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废弃临时心外膜起搏导线患者的MRI安全性:一项八年回顾性研究:原始研究文章

MRI safety in patients with abandoned temporary epicardial pacing wires: an eight-year retrospective study : Original Research Article.

作者信息

Chamberlin Jordan H, Glenn Eleanor, Hamishegi Fatemeh S, Burt Jeremy R, Antonucci Michael, Baruah Dhiraj, Kabakus Ismail Mikdat

机构信息

Division of Cardiothoracic Imaging, Department of Radiology, Medical University of South Carolina, Charleston, SC, USA.

Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Int J Cardiovasc Imaging. 2025 Aug 7. doi: 10.1007/s10554-025-03482-y.

Abstract

To evaluate the prevalence and types of adverse events associated with magnetic resonance imaging (MRI) in patients with abandoned temporary epicardial pacing wires (TEPW) over an eight-year period. A total of 54 patients and 104 MRI examinations with abandoned TEPW (9 cardiac, 6 non-cardiac thoracic, 89 other) were included in the final analysis. Imaging was reviewed to confirm wire presence and billing information was queried to identify hardware manufacturer. The prevalence of major and minor adverse events as clinically documented or reported by the MRI safety team was recorded. Results were contextualized based on the duration that wires were in situ, when this information was available. No major adverse events were recorded. One minor sensory event occurred during a 1.5T cervical spine MRI in a patient with wires retained for 215 days. No acute abnormalities or wire positioning changes were noted. In situ duration ranged from 3 to 8684 days, with 4.8% of patients having wires for less than 1 month. Brain (36%) and abdominal (28.2%) MRIs were most frequent. No adverse events were reported in cardiac or thoracic MRIs. Most leads, including in the minor event, were Medtronic Bipolar Coaxial 6495. MRI in patients with abandoned TEPW has a very low rate of minor adverse events. No major events occurred over 8 years. MRI should not be withheld from patients with abandoned TEPW. Routine discussion of risks and benefits should continue with recognition that alternative tests may obviate the need for MRI. The low prevalence of minor adverse events is reassuring, and risks can be mitigated by ensuring compliance with manufacturer guidelines and minimizing energy deposition during imaging.

摘要

评估在八年期间内,废弃临时心外膜起搏导线(TEPW)的患者中与磁共振成像(MRI)相关的不良事件的发生率及类型。最终分析纳入了54例患者及104次伴有废弃TEPW的MRI检查(9例心脏检查,6例非心脏胸部检查,89例其他检查)。对影像进行复查以确认导线的存在,并查询计费信息以确定硬件制造商。记录临床记录或MRI安全团队报告的主要和次要不良事件的发生率。若有导线在位时间信息,根据该时间对结果进行背景分析。未记录到主要不良事件。1例导线留存215天的患者在1.5T颈椎MRI检查期间发生了1次轻微感觉事件。未观察到急性异常或导线位置改变。导线在位时间为3至8684天,4.8%的患者导线留存时间不足1个月。脑部MRI(36%)和腹部MRI(28.2%)最为常见。心脏或胸部MRI检查未报告不良事件。包括轻微事件中的大多数导线为美敦力双极同轴6495型。废弃TEPW患者进行MRI检查时轻微不良事件发生率极低。8年期间未发生重大事件。不应拒绝为有废弃TEPW的患者进行MRI检查。应继续常规讨论风险和益处,同时认识到替代检查可能无需进行MRI检查。轻微不良事件的低发生率令人安心,通过确保遵守制造商指南并在成像期间尽量减少能量沉积可降低风险。

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