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美国麻醉医师协会监测标准与磁共振成像

ASA monitoring standards and magnetic resonance imaging.

作者信息

Jorgensen N H, Messick J M, Gray J, Nugent M, Berquist T H

机构信息

Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.

出版信息

Anesth Analg. 1994 Dec;79(6):1141-7. doi: 10.1213/00000539-199412000-00020.

DOI:10.1213/00000539-199412000-00020
PMID:7978439
Abstract

Some patients, often because of age or altered mental state, require general anesthesia or monitored anesthesia care and sedation if adequate magnetic resonance imaging (MRI) is to be accomplished. This study evaluated whether patients can be monitored during MRI with 1.5-tesla scanners in a manner which complies with ASA monitoring standards without causing degradation of image quality. Ten volunteers were scanned in the MRI without sedation. Monitors meeting ASA standards were placed and electronic artifact produced by the magnetic resonance (MR) scanner was evaluated, after which two scans of the head and two of the chest were performed. One of each pair of scans was obtained with the monitors functioning and one with them turned off. Four radiologists, blinded as to whether the monitors were turned on or off, independently evaluated the 20 pairs of scans. Differences in diagnostic quality and image degradation between the scans were evaluated and scores assigned. All monitors functioned appropriately during the scans, with the exception of the electrocardiogram (ECG) which was grossly distorted to the extent that only ventricular rate could be evaluated. None of the head or body scans was nondiagnostic; however, images with the monitors off were of better quality overall than with them on. Two types of noise were generated and are described. During the head scans, three of seven monitoring combinations caused degradation of the images, while four were judged clinically adequate. During the body scans, two of six monitoring combinations created noticeable noise, while four introduced no significant noise. Ungated cardiac scans were nondiagnostic.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

一些患者,通常由于年龄或精神状态改变,如果要完成足够的磁共振成像(MRI)检查,需要全身麻醉或接受麻醉监护与镇静。本研究评估了在使用1.5特斯拉扫描仪进行MRI检查时,能否以符合美国麻醉医师协会(ASA)监测标准的方式对患者进行监测,同时又不导致图像质量下降。10名志愿者在未使用镇静剂的情况下接受了MRI扫描。放置了符合ASA标准的监测设备,并对磁共振(MR)扫描仪产生的电子伪影进行了评估,之后对头部进行了两次扫描,对胸部进行了两次扫描。每对扫描中,一次在监测设备运行时进行,另一次在监测设备关闭时进行。四名放射科医生在不知道监测设备是否开启的情况下,独立评估这20对扫描图像。评估了扫描图像之间诊断质量和图像退化的差异,并给出评分。除心电图(ECG)严重失真以至于只能评估心室率外,所有监测设备在扫描过程中均运行正常。头部或身体扫描图像均无不可诊断的情况;然而,监测设备关闭时的图像总体质量优于开启时。产生了两种类型的噪声并进行了描述。在头部扫描中,七种监测组合中有三种导致图像退化,而四种在临床上被认为是足够的。在身体扫描中,六种监测组合中有两种产生了明显的噪声,而四种没有引入明显的噪声。非门控心脏扫描图像不可诊断。(摘要截短于250字)

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