E1697. To Scan or Not to Scan: MRI Safety Questions and Answers to the Various Implanted Electronic Devices
Hershey Medical Center
Hershey Medical Center
A variety of active implanted medical devices (AIMD) are available for treatment of multiple conditions. AIMDs contain an energy source such as a battery or have the ability to be inductively coupled exposure to the different fields inherent in the MR environment (e.g., heating of leads) or to secondary injury from device malfunction (e.g., infusion pump failure to restart; damaged circuitry in a cardiac pacemaker) as a consequence of exposure to the MR environment. With all these AIMDs, the MR environment is associated with multiple challenges to safe scanning in patients. As MR practices become increasingly complex, MR safety practices must continue to evolve to meet the associated challenges.
Educational Goals / Teaching Points
The goals of this exhibit are to discuss the safety challenges of MR and scanning AIMDs and discuss the ACR safety guidelines and approach to the various AIMDs.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The MR environment is associated with multiple challenges to safe scanning in patients with AIMDs. A variety of AIMDs are implanted for the treatment of multiple conditions. These patients are likely to require advanced imaging, including MRI, to follow up on their disease conditions. These devices under exposure to the MR environment may cause heating of leads and burns to the surrounding vital tissues and device malfunction (e.g., infusion pump failure to restart; damaged circuitry in a cardiac pacemaker). In this exhibit, we discuss the approach to investigate the safety of the various implanted electronic devices including cardiac devices (pacemakers and defibrillators) and neurostimulators (deep brain, auditory brainstem implant, spinal cord, vagal nerve, sacral nerve, hypoglossal nerve, phrenic nerve, peripheral nerve, and auditory nerve/cochlear implants) as well as implantable medication pumps.
It is paramount to discuss the important points to remember while screening for patient safety with the various common and less common AIMDs before the patient is subjected to MRI examination.