Cahill Ellen M, Chee Michael, Kwong Kelvin
Rutgers Robert Wood Johnson Medical School(RWJMS), Piscataway, NJ, USA.
Division of Pediatric Otolaryngology, Joseph M. Sanzari Children's Hospital, Hackensack Meridian Children's Health, Hackensack, NJ, USA.
Ear Nose Throat J. 2025 Aug;104(8):508-512. doi: 10.1177/01455613221132388. Epub 2022 Oct 19.
Silicone tracheostomy tubes are a popular choice for pediatric patients with chronic tracheostomies due to their pliability and increased comfort. However, the presence of wire reinforcement causes them to be labeled "MR-conditional." The objective of this study was to understand practice patterns across radiology departments for obtaining MRI in children with MR-conditional tracheostomy tubes.
A survey consisting of 7 questions aimed at determining a facility's protocol for obtaining MRI in children with tracheostomy tubes was developed and administered via telephone to MRI technologists at US children's hospitals.
182 children's hospitals were identified and 59 responses were obtained across 30 states (32.4%). 19 sites (32%) were excluded as they were unable to perform MRI. All 40 facilities reported that they have a standard questionnaire for medical implants, however only 20 reported that tracheostomy tubes are included on that questionnaire (50%). 6 (15%) reported all MR-conditional tubes are changed to MR-safe ones. Of the remaining 34, protocols were as follows: 1 (2.9%) scans patients with conditional tubes for a maximum of 15 minutes, 5 (14.7%) only use a 1.5T magnet, and 28 (82.3%) reported following the manufacturer conditions. In terms of artifact, 3 sites change MR-conditional tubes to MR-safe if scanning the head, neck, chest, or abdomen (8.8%), 6 (17.6%) change the tube if scanning the head or neck, 15 (44.1%) change the tube only if scanning the neck, and 10 (29.4%) were not aware of issues with artifact.
Based on this survey of MRI technologists at US children's hospitals, there is no unified protocol for obtaining MRI in pediatric patients with MR-conditional tracheostomy tubes. A lack of standardized protocols may be contributing to unnecessary tracheostomy changes. Future research includes clearly defining the anatomical regions affected by wire-related artifact and developing a standardized MRI protocol for these patients.
硅胶气管造口管因其柔韧性和更高的舒适度，成为患有慢性气管造口术的儿科患者的常用选择。然而，由于有钢丝加固，它们被标记为“MR条件性”。本研究的目的是了解各放射科针对使用MR条件性气管造口管的儿童进行MRI检查的实践模式。
设计了一份包含7个问题的调查问卷，旨在确定医疗机构对使用气管造口管的儿童进行MRI检查的方案，并通过电话向美国儿童医院的MRI技术人员进行调查。
共识别出182家儿童医院，在30个州获得了59份回复（32.4%）。19个机构（32%）因无法进行MRI检查而被排除。所有40个机构均报告称他们有针对医疗植入物的标准问卷，但只有20个机构报告该问卷包含气管造口管（50%）。6个机构（15%）报告将所有MR条件性导管更换为MR安全型导管。在其余34个机构中，方案如下：1个机构（2.9%）对使用条件性导管的患者扫描最长15分钟，5个机构（14.7%）仅使用1.5T磁体，28个机构（82.3%）报告遵循制造商的条件。在伪影方面，3个机构在扫描头部、颈部、胸部或腹部时将MR条件性导管更换为MR安全型导管（8.8%），6个机构（17.6%）在扫描头部或颈部时更换导管，15个机构（44.1%）仅在扫描颈部时更换导管，10个机构（29.4%）未意识到伪影问题。
基于对美国儿童医院MRI技术人员的这项调查，对于使用MR条件性气管造口管的儿科患者进行MRI检查，没有统一的方案。缺乏标准化方案可能导致不必要的气管造口管更换。未来的研究包括明确界定受钢丝相关伪影影响的解剖区域，并为这些患者制定标准化的MRI方案。
