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Published on: September 13, 2015
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In Vitro Magnetic Resonance Imaging Evaluation of Fragmented, Open-Coil, Percutaneous Peripheral Nerve Stimulation
Frank G Shellock1, Armaan Zare2, Brian M Ilfeld3
1Departments of Radiology and Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Summary
MRI can be safely performed on patients with retained percutaneous peripheral nerve stimulation (PNS) lead fragments at 1.5 Tesla. However, 3 Tesla MRI is not recommended due to potential excessive heating of these metallic fragments.
Area of Science:
- Medical Devices
- Radiology
- Pain Management
Background:
- Percutaneous peripheral nerve stimulation (PNS) is an FDA-cleared pain treatment.
- Metallic lead fragments may be retained after PNS lead removal, posing potential MRI risks.
- Understanding these risks is crucial for patient safety during diagnostic imaging.
Purpose of the Study:
- To evaluate magnetic resonance imaging (MRI)-related issues for retained percutaneous peripheral nerve stimulation (PNS) lead fragments.
- Assess magnetic field interactions, heating, and image artifacts associated with various lead fragment lengths.
- Determine safe MRI conditions for patients with retained PNS lead fragments.
Main Methods:
- Testing involved standardized techniques on lead fragments of varying lengths (50%, 75%, 100% of 12.7 cm).
- Magnetic field interactions and artifacts were assessed at 3 Tesla.
- MRI-related heating was evaluated at 1.5 Tesla and 3 Tesla using a gelled-saline phantom.
Main Results:
- Minor magnetic field interactions were observed with the longest lead fragment.
- Physiologically inconsequential heating occurred at 1.5 Tesla.
- Excessive temperature elevations were possible at 3 Tesla under certain conditions.
- Artifacts extended approximately 7 mm from the lead fragments on gradient echo sequences.
Conclusions:
- MRI is considered safe for patients with retained PNS lead fragments at 1.5 Tesla under specific MR Conditional guidelines.
- Due to potential excessive heating, MRI at 3 Tesla is currently not advised for these patients.
- Further research may inform future safety protocols for higher field strength MRI.
