Department of Otolaryngology, The Richard Ramsden Centre for Hearing Implants, Manchester Royal Infirmary, Manchester, UK.
Department of ENT, Great Western Hospital, Swindon, UK.
Cochlear Implants Int. 2023 Sep;24(5):260-267. doi: 10.1080/14670100.2023.2172828. Epub 2023 Mar 20.
Many patients with cochlear implants (CI) and auditory brainstem implants (ABI) require magnetic resonance imaging (MRI) following implantation. This study explores the patient experience of MRI, identifying factors associated with pain, and the effect of interventions designed to enhance comfort and safety.
A prospective observational case series from a tertiary referral unit. Tight head bandaging ± local anaesthetic injection (devices with non-MRI-compatible magnets) or observation alone (implants with MRI-compatible magnets) were employed for 1.5 T MRI of consecutive adult patients with CI or ABI without magnet removal. Pain was recorded via visual analogue scale (1 = no pain, 5 = extreme pain) at three time points; (1) baseline, (2) head bandage applied (3) during scanning. Patient age, device type, body area imaged and total scan time were recorded as variables, alongside adverse events.
Data were collected for 227 MRI scans (34 patients with ABI, 32 with CI). In patients managed with bandaging, pain score after bandaging but prior to scanning (median 2.2) did not differ from pain during scanning (2.1), but both were significantly higher than baseline (1.4, both P≤0.001). Scanning areas other than the head/cervical spine was associated with higher pain scores (P = 0.036). Pain during MRI differed between different manufacturers implants (P≤0.001). Adverse events occurred in 8/227 scans (3.5%), none occurring with devices containing an MRI-compatible magnet.
MRI scanning with auditory implant magnets in situ is safe and well tolerated by patients.
许多植入人工耳蜗（CI）和听觉脑干植入物（ABI）的患者在植入后需要进行磁共振成像（MRI）检查。本研究探讨了患者接受 MRI 的体验，确定了与疼痛相关的因素，以及旨在增强舒适度和安全性的干预措施的效果。
这是一项来自三级转诊单位的前瞻性观察性病例系列研究。对连续的成人 CI 或 ABI 患者进行 1.5T MRI 检查，这些患者的设备带有非 MRI 兼容的磁铁，使用了紧密的头带包扎加局部麻醉注射（或仅观察）。通过视觉模拟评分（1=无疼痛，5=极度疼痛）在三个时间点记录疼痛：（1）基线，（2）头带包扎，（3）扫描期间。记录患者年龄、设备类型、成像身体部位和总扫描时间等变量，以及不良事件。
共收集了 227 次 MRI 扫描（34 例 ABI 患者，32 例 CI 患者）的数据。在接受包扎管理的患者中，包扎后但在扫描前的疼痛评分（中位数为 2.2）与扫描期间的疼痛评分（2.1）没有差异，但均明显高于基线（1.4，均 P≤0.001）。除头部/颈椎以外的扫描区域与更高的疼痛评分相关（P=0.036）。不同制造商的植入物在 MRI 期间的疼痛存在差异（P≤0.001）。227 次扫描中有 8 次（3.5%）发生了不良事件，均未发生在含有 MRI 兼容磁铁的设备中。
原位植入听觉植入物磁铁进行 MRI 扫描对患者是安全且可耐受的。
