不同类型人工耳蜗植入术后行磁共振检查致磁铁脱位的风险：单中心回顾性研究。
Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study.
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Waldstraße 1, 91054, Erlangen, Germany.
Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315, Straubing, Germany.
出版信息
J Otolaryngol Head Neck Surg. 2023 Apr 21;52(1):28. doi: 10.1186/s40463-023-00633-w.
BACKGROUND
When performing magnetic resonance imaging (MRI) in patients with a cochlear implant (CI), complication rates vary widely in the literature. The primary objective of this retrospective study was to determine the prevalence of complications, in particular magnet dislocation, in patients with CI undergoing 1.5 Tesla (T) MRI. As a secondary objective, the prevalence of magnet dislocation for specific cochlear implant device types was elaborated.
METHODS
In a single-center retrospective study, all patients with a cochlear implant presenting for an MRI examination at 1.5 T at our institution between January 1st, 2010 and December 31st, 2020 were included. Implants with axial and diametrical magnets were included in the study. MRI safety measures were applied before imaging. The prevalence of complications was evaluated. Magnet dislocation rates were calculated for device types with at least 20 MRI exposures.
RESULTS
During the study period, 196 MRI examinations were performed in a total of 128 patients, accounting for 149 different implants (21 implanted bilaterally) with a total of 231 implant exposures to MRI (average 1.69 ± 1.57; min. 1, max. 12). Complications were reported in 50 out of 231 cochlear implant exposures (21.6%). Magnet dislocation occurred in a total of 27 cases (11.7%). Dislocation rates were 29.6% for the Cochlear® CI500 series (24 dislocations from 81 exposures), 1.1% for the Cochlear® CI24RE series (1 from 87) and 0% for the MED-EL® Synchrony (0 from 36). The dislocation rate for the CI500 was significantly higher than for the CI24RE (χ = 26.86; p < 0.001; ϕ = 0.40) or the Synchrony (χ = 13.42; p < 0.001; ϕ = 0.34).
CONCLUSIONS
For 1.5 T MRI, the risk of magnet dislocation ranges from 0 to 29.6% and depends on the CI device type. Implants with a diametrical magnet can be considered potentially MRI-safe, whereas in CIs with axial magnets, the CI500 is at high risk of magnet dislocation. Therefore, apart from a strict indication for an MRI and adherence to safety protocols, post-MRI follow-up examination to rule out magnet dislocation is recommended.
背景
在接受人工耳蜗植入（CI）的患者中进行磁共振成像（MRI）时，文献中的并发症发生率差异很大。本回顾性研究的主要目的是确定在我们机构接受 1.5T MRI 的 CI 患者中出现并发症（尤其是磁铁脱位）的发生率。作为次要目标，阐述了特定人工耳蜗植入装置类型的磁铁脱位发生率。
方法
在单中心回顾性研究中，纳入 2010 年 1 月 1 日至 2020 年 12 月 31 日期间在我院因 1.5T MRI 而就诊的所有接受 CI 的患者。研究纳入了具有轴向和直径磁铁的植入物。在成像前应用 MRI 安全措施。评估并发症的发生率。对于至少有 20 次 MRI 暴露的设备类型，计算磁铁脱位率。
结果
在研究期间，共对 128 名患者的 196 次 MRI 检查进行了评估，涉及 149 个不同的植入物（双侧植入 21 个），总共进行了 231 次植入物 MRI 暴露（平均 1.69±1.57；最小 1，最大 12）。在 231 次人工耳蜗植入物暴露中，有 50 次报告了并发症（21.6%）。总共发生了 27 例磁铁脱位（11.7%）。 Cochlear®CI500 系列的脱位率为 29.6%（81 次暴露中有 24 次脱位）， Cochlear®CI24RE 系列的脱位率为 1.1%（87 次暴露中有 1 次脱位），MED-EL®Synchrony 的脱位率为 0%（36 次暴露中无脱位）。CI500 的脱位率明显高于 CI24RE（χ²=26.86；p<0.001；φ=0.40）或 Synchrony（χ²=13.42；p<0.001；φ=0.34）。
结论
对于 1.5T MRI，磁铁脱位的风险范围为 0%至 29.6%，取决于 CI 装置类型。具有直径磁铁的植入物可被认为具有潜在的 MRI 安全性，而具有轴向磁铁的 CI 中，CI500 有很高的磁铁脱位风险。因此，除了严格的 MRI 适应证和遵守安全协议外，建议在 MRI 后进行随访检查以排除磁铁脱位。
Zotero 插件