Zilberti Luca, Arduino Alessandro, Torchio Riccardo, Zanovello Umberto, Baruffaldi Fabio, Sanchez-Lopez Hector, Bettini Paolo, Alotto Piergiorgio, Chiampi Mario, Bottauscio Oriano
Istituto Nazionale di Ricerca Metrologica (INRIM), Torino, Italy.
Department of Industrial Engineering, Università degli Studi di Padova, Padova, Italy.
Magn Reson Med. 2024 Jan;91(1):398-412. doi: 10.1002/mrm.29861. Epub 2023 Sep 29.
To investigate whether the risk of peripheral nerve stimulation increases in the presence of bulky metallic prostheses implanted in a patient's body.
A computational tool was used to calculate the electric field (E-field) induced in a realistic human model due to the action of gradient fields. The calculations were performed both on the original version of the anatomical model and on a version modified through "virtual surgery" to incorporate knee, hip, and shoulder prostheses. Five exam positions within a body gradient coil and one position using a head gradient coil were simulated, subjecting the human model to the readout gradient from an EPI sequence. The induced E-field in models with and without prostheses was compared, focusing on the nerves and all other tissues (both including and excluding the bones from the analysis).
In the nerves, the most pronounced increase in the E-field (+24%) was observed around the knee implant during an abdominal MRI (Y axis readout). When extending the analysis to encompass all tissues (excluding bones), the greatest amplification (+360%) occurred around the knee implant during pelvic MRI (Z axis readout). Notable increases in E-field peaks were also identified around the shoulder and hip implants in multiple scenarios.
Based on the presented results, further investigations aimed at quantifying the threshold of nerve stimulation in the presence of bulky implants are desirable.
研究患者体内植入大型金属假体时周围神经刺激风险是否增加。
使用一种计算工具来计算在现实人体模型中由于梯度场作用而感应产生的电场(E场)。计算在解剖模型的原始版本以及通过“虚拟手术”修改以纳入膝关节、髋关节和肩关节假体的版本上进行。模拟了人体梯度线圈内的五个检查位置以及使用头部梯度线圈的一个位置,使人体模型受到来自EPI序列的读出梯度的作用。比较了有假体和无假体模型中感应产生的E场,重点关注神经以及所有其他组织(分析中包括和不包括骨骼)。
在神经方面,腹部MRI(Y轴读出)期间,在膝关节植入物周围观察到E场最显著的增加(+24%)。当将分析扩展到涵盖所有组织(不包括骨骼)时,盆腔MRI(Z轴读出)期间膝关节植入物周围出现了最大的放大(+360%)。在多种情况下,还在肩关节和髋关节植入物周围发现了E场峰值的显著增加。
基于所呈现的结果,需要进一步开展研究以量化存在大型植入物时神经刺激的阈值。