术中高场强磁共振扫描对心电图的影响

目的观察术中高场强（1.5T）磁共振扫描对患者心电图的影响。方法12例术前心电图正常的成年患者,在术中磁共振成像及神经导航下行开颅肿瘤切除手术,采用磁兼容的无线心电图模块进行心电图监测,分别在磁体进入手术室前、磁体进入移至头部准备扫描前（静态磁场）、T1加权像、T2加权像、弥散张量成像各时间段描记患者II导联心电图,并观察患者扫描过程中生命体征的变化。结果患者在静态磁场环境及不同序列磁共振扫描时,心电图波形出现了明显的变化,主要表现为心电图基线改变、ST-T改变及＂严重心律失常＂。患者扫描过程中生命体征平稳。结论磁共振扫描时,心电图出现失真情况,需依靠脉搏及有创动脉压波形等监测综合判断,鉴别心脏事件,维护患者安全。

The influences of intraoperative high-field MRI scanning on ECG

Objective To investigate the influences of intraoperative high-field magnetic resonance imaging （MRI） scanning on electrocaroliogram （ECG）. Methods 12 neurosurgical adult patients with normal ECG received intracranial tumor resection via intraoperative high-field MRI scanning and MRI-guided system.MRI compatible and wireless ECG monitor was used, ECG waves（lead II） were recorded at different time points：before MRI scanner moved to operation room,scanner moved to patients,different MRI sequences T1、T2, diffusion tension imaging. Vital signs were observed intraoperatively. Results There was remarkably strong interference on ECG in static MRI field and different scanning sequences, such as the change of ECG baseline and multiphasic ST-segment and ＂severe arrhythmia＂, but the vital signs were stable. Conclusions During high-field MRI scan, the ECG is interfered. Interference-free parameters such as invasive arterial pressure waves and pulse oximetry should be used to prevent misinterptetation of ECG.