计算机断层扫描期间辐射对可植入心脏转换器-除器的功能的影响
Yusaku Nishikawa1,2, Naoki Fujimoto1, Tomoaki Kurata3
1Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
The Journal of innovations in cardiac rhythm management
|July 16, 2024
概括
计算机断层扫描 (CT) 扫描可以干扰植入式心脏转换器-除器 (ICD),可能导致过度传感和冲击传递. 一个ICD模型出现了故障,突出了最大功率CT成像和不适当的扫描定位期间的风险.
科学领域:
- 医学成像和电生理学
- 生物医学工程 生物医学工程
背景情况:
- 计算机断层扫描 (CT) 辐射对可植入心脏变压器 (ICD) 的影响需要在各种临床场景中进行彻底评估.
- 了解潜在的电磁干扰 (EMI) 对于在使用植入器件进行CT成像时的患者安全至关重要.
研究的目的:
- 用幻影实验评估CT照射期间在各种临床可用的ICD中EMI发生的情况.
- 识别ICD患者CT照射相关的潜在风险.
- 为了确定不同CT参数对ICD性能的影响.
主要方法:
- 用心电图 (ECG) 模拟器测试了五种ICD模型,这些模拟器在一个接受CT成像的胸部幻影中进行了测试.
- 辐射条件包括最大功率设置和管电压,电流和旋转时间的144个变化.
- 测试还模拟了典型的临床剂量和不适当的扫描设置.
主要成果:
- 一个Medtronic ICD模型在最大CT功率时由于过度传感而产生了冲击.
- 这种功能故障的ICD在144种辐射模式中,在134个模式中显示出过度传感,在20个实例中检测出心室动 (VF).
- 在特定的临床环境和不适当的扫描定位中发生过度感应,特别是在对比度增强的CT玻璃追踪期间.
结论:
- 最大功率CT成像可以在易受ICD模型中诱导腹腔动心/腹腔 (VT/VF) 检测和冲击传递.
- 高管电压和更长的辐射时间与VT/VF检测有关.
- 在不适当的CT成像过程中,过度感知是一种风险,特别是当扫描切片直接放置在ICD上时.
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