磁共振与心脏起搏器.pptVIP

MRI是软组织成像的标准方法 任意方向断层显示病变； 丰富的组织信息T1/T2/Pd/V 可反映功能信息； 活体测量组织物质含量变化 更全面、准确反映疾病特征 不产生CT检查的骨伪影 无电离辐射 CVD发病率均从65岁开始显著递增。高血压、糖尿病、高脂血症、TIA脑卒中史、吸烟、酗酒、高同型半胱氨酸血症、体力活动减少、高盐、动物油高摄入饮食、超重等是共同的RF 。 MR扫描期间有三大强电磁场 MRI磁场对起搏系统的影响 优化的生理性起搏间接减少与MRI冲突的概率 哪些患者需MRI兼容起搏系统 65以上起搏适应证患者 有中风高危的：高血压、糖尿病、房颤、心衰等 有骨关节、脊柱软组织疾病史 已患或怀疑肿瘤 起搏前有MRI检查史 年轻、一般状况好，需 起搏支持一生 美敦力MRI兼容SureScan起搏器无扫描部位限制，2011年8月1日登陆中国MRI兼容起搏患者行胸部MRI实例 MRI兼容起搏器无扫描部位限，是最好选择！ 男、67岁，病窦快慢征，肺癌术后5年。房室结改良后DDD起搏12月。MRI复查2次阴性。 * * * MRI procedures per year (2004) France 1.7 million 6.8% CAGR Italy 1.7 million 11.9% CAGR Germany 4.9 million 9.3 % CAGR Spain 1.9 million 11.9% CAGR Netherlands 0.7 million 0.9% CAGR UK 0.9 million 12% CAGR Belgium 0.45 million * * * * Over-sensing of the sense amplifiers leading to tracking to the upper rate * * Programming the pacemaker in an asynchronous mode is not a risk free solution! Yes, it is! Look at this Worst Case Scenario IV. When an electrical reset occurs during MRI, the PM switches to a VVI mode and is sensitive for inhibition which might be fatal in case of PM dependency. * * * MRI uses 3 powerful electromagnetic fields to create an image – the Static, the Gradient and the Radio Frequency. MRI使用了3个强大的电磁场从而造成一个图像-静电噪声区，梯度区及无线电频区 For the pacemaker patient each of these fields individually or in combination has the potential to cause harm. 起搏器病人单独在每一个区域或重叠区域都有潜在损坏的可能 The MRI environment is a hostile one for patients with pacemakers. MRI区域是起搏器病人的禁区 The strength of the static magnetic field alone - is approximately 30,000 times the earth’s magnetic field. 单独静电噪声区磁场强度-大约30000倍于地球磁场 MR Basic Information First developed in the 1980’s, MRI has become one of the most powerful and sensitive diagnostic tools in use. When a patient is exposed to a intense magnetic field, the hydrogen atoms emit a signal called “magnetic resonance”. See the Study Guide for more information. * * What did Medtronic do to make a system MR-Conditional? In general terms ( the specifi