Journal of magnetic resonance imaging : JMRI · 2025
Multidisciplinary Protocol for 1.5T MRI in Adult Patients With Active Implantable Medical Devices: Safety and Efficacy in a Five-Year Single-Center Experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Filice Silvano, Pavarani Antonio, Placci Angelo, Falcioni Maurizio, Manferdini Maria Elena
Аннотация
BACKGROUND: The growing population of patients with active implantable medical devices (AIMDs) presents challenges for MRI access. Safety concerns regarding device malfunction and patient risk, demand standardized management strategies.
PURPOSE: To evaluate the safety and feasibility of a structured multidisciplinary safety protocol for 1.5T MRI in AIMD carriers.
STUDY TYPE: Retrospective.
POPULATION: 514 consecutive patients with AIMDs (cardiac implantable electronic devices (CIEDs) (n = 347), auditory implants (n = 85), neurostimulators (n = 61), and drug delivery systems (n = 21)) scheduled for clinical MRI (head (34.3%), spine (19.0%), prostate (10.5%), abdomen/pelvis (9.5%), knee (8.6%), heart (3.8%), and other sites (14.3%)) between 2019 and 2025.
FIELD STRENGTH/SEQUENCE: MRI was performed on 1.5T scanners using predefined protocols, with automatic compliance to device-specific SAR limits through the Philips ScanWise Implant software.
ASSESSMENT: The safety protocol included device verification, MRI-mode programming, compliance with manufacturer safety conditions, physiologic monitoring, and post-MRI device interrogation. MRI completion rates, exclusion frequencies, and adverse events were recorded, and exclusion proportions were compared across AIMD categories.
STATISTICAL TESTS: Descriptive statistics.
RESULTS: Of 514 patients, 50 (9.7%) with MR-unsafe, MR-nonconditional, or artifact-prone devices were not scanned: MR-unsafe (n = 23), MR-nonconditional (n = 22), or anticipated severe artifacts (n = 3). Four hundred and sixty-four (90.3%) patients successfully completed diagnostic MRI. Two brain examinations were terminated early due to implant-site pain. No device resets, malfunctions, or significant changes in sensing/pacing thresholds occurred. Internal magnet displacement was observed in three (3.5%) auditory implants, with two requiring surgical repositioning. Exclusion rates varied by device type, ranging from 11% to 14% for CIEDs to 29% for specific neurostimulators.
DATA CONCLUSION: A structured, multidisciplinary protocol enables safe MRI in the majority of patients with MR-conditional AIMDs. Standardized pre-MRI screening and management support safe implementation, and improve MRI accessibility for this growing and complex patient population.
TECHNICAL EFFICACY STAGE: 5.
PURPOSE: To evaluate the safety and feasibility of a structured multidisciplinary safety protocol for 1.5T MRI in AIMD carriers.
STUDY TYPE: Retrospective.
POPULATION: 514 consecutive patients with AIMDs (cardiac implantable electronic devices (CIEDs) (n = 347), auditory implants (n = 85), neurostimulators (n = 61), and drug delivery systems (n = 21)) scheduled for clinical MRI (head (34.3%), spine (19.0%), prostate (10.5%), abdomen/pelvis (9.5%), knee (8.6%), heart (3.8%), and other sites (14.3%)) between 2019 and 2025.
FIELD STRENGTH/SEQUENCE: MRI was performed on 1.5T scanners using predefined protocols, with automatic compliance to device-specific SAR limits through the Philips ScanWise Implant software.
ASSESSMENT: The safety protocol included device verification, MRI-mode programming, compliance with manufacturer safety conditions, physiologic monitoring, and post-MRI device interrogation. MRI completion rates, exclusion frequencies, and adverse events were recorded, and exclusion proportions were compared across AIMD categories.
STATISTICAL TESTS: Descriptive statistics.
RESULTS: Of 514 patients, 50 (9.7%) with MR-unsafe, MR-nonconditional, or artifact-prone devices were not scanned: MR-unsafe (n = 23), MR-nonconditional (n = 22), or anticipated severe artifacts (n = 3). Four hundred and sixty-four (90.3%) patients successfully completed diagnostic MRI. Two brain examinations were terminated early due to implant-site pain. No device resets, malfunctions, or significant changes in sensing/pacing thresholds occurred. Internal magnet displacement was observed in three (3.5%) auditory implants, with two requiring surgical repositioning. Exclusion rates varied by device type, ranging from 11% to 14% for CIEDs to 29% for specific neurostimulators.
DATA CONCLUSION: A structured, multidisciplinary protocol enables safe MRI in the majority of patients with MR-conditional AIMDs. Standardized pre-MRI screening and management support safe implementation, and improve MRI accessibility for this growing and complex patient population.
TECHNICAL EFFICACY STAGE: 5.