Safety of Magnetic Resonance Imaging in Orthopaedic Trauma Patients With External Fixation: A Two-Center Case Series.

Autor: Borgida JS; Harvard Orthopaedic Trauma Initiative, Massachusetts General Hospital, Boston, MA.; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Wagner RK; Harvard Orthopaedic Trauma Initiative, Massachusetts General Hospital, Boston, MA.; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Wong AW; Harvard Orthopaedic Trauma Initiative, Massachusetts General Hospital, Boston, MA.; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Yee S; Department of Radiology, Massachusetts General Hospital, Boston, MA; and., Husseini J; Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA., Aneja A; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Harris MB; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Ly TV; Harvard Orthopaedic Trauma Initiative, Massachusetts General Hospital, Boston, MA.; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Jazyk: angličtina
Zdroj: Journal of orthopaedic trauma [J Orthop Trauma] 2024 Sep 01; Vol. 38 (9), pp. 510-514.
DOI: 10.1097/BOT.0000000000002843
Abstrakt: Objectives: To report on adverse events during magnetic resonance imaging (MRI) in patients with external fixators.
Methods:  .
Design: Retrospective case series.
Setting: Two Level 1 trauma centers.
Patient Selection Criteria: Patients with external fixators on the appendicular skeleton or pelvis undergoing MRI between January 2005 and September 2023.
Outcome Measures and Comparisons: Adverse events, defined as any undesirable event associated with the external fixator being inside or outside the MRI bore during imaging, including (subjective) heating, displacement or pullout of the external fixator, or early MRI termination for any reason.
Results: A total of 97 patients with 110 external fixators underwent at least one MRI scan with an external fixator inside or outside of the MRI bore. The median age was 51 years (interquartile range: 39-63) and 56 (58%) were male. The most common external fixator locations were the ankle (24%), knee (21%), femur (21%), and pelvis (19%). The median duration of the MRI was 40 minutes (interquartile range: 26-58), 86% was performed using 1.5-Tesla MRI, and 14% was performed using 3.0-Tesla MRI. Ninety-five percent of MRI was performed for the cervical spine/head. Two MRI scans (1.6%), one of the shoulder and one of the head and cervical spine, with the external fixator outside of the bore were terminated early because of patient discomfort. There were no documented events of displacement or pullout of the external fixator.
Conclusions: These findings suggest that MRI scans of the (cervical) spine and head can be safely obtained in patients with external fixators on the appendicular skeleton or pelvis. Given the low numbers of MRI scans performed with the external fixator inside the bore, additional studies are necessitated to determine the safety of this procedure. The results from this study can aid orthopaedic surgeons, radiologists, and other stakeholders in developing local institutional guidelines on MRI scanning with external fixators in situ.
Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Competing Interests: T. V. Ly reports honoraria from the Arbeitsgemeinschaft fur Osteosynthesefragen foundation and consulting fees from DePuy Synthes (Warsaw, Indiana). A. Aneja reports honoraria from the Arbeitsgemeinschaft fur Osteosynthesefragen foundation and research support from the Orthopaedic Trauma Association, American Orthopaedic Foot and Ankle Society, and United States Department of Defense. The remaining authors report no conflict of interest.
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Databáze: MEDLINE
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