超低场便携式磁共振成像和体外膜氧合:临床前安全测试。

Q4 Medicine Critical care explorations Pub Date : 2024-10-18 eCollection Date: 2024-10-01 DOI:10.1097/CCE.0000000000001169
Jin Kook Kang, Eric Etchill, Kate Verdi, Ana K Velez, Sean Kearney, Jeffrey Dodd-O, Errol Bush, Samantha By, Eddy Boskamp, Christopher Wilcox, Chun Woo Choi, Bo Soo Kim, Glenn J R Whitman, Sung-Min Cho
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引用次数: 0

摘要

背景:传统磁共振成像与体外膜氧合(ECMO)插管和泵不兼容。0.064 特斯拉的超低场便携式磁共振成像(ULF-pMRI)可能是一种解决方案,但其安全性和兼容性尚不清楚:假设:ULF-pMRI 不会导致 ECMO 插管明显移位和发热,也不会影响 ECMO 泵的功能:方法和模型:根据美国材料与试验协会的标准,使用模型对不同尺寸的 ECMO 插管进行体外测试,以评估位移力和加热情况。ECMO 泵功能通过泵流量和功耗进行评估。体内研究涉及五头雌性家猪(20-42 千克),它们接受了不同的 ECMO 配置(外周和中央插管)和插管类型,成像方案包括 T2 加权、T1 加权、FLUID-衰减反转恢复和扩散加权成像序列:模型显示,各种尺寸(15-24 英尺)的单腔 ECMO 插管和双腔插管的平均位移力均小于超低频-pMRI 5 高斯安全线内的重力,扫描 15 分钟内的温度变化小于 1°C,ECMO 泵在 5 高斯线外保持稳定的流量和耗电量。所有猪模型都没有因插管的位移力或加热而出现明显的移动。ECMO 流量和动物的血液动力学状态保持稳定,变化幅度分别不超过 10%:超低频-pMRI 在标准 ECMO 配置下使用安全可行,支持其作为 ECMO 患者神经成像模式的临床应用。
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Ultra-Low-Field Portable MRI and Extracorporeal Membrane Oxygenation: Preclinical Safety Testing.

Context: Conventional MRI is incompatible with extracorporeal membrane oxygenation (ECMO) cannulas and pumps. Ultra-low-field portable MRI (ULF-pMRI) with 0.064 Tesla may provide a solution, but its safety and compatibility is unknown.

Hypothesis: ULF-pMRI does not cause significant displacement and heating of ECMO cannulas and does not affect ECMO pump function.

Methods and models: ECMO cannulas in various sizes were tested ex vivo using phantom models to assess displacement force and heating according to the American Society for Testing and Materials criteria. ECMO pump function was assessed by pump flow and power consumption. In vivo studies involved five female domestic pigs (20-42 kg) undergoing different ECMO configurations (peripheral and central cannulation) and types of cannulas with an imaging protocol consisting of T2-weighted, T1-weighted, FLuid-Attenuated Inversion Recovery, and diffusion-weighted imaging sequences.

Results: Phantom models demonstrated that ECMO cannulas, both single lumen with various sizes (15-24-Fr) and double lumen cannula, had average displacement force less than gravitational force within 5 gauss safety line of ULF-pMRI and temperature changes less than 1°C over 15 minutes of scanning and ECMO pump maintained stable flow and power consumption immediately outside of the 5 gauss line. All pig models showed no visible motion due to displacement force or heating of the cannulas. ECMO flow and the animals' hemodynamic status maintained stability, with no changes greater than 10%, respectively.

Interpretation and conclusions: ULF-pMRI is safe and feasible for use with standard ECMO configurations, supporting its clinical application as a neuroimaging modality in ECMO patients.

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