摘要
目的患者接受MRI检查时,植入体内的金属心脏支架将受到静磁场、梯度磁场和射频磁场的影响,其中射频磁场能使金属材料产生热效应。在目前临床诊断中,还没有心脏支架基于MRI检查中的致升温效应相应的数据,不能保证金属植入患者接受MRI检查的安全性。探讨心脏支架在MRI检查中的致升温效应与安全性分析。方法使用一种接近人体血液密度的组织补偿膜模拟心脏支架在人体血管内流动的内环境,并对植入金属心脏支架的人体仿真物进行3.0 T MRI扫描,采用自旋回波(SE)序列、平面回波成像(EPI)序列、快速自旋回波(FSE)序列和梯度回波(GRE)序列进行实验。通过采集卡和LabVIEW软件采集测温分压电路中紧贴心脏支架的负温度系数(NTC)热敏电阻两端电压变化情况,从而间接测量心脏支架温度变化量,最后利用Origin软件进行后续的数据处理,绘制不同序列下的心脏支架时间-温度曲线并进行相关数据分析。结果植入心脏支架的患者在进行MRI检查时支架温度会升高,并且在不同的MRI序列下升温的幅度不同,体积小的心脏支架升温幅度比体积大的心脏支架小,且大多处于0.1℃~1.5℃内。结论从临床角度来说,实验所获得的升温情况是否安全需要进一步考量,心脏支架在MRI检查中致升温效应可能会导致心肌水肿和心肌瘢痕形成等不良反应,其中血管收缩对动脉硬化狭窄的患者是很危险的,有时甚至是致命的。因此需要MRI医技人员在对装有心脏支架的患者进行MRI检查时多加注意,确保患者的安全。
Objective To study warming effect and conduct safety analysis of cardiac stents in MRI examination, under the consideration that implanted metal heart stent is affected by static magnetic field, gradient magnetic field and radio frequencymagnetic field which makes metal material to produce thermal effects during MRI examination;and the safety of MRI examination for patients with metal implantation cannot be guaranteed since there has no data on warming effect of cardiac stents based on MRI in current clinical study. Methods A tissue compensation membrane closed to density of human blood was used to simulate internal environment of cardiac stents flowing in vessel, and 3.0 T MRI scan with SE sequence, EPI sequence,FSE sequence and GRE sequence were performed on human simulation with implanted metal cardiac stents. The voltage change at both ends of negative temperature coefficient(NTC) thermistor closed cardiac stents in temperature divider circuit was collected by acquisition card and LabVIEW software, which indirectly measured temperature change of cardiac stents. The Origin software was used to perform data process, and time-temperature curves of cardiac stents of different sequences were drawn and analyzed. Results The stent temperature increased when patient with implanted cardiac stents underwent MRI examination, and temperature was differently increased under different MRI sequences. Smaller cardiac stents showed smaller temperature increase than larger one, and the temperature increase was mostly within 0.1 ℃-1.5 ℃. Conclusion It is demonstrated that the safety of warming effect obtained from the experiment needs further discussion in clinical study. The warming effect of cardiac stents in MRI may lead to adverse reactions including myocardial edema and myocardial scar formation, of which vasoconstriction is very dangerous and even fatal to patients with arteriosclerosis and stenosis. Therefore, more attention should be paid to patients with implanted cardiac stents to ensure their safety during MRI ex
作者
杨春花
韩佳薇
何伟
王传兵
秦鑫
周雪芳
陈晓宇
YANG Chun-hua;HAN Jia-wei;HE Wei;WANG Chuan-bing;QIN Xin;ZHOU Xue-fang;CHEN Xiao-yu(Department of Clinical Medical Engineering,Jiangsu Province Hospital,Nanjing 210029,Jiangsu,China;Department of Radiology,Jiangsu Province Hospital,Nanjing 210029,Jiangsu,China;Institute of Science and Technology for Brain-Inspired Intelligence,Fudan University,Shanghai 200433,China;Suzhou Jimeirui Medical Instrument Co.,Ltd.,Zhangjiagang 215625,Jiangsu,China)
出处
《生物医学工程与临床》
CAS
2021年第3期271-276,共6页
Biomedical Engineering and Clinical Medicine
基金
南京医科大学十二五教学课题(NY2222015038)
江苏高校优势学科建设工程资助项目(JXl0231801)。
