MR兼容心脏起搏器植入患者MR检查的安全性观察  

The safety of magnetic resonance scan in patients implanted with magnetic resonance imaging conditional pacemaker

作　　者：陈巧莉 张杰芳[2] 杨莹[2] 姜冬梅 傅国胜[2] CHEN Qiaoli;ZHANG Jiefang;YANG Ying;JIANG Dongmei;FU Guosheng(Department of Cardiology,Sir Run Run Shaw Hospital of Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]金华市武义县第一人民医院心内科 [2]浙江大学医学院附属邵逸夫医院心内科,杭州310016

出　　处：《心电与循环》2020年第5期463-468,共6页Journal of Electrocardiology and Circulation

摘　　要：目的观察MR兼容心脏起搏器植入患者MR检查的安全性。方法回顾分析2015年8月至2017年8月浙江大学医学院附属邵逸夫医院147例植入MRI兼容双腔起搏器患者的完整临床资料,其中非2型糖尿病107例,2型糖尿病40例,比较两组患者术中、术后1、2、3个月心房及心室感知、阈值、阻抗。分析1.5T MRI检查后这些参数、电池电量变化及MRI图像质量。结果糖尿病与非糖尿病患者术中及术后3月内的起搏器参数比较,差异无统计学意义(P>0.05)。术后11例患者进行16次1.5T MRI检查,其中头颅5次、脊椎4次、关节3次、腹部、心脏各2次。单次和多次MRI检查均未引发起搏参数异常、起搏器工作异常及电量异常耗损。除心脏MRI图像外其余MRI图像均很好达到了诊断要求。结论2型糖尿病对MRI兼容起搏器急性期起搏参数影响不大,1.5T MRI检查是安全的且不影响起搏器功能。Objective To observe the safety of magnetic resonance scan in patients with magnetic resonance imaging(MRI)conditional cardiac pacemaker.Methods The clinical data of 147 patient implanted with MRI conditional pacemaker were retrospectively analyzed.Of them,107 cases were non-diabetic patients and 40 cases were type-2 diabetic patients.The pacing parameters including atrial/ventricular sensing amplitude,capture threshold and lead impedance during operation,at 1,2 and 3 months after pacemaker implantation were compared between diabetic and non-diabetic patients.These parameters and battery level after 1.5T MRI scan and the quality of MRI were analyzed.Results There was no significant difference in pacing parameters during the procedure and within 3 months after the procedure between diabetic and non-diabetic patients.11 patients underwent 16 times 1.5T MRI examinations,including 5 times for skull,4 times for vertebration,3 times for joint,2 times for abdomen and heart after the procedure.No abnormal pacing parameters,abnormal pacemaker operation and abnormal battery power consumption were induced by single or multiple MRI examinations.All MR images,except for cardiac MR images,fully met diagnostic requirements.Conclusion Type-2 diabetes has little impact on pacing parameters of MRI conditional pacemaker in acute phase.1.5T MRI scan is safety and does not interfere with pacemaker function.

关 键 词：磁共振显像 植入型电子器械 糖尿病 糖化血红蛋白 起搏参数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R541.7[医药卫生—诊断学]