Vol 49, No 1 (2015)

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The use of 1.5T magnetic resonance imaging for therapeutic decisions in patients with cardiac implantable electronic devices and significant neurological, neurosurgical and neuro-oncology diagnostic indications

Łukasz Hawryluk1, Maciej Sterliński1, Magdalena Marczak2, Jolanta Miśko2, Jan Krzysztof Podgórski3, Hanna Szwed1
DOI: 10.1016/j.pjnns.2014.12.005
Neurol Neurochir Pol 2015;49(1):16-23.

Abstract

Between September 2009 and May 2014 the classification of 36 patients with cardiac implantable electronic devices (CIEDs) in terms of the feasibility of MRI scanning due to strong clinical indications was carried out. Finally MRI examinations were performed in 20 patients, of whom 27 studies were conducted and a total number of 35 anatomical regions were scanned. Neurological, neurosurgical and neuro-oncology indications for MRI were reported in 19 patients (95%) in whom 26 MRI studies (96.3%) were performed, and 34 anatomical regions (97.1%) were scanned. One patient had indications for MRI in the field of cardiology.

Medical information obtained from 27 MRI studies allowed decisions to be made regarding the treatment in all patients. After 8 studies (29.6%), patients were classified into 9 different neurosurgical procedures. In the case of the remaining 19 studies (70.4%), there were no indications for surgical treatment and the decisions to implement conservative treatment were made.

There were no complications related to the implanted CIEDs observed: neither immediate nor in the follow-up.

Conclusions

(1)Magnetic resonance imaging studies in patients with non-MRI-conditional CIEDs in the vast majority are performed because of significant neurological, neurosurgical and neuro-oncology clinical indications.(2)Careful determination of the indications for MRI in each case allows the data necessary to be obtained to make definitive treatment decisions.(3)The adherence to examination protocol and device controlling procedures after MRI allows a very high safety profile of the method to be achieved.

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Neurologia i Neurochirurgia Polska