Safety and Utility of Spinal Magnetic Resonance Imaging in Patients with High-Frequency Spinal Cord Stimulators: A Prospective Single-Centre Study.
Electrodes, Implanted
/ standards
Humans
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Pain
/ diagnostic imaging
Pain Management
/ instrumentation
Prospective Studies
Retrospective Studies
Spinal Cord
/ diagnostic imaging
Spinal Cord Stimulation
/ instrumentation
Tomography, X-Ray Computed
/ methods
High-fequency spinal cord stimulator implantation
Spinal cord stimulation
Spinal magnetic resonance imaging
Journal
Stereotactic and functional neurosurgery
ISSN: 1423-0372
Titre abrégé: Stereotact Funct Neurosurg
Pays: Switzerland
ID NLM: 8902881
Informations de publication
Date de publication:
2019
2019
Historique:
received:
08
03
2019
accepted:
26
09
2019
pubmed:
28
10
2019
medline:
1
4
2020
entrez:
28
10
2019
Statut:
ppublish
Résumé
Implanted high-frequency spinal cord stimulators at 10 kHz (HF-SCS) have recently acquired conditional approval for magnetic resonance imaging (MRI), including retrospective application to previously implanted devices. Under certain conditions, there are greater specific absorption rate (SAR) scanning restrictions compared to some conventional alternatives. This poses technical challenges to obtain diagnostic quality imaging. To describe our experience with 9 such scans, demonstrating that safe and diagnostically useful images can be obtained despite these restrictions. We report a prospective single-centre series of 9 scans within a tertiary neuroscience centre, all obtained within the required SAR limit of ≤0.4 W/kg, and describe the scanning protocol we have developed. We further illustrate this with 2 representative patient cases. The imaging studies were well tolerated without complication. In all cases, the imaging quality was sufficient for the reporting neuroradiologist to answer the clinical question posed. Despite technical challenges, MRI is feasible, safe and diagnostically useful in HF-SCS-implanted patients. We would invite other centres that implant these devices to consider the development of their own scanning protocols to avoid the morbidity and inconvenience of explantation or computed tomography myelography. To our knowledge, this is the first reported study of MRI in HF-SCS-implanted patients achieving the requisite SAR limit of ≤0.4 W/kg.
Sections du résumé
BACKGROUND
Implanted high-frequency spinal cord stimulators at 10 kHz (HF-SCS) have recently acquired conditional approval for magnetic resonance imaging (MRI), including retrospective application to previously implanted devices. Under certain conditions, there are greater specific absorption rate (SAR) scanning restrictions compared to some conventional alternatives. This poses technical challenges to obtain diagnostic quality imaging.
OBJECTIVES
To describe our experience with 9 such scans, demonstrating that safe and diagnostically useful images can be obtained despite these restrictions.
METHODS
We report a prospective single-centre series of 9 scans within a tertiary neuroscience centre, all obtained within the required SAR limit of ≤0.4 W/kg, and describe the scanning protocol we have developed. We further illustrate this with 2 representative patient cases.
RESULTS
The imaging studies were well tolerated without complication. In all cases, the imaging quality was sufficient for the reporting neuroradiologist to answer the clinical question posed.
CONCLUSION
Despite technical challenges, MRI is feasible, safe and diagnostically useful in HF-SCS-implanted patients. We would invite other centres that implant these devices to consider the development of their own scanning protocols to avoid the morbidity and inconvenience of explantation or computed tomography myelography. To our knowledge, this is the first reported study of MRI in HF-SCS-implanted patients achieving the requisite SAR limit of ≤0.4 W/kg.
Identifiants
pubmed: 31655819
pii: 000503730
doi: 10.1159/000503730
pmc: PMC6979418
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
272-277Informations de copyright
The Author(s). Published by S. Karger AG, Basel.
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