Repeated MRI of a Patient with an Intramedullary Tumour and Implanted Cardiac Resynchronization Therapy Defibrillator (C
- PDF / 1,659,370 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 21 Downloads / 184 Views
Correspondence
Repeated MRI of a Patient with an Intramedullary Tumour and Implanted Cardiac Resynchronization Therapy Defibrillator (CRT-D) C. Brockmann · T. Sommer · R. Pirzer · H. U. Kerl · I. S. Nolte · A. Förster · M. A. Brockmann
Received: 29 March 2012 / Accepted: 19 September 2012 / Published online: 19 October 2012 © Springer-Verlag Berlin Heidelberg 2012
Introduction The increasing life expectancy of the population of industrialised countries in combination with an increasing availability of novel cardiovascular implantable electronic devices (CIED) and therapeutic fields of application for these devices leads to an increasing number of (younger) patients with implanted CIED. This development is paralleled by an increasing availability of magnetic resonance (MR) scanners and the increasing need of MR imaging in a population continuously growing older [1, 2]. While for many medical questions the computed tomography (CT) provides an excellent diagnostic tool, subtle but relevant changes observed in neuroradiological disease processes frequently require the use of MRI to be detected and interpreted correctly [3]. Exemplarily, for imaging of small structures such as the myelon, an MRI is the unrivalled diagnostic tool due to its high soft tissue contrast [4]. As MRI generally is considered a strict contraindication for patients with a CIED, the number of patients being denied an MR study for this reason is increasing and for the year 2004 it has been estimated to be as high as 200,000 [1]. On M. A. Brockmann () · C. Brockmann · H. U. Kerl · I. S. Nolte · A. Förster Department of Neuroradiology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany e-mail: [email protected] T. Sommer Department of Radiology, DRK Hospital Neuwied, Neuwied, Germany R. Pirzer Department of Cardiology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany
the other hand, for patients with implanted pacemakers and implantable cardioverter defibrillator (ICD), several studies have demonstrated the relative safety of undergoing MRI (reviewed in [5]), whereas for patients with cardiac resynchronization therapy defibrillators (CRT–D) fewer studies exist [6]. Since MRI in patients with most of the used CIED is not approved by the Food and Drug Administration (FDA) but the aforementioned problem is likely to increase, in this article we (a) illustrate the feasibility to perform MRI of the head and spine in a patient with implanted CRT-D, (b) address possible complications and hazards that may be encountered and that need to be discussed with the patient prior to MRI, and (c) provide an overview of the precautionary measures that need to be taken before, during, and after MRI. Case report A 64-year-old female suffering from increasing gait ataxia and right sided hypaesthesia/paraesthesia downward from the level of T6–7 was transferred from an outside hospital for spinal myelography. She was operated 24 years ago on an extrad
Data Loading...
