED，但不存在MR安全的CIED。CIED患者在MRI检查期间面临的潜在风险始终存在，需要仔细监测。MRI扫描仪中的三个磁场会以可能损坏CIED或伤害患者的方式与设备相互作用。出于安全考虑并为谨慎起见，目前大多数CIED患者的MRI检查被拒绝。然而，遵循特定的MRI检查方案时，这些风险可以得到缓解。
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