Harvard Orthopaedic Trauma Initiative, Massachusetts General Hospital, Boston, MA.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
J Orthop Trauma. 2024 Sep 1;38(9):510-514. doi: 10.1097/BOT.0000000000002843.
To report on adverse events during magnetic resonance imaging (MRI) in patients with external fixators.
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Retrospective case series.
Two Level 1 trauma centers.
Patients with external fixators on the appendicular skeleton or pelvis undergoing MRI between January 2005 and September 2023.
Adverse events, defined as any undesirable event associated with the external fixator being inside or outside the MRI bore during imaging, including (subjective) heating, displacement or pullout of the external fixator, or early MRI termination for any reason.
A total of 97 patients with 110 external fixators underwent at least one MRI scan with an external fixator inside or outside of the MRI bore. The median age was 51 years (interquartile range: 39-63) and 56 (58%) were male. The most common external fixator locations were the ankle (24%), knee (21%), femur (21%), and pelvis (19%). The median duration of the MRI was 40 minutes (interquartile range: 26-58), 86% was performed using 1.5-Tesla MRI, and 14% was performed using 3.0-Tesla MRI. Ninety-five percent of MRI was performed for the cervical spine/head. Two MRI scans (1.6%), one of the shoulder and one of the head and cervical spine, with the external fixator outside of the bore were terminated early because of patient discomfort. There were no documented events of displacement or pullout of the external fixator.
These findings suggest that MRI scans of the (cervical) spine and head can be safely obtained in patients with external fixators on the appendicular skeleton or pelvis. Given the low numbers of MRI scans performed with the external fixator inside the bore, additional studies are necessitated to determine the safety of this procedure. The results from this study can aid orthopaedic surgeons, radiologists, and other stakeholders in developing local institutional guidelines on MRI scanning with external fixators in situ.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
报告在带有外部固定器的患者进行磁共振成像（MRI）期间发生的不良事件。
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回顾性病例系列。
两个 1 级创伤中心。
四肢骨骼或骨盆上带有外部固定器，在 2005 年 1 月至 2023 年 9 月期间进行 MRI 的患者。
不良事件，定义为与成像过程中外置固定器在 MRI 孔内或孔外相关的任何不良事件，包括（主观）加热、外置固定器的移位或脱出，或因任何原因提前结束 MRI。
共有 97 名患者，110 个外部固定器在 MRI 孔内或孔外进行了至少一次 MRI 扫描。中位年龄为 51 岁（四分位距：39-63），56 名（58%）为男性。最常见的外部固定器位置是踝关节（24%）、膝关节（21%）、股骨（21%）和骨盆（19%）。MRI 的中位持续时间为 40 分钟（四分位距：26-58），86%采用 1.5-Tesla MRI，14%采用 3.0-Tesla MRI。95%的 MRI 是为颈椎/头部进行的。两次 MRI 扫描（1.6%），一次是肩部，一次是头部和颈椎，由于患者不适，外置固定器在孔外提前结束。没有记录到外置固定器移位或脱出的事件。
这些发现表明，在四肢骨骼或骨盆上带有外部固定器的患者中，可以安全地进行（颈椎）脊柱和头部的 MRI 扫描。鉴于在孔内进行的外部固定器 MRI 扫描数量较少，需要进一步研究以确定该程序的安全性。本研究的结果可以帮助骨科医生、放射科医生和其他利益相关者制定关于在原位带有外部固定器进行 MRI 扫描的本地机构指南。
预后 III 级。请参阅作者说明，以获取完整的证据水平描述。
