Skip to main content
Erschienen in: Der Radiologe 8/2015

01.08.2015 | Leitthema

Physikalische Wechselwirkungen in der MRT

Einige Daumenregeln zu ihrer Reduktion

verfasst von: Dr. M. Mühlenweg, G. Schaefers, S. Trattnig

Erschienen in: Die Radiologie | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Magnetresonanztomographie ist eines der leistungsfähigsten und zugleich schonendsten klinischen bildgebenden Verfahren der heutigen Zeit. Allerdings bergen ihre enorme physikalische Komplexität, aber auch einfache Unaufmerksamkeiten („Projektileffekt“) ein signifikantes Risikopotenzial in sich und stellen hohe Anforderungen an die MR-Bediener, um einen sicheren Betrieb zu gewährleisten. Ein solides Wissen um die potenziellen MR-Wechselwirkungen ist die Grundlage für einen sicheren und für alle Seiten gewinnbringenden Betrieb.
Der erste Teil der Arbeit behandelt die 3 zentralen Quellen für physikalische Wechselwirkungen in der Magnetresonanztomographie (statisches Magnetfeld, geschaltete Gradienten- und HF-Felder). Es werden für jede Feldart die Auswirkungen auf den Menschen, Wechselwirkungen mit magnetischen und elektrisch leitenden Objekten/Implantaten und relevante Sicherheitsstandards besprochen. Daran angeschlossen ist jeweils ein Abschnitt mit einfachen „Daumenregeln“, um potenziell unerwünschte physikalische MR-Wechselwirkungen zu minimieren.
Literatur
1.
Zurück zum Zitat Armenean C, Perrin E, Armenean M et al (2004) RF-induced temperature elevation along metallic wires in clinical magnetic resonance imaging: influence of diameter and length. Magn Reson Med 52(5):1200–1206CrossRefPubMed Armenean C, Perrin E, Armenean M et al (2004) RF-induced temperature elevation along metallic wires in clinical magnetic resonance imaging: influence of diameter and length. Magn Reson Med 52(5):1200–1206CrossRefPubMed
2.
Zurück zum Zitat Bhave G, Lewis JB, Chang SS (2008) Association of gadolinium based magnetic resonance imaging contrast agents and nephrogenic systemic fibrosis. J Urol 180(3):830–835 (discussion 835)PubMedCentralCrossRefPubMed Bhave G, Lewis JB, Chang SS (2008) Association of gadolinium based magnetic resonance imaging contrast agents and nephrogenic systemic fibrosis. J Urol 180(3):830–835 (discussion 835)PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Bourland JD, Nyenhuis JA, Schaefer DJ (1999) Physiologic effects of intense MR imaging gradient fields. Neuroimaging Clin North Am 9(2):363–377 Bourland JD, Nyenhuis JA, Schaefer DJ (1999) Physiologic effects of intense MR imaging gradient fields. Neuroimaging Clin North Am 9(2):363–377
4.
Zurück zum Zitat Expert Panel on MR Safety, Kanal E, Barkovich AJ et al (2013) ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging 37(3):501–530CrossRef Expert Panel on MR Safety, Kanal E, Barkovich AJ et al (2013) ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging 37(3):501–530CrossRef
5.
Zurück zum Zitat Foster JR, Hall DA, Summerfield AQ et al (2000) Sound-level measurements and calculations of safe noise dosage during EPI at 3 T. J Magn Reson Imaging 12(1):157–163CrossRefPubMed Foster JR, Hall DA, Summerfield AQ et al (2000) Sound-level measurements and calculations of safe noise dosage during EPI at 3 T. J Magn Reson Imaging 12(1):157–163CrossRefPubMed
6.
Zurück zum Zitat Glover PM (2009) Interaction of MRI field gradients with the human body. Phys Med Biol 54(21):R99–R115CrossRefPubMed Glover PM (2009) Interaction of MRI field gradients with the human body. Phys Med Biol 54(21):R99–R115CrossRefPubMed
7.
Zurück zum Zitat Glover PM, Cavin I, Qian W et al (2007) Magnetic-field-induced vertigo: a theoretical and experimental investigation. Bioelectromagnetics 28(5):349–361CrossRefPubMed Glover PM, Cavin I, Qian W et al (2007) Magnetic-field-induced vertigo: a theoretical and experimental investigation. Bioelectromagnetics 28(5):349–361CrossRefPubMed
8.
Zurück zum Zitat Ham CL, Engels JM, Wiel GT van de et al (1997) Peripheral nerve stimulation during MRI: effects of high gradient amplitudes and switching rates. J Magn Reson Imaging 7(5):933–937CrossRefPubMed Ham CL, Engels JM, Wiel GT van de et al (1997) Peripheral nerve stimulation during MRI: effects of high gradient amplitudes and switching rates. J Magn Reson Imaging 7(5):933–937CrossRefPubMed
9.
Zurück zum Zitat Hartwig V, Giovannetti G, Vanello N et al (2009) Biological effects and safety in magnetic resonance imaging: a review. Int J Environ Res Public Health 6(6):1778–1798PubMedCentralCrossRefPubMed Hartwig V, Giovannetti G, Vanello N et al (2009) Biological effects and safety in magnetic resonance imaging: a review. Int J Environ Res Public Health 6(6):1778–1798PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Heinrich A, Szostek A, Nees F et al (2011) Effects of static magnetic fields on cognition, vital signs, and sensory perception: a meta-analysis. J Magn Reson Imaging 34(4):758–763CrossRefPubMed Heinrich A, Szostek A, Nees F et al (2011) Effects of static magnetic fields on cognition, vital signs, and sensory perception: a meta-analysis. J Magn Reson Imaging 34(4):758–763CrossRefPubMed
11.
Zurück zum Zitat International Commission on Non-Ionizing Radiation Protection (2014) Guidelines for limiting exposure to electric fields induced by movement of the human body in a static magnetic field and by time-varying magnetic fields below 1 Hz. Health Phys 106(3):418–425 International Commission on Non-Ionizing Radiation Protection (2014) Guidelines for limiting exposure to electric fields induced by movement of the human body in a static magnetic field and by time-varying magnetic fields below 1 Hz. Health Phys 106(3):418–425
12.
Zurück zum Zitat International Commission on Non-Ionizing Radiation Protection (2004) Medical magnetic resonance (MR) procedures: protection of patients. International Commission on Non-Ionizing Radiation Protection. Health Phys 87(2):197–216CrossRef International Commission on Non-Ionizing Radiation Protection (2004) Medical magnetic resonance (MR) procedures: protection of patients. International Commission on Non-Ionizing Radiation Protection. Health Phys 87(2):197–216CrossRef
13.
Zurück zum Zitat International Electrotechnical Commision (IEC) (2015) IEC 60601-2-33/AMD 2:2010 Amendment 2 – Medical electrical equipment – Part 2–33 (ed.3): particular requirements for the safety of magnetic resonance equipment for medical diagnosis International Electrotechnical Commision (IEC) (2015) IEC 60601-2-33/AMD 2:2010 Amendment 2 – Medical electrical equipment – Part 2–33 (ed.3): particular requirements for the safety of magnetic resonance equipment for medical diagnosis
14.
Zurück zum Zitat International Electrotechnical Commision (IEC) (2014) IEC 62570 Standard practice for marking medical devices and other items for safety in the magnetic resonance environment. Geneva International Electrotechnical Commision (IEC) (2014) IEC 62570 Standard practice for marking medical devices and other items for safety in the magnetic resonance environment. Geneva
15.
Zurück zum Zitat International Electrotechnical Commision (IEC) (2010) IEC 60601-2-33 (ed.3) Medical electrical equipment – Part 2–33 (ed.3): particular requirements for the safety of magnetic resonance equipment for medical diagnosis. Geneva International Electrotechnical Commision (IEC) (2010) IEC 60601-2-33 (ed.3) Medical electrical equipment – Part 2–33 (ed.3): particular requirements for the safety of magnetic resonance equipment for medical diagnosis. Geneva
16.
Zurück zum Zitat International Organisation of Standardisation (ISO) (2012) ISO/TS 10974:2012(E) ISO/TS 10974 Assessment of the safety of magnetic resonance imaging for patients with an active implantable medical device. Geneva International Organisation of Standardisation (ISO) (2012) ISO/TS 10974:2012(E) ISO/TS 10974 Assessment of the safety of magnetic resonance imaging for patients with an active implantable medical device. Geneva
17.
Zurück zum Zitat Ito Y, Omoto Y, Habe K et al (2007) Magnetic resonance (MR) imaging-induced deep second-degree burns of lower extremities by conducting loop. J Eur Acad Dermatol Venereol 21(8):1140–1141CrossRefPubMed Ito Y, Omoto Y, Habe K et al (2007) Magnetic resonance (MR) imaging-induced deep second-degree burns of lower extremities by conducting loop. J Eur Acad Dermatol Venereol 21(8):1140–1141CrossRefPubMed
18.
Zurück zum Zitat Kitajima K, Maeda T, Watanabe S et al (2012) Recent topics related to nephrogenic systemic fibrosis associated with gadolinium-based contrast agents. Int J Urol 19(9):806–811CrossRefPubMed Kitajima K, Maeda T, Watanabe S et al (2012) Recent topics related to nephrogenic systemic fibrosis associated with gadolinium-based contrast agents. Int J Urol 19(9):806–811CrossRefPubMed
19.
Zurück zum Zitat Klucznik RP, Carrier DA, Pyka R et al (1993) Placement of a ferromagnetic intracerebral aneurysm clip in a magnetic field with a fatal outcome. Radiology 187(3):855–856CrossRefPubMed Klucznik RP, Carrier DA, Pyka R et al (1993) Placement of a ferromagnetic intracerebral aneurysm clip in a magnetic field with a fatal outcome. Radiology 187(3):855–856CrossRefPubMed
20.
Zurück zum Zitat Langman DA, Goldberg IB, Finn JP et al (2011) Pacemaker lead tip heating in abandoned and pacemaker-attached leads at 1.5 Tesla MRI. J Magn Reson Imaging 33(2):426–431CrossRefPubMed Langman DA, Goldberg IB, Finn JP et al (2011) Pacemaker lead tip heating in abandoned and pacemaker-attached leads at 1.5 Tesla MRI. J Magn Reson Imaging 33(2):426–431CrossRefPubMed
21.
Zurück zum Zitat Mattei E, Gentili G, Censi F et al (2015) Impact of capped and uncapped abandoned leads on the heating of an MR-conditional pacemaker implant. Magn Reson Med 73:390–400CrossRef Mattei E, Gentili G, Censi F et al (2015) Impact of capped and uncapped abandoned leads on the heating of an MR-conditional pacemaker implant. Magn Reson Med 73:390–400CrossRef
22.
Zurück zum Zitat Robbie DW (2012) Occupational exposure in MRI. Br J Radiol 85(1012):293–312CrossRef Robbie DW (2012) Occupational exposure in MRI. Br J Radiol 85(1012):293–312CrossRef
23.
Zurück zum Zitat Michaely HJ, Thomsen HS, Reiser MF et al (2007) Nephrogenic systemic fibrosis (NSF) – implications for radiology. Radiologe 47(9):785–793CrossRefPubMed Michaely HJ, Thomsen HS, Reiser MF et al (2007) Nephrogenic systemic fibrosis (NSF) – implications for radiology. Radiologe 47(9):785–793CrossRefPubMed
24.
Zurück zum Zitat Nitz WR, Brinker G, Diehl D et al (2005) Specific absorption rate as a poor indicator of magnetic resonance-related implant heating. Invest Radiol 40(12):773–776CrossRefPubMed Nitz WR, Brinker G, Diehl D et al (2005) Specific absorption rate as a poor indicator of magnetic resonance-related implant heating. Invest Radiol 40(12):773–776CrossRefPubMed
25.
Zurück zum Zitat Normenausschuss Radiologie (NAR) im DIN (2014) DIN 6876 DIN 6876 Betrieb von medizinischen Magnetresonanzsystemen. Berlin. http://www.beuth.de/de/norm/din-6876/197576544 Normenausschuss Radiologie (NAR) im DIN (2014) DIN 6876 DIN 6876 Betrieb von medizinischen Magnetresonanzsystemen. Berlin. http://​www.​beuth.​de/​de/​norm/​din-6876/​197576544
26.
Zurück zum Zitat Robitaille P, Berliner L (2006) Ultra high field magnetic resonance imaging. Springer, Berlin Heidelberg New York Robitaille P, Berliner L (2006) Ultra high field magnetic resonance imaging. Springer, Berlin Heidelberg New York
27.
Zurück zum Zitat Schaap K, Christopher-de Vries Y, Mason CK et al (2014) Occupational exposure of healthcare and research staff to static magnetic stray fields from 1.5–7 Tesla MRI scanners is associated with reporting of transient symptoms. Occup Environ Med 71(6):423–429PubMedCentralCrossRefPubMed Schaap K, Christopher-de Vries Y, Mason CK et al (2014) Occupational exposure of healthcare and research staff to static magnetic stray fields from 1.5–7 Tesla MRI scanners is associated with reporting of transient symptoms. Occup Environ Med 71(6):423–429PubMedCentralCrossRefPubMed
28.
Zurück zum Zitat Schaefer DJ, Bourland JD, Nyenhuis JA (2000) Review of patient safety in time-varying gradient fields. J Magn Reson Imaging 12(1):20–29CrossRefPubMed Schaefer DJ, Bourland JD, Nyenhuis JA (2000) Review of patient safety in time-varying gradient fields. J Magn Reson Imaging 12(1):20–29CrossRefPubMed
29.
Zurück zum Zitat Schenck JF (2000) Safety of strong, static magnetic fields. J Magn Reson Imaging 12(1):2–19CrossRefPubMed Schenck JF (2000) Safety of strong, static magnetic fields. J Magn Reson Imaging 12(1):2–19CrossRefPubMed
30.
Zurück zum Zitat Siemens AG (2010) Betreiberhandbuch Magnetom Skyra. München Siemens AG (2010) Betreiberhandbuch Magnetom Skyra. München
31.
32.
Zurück zum Zitat Stenschke J, Li D, Thomann M et al (2007) A numerical investigation of RF heating effects on implants during MRI compared to experimental measurements. Proc Physics 114:53–59 Stenschke J, Li D, Thomann M et al (2007) A numerical investigation of RF heating effects on implants during MRI compared to experimental measurements. Proc Physics 114:53–59
33.
Zurück zum Zitat Sundgren PC, Leander P (2011) Is administration of gadolinium-based contrast media to pregnant women and small children justified? J Magn Reson Imaging 34(4):750–757CrossRefPubMed Sundgren PC, Leander P (2011) Is administration of gadolinium-based contrast media to pregnant women and small children justified? J Magn Reson Imaging 34(4):750–757CrossRefPubMed
34.
Zurück zum Zitat U.S. Food and Drug Administration (FDA) (2005) FDA public health notification: MRI-caused injuries in patients with implanted neurological stimulators. http://www.fda.gov/medicaldevices/safety/alertsandnotices/publichealthnotifications/ucm062125.htm. Zugegriffen: 17. Feb. 2015 U.S. Food and Drug Administration (FDA) (2005) FDA public health notification: MRI-caused injuries in patients with implanted neurological stimulators. http://​www.​fda.​gov/​medicaldevices/​safety/​alertsandnotices​/​publichealthnoti​fications/​ucm062125.​htm.​ Zugegriffen: 17. Feb. 2015
35.
Zurück zum Zitat U.S. Food and Drug Administration (FDA) (1992) FDA safety alert: mri related death of patient with aneurysm clip. http://www.fda.gov/medicaldevices/safety/alertsandnotices/publichealthnotifications/ucm242613.htm. Zugegriffen: 17. Feb. 2015 U.S. Food and Drug Administration (FDA) (1992) FDA safety alert: mri related death of patient with aneurysm clip. http://​www.​fda.​gov/​medicaldevices/​safety/​alertsandnotices​/​publichealthnoti​fications/​ucm242613.​htm.​ Zugegriffen: 17. Feb. 2015
36.
Zurück zum Zitat U.S. Food and Drug Administration (FDA) (2015) MAUDE – manufacturer and user facility device experience. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/Search.cfm. Zugegriffen: 11. Feb. 2015 U.S. Food and Drug Administration (FDA) (2015) MAUDE – manufacturer and user facility device experience. http://​www.​accessdata.​fda.​gov/​scripts/​cdrh/​cfdocs/​cfMAUDE/​Search.​cfm.​ Zugegriffen: 11. Feb. 2015
37.
Zurück zum Zitat Valiron O, Peris L, Rikken G et al (2005) Cellular disorders induced by high magnetic fields. J Magn Reson Imaging 22(3):334–340CrossRefPubMed Valiron O, Peris L, Rikken G et al (2005) Cellular disorders induced by high magnetic fields. J Magn Reson Imaging 22(3):334–340CrossRefPubMed
38.
Zurück zum Zitat Vocht de F, Stevens T, Wendel-de-Joode B van et al (2006) Acute neurobehavioral effects of exposure to static magnetic fields: analyses of exposure-response relations. J Magn Reson Imaging 23(3):291–297CrossRefPubMed Vocht de F, Stevens T, Wendel-de-Joode B van et al (2006) Acute neurobehavioral effects of exposure to static magnetic fields: analyses of exposure-response relations. J Magn Reson Imaging 23(3):291–297CrossRefPubMed
39.
Zurück zum Zitat Vogt FM, Ladd ME, Hunold P et al (2004) Increased time rate of change of gradient fields: effect on peripheral nerve stimulation at clinical MR imaging. Radiology 233(2):548–554CrossRefPubMed Vogt FM, Ladd ME, Hunold P et al (2004) Increased time rate of change of gradient fields: effect on peripheral nerve stimulation at clinical MR imaging. Radiology 233(2):548–554CrossRefPubMed
40.
Zurück zum Zitat Warmuth J (2011) Das stärkste Magnetfeld der Welt. http://www.weltderphysik.de/gebiet/technik/news/das-staerkste-magnetfeld-der-welt/. Zugegriffen: 01. Feb. 2015 Warmuth J (2011) Das stärkste Magnetfeld der Welt. http://​www.​weltderphysik.​de/​gebiet/​technik/​news/​das-staerkste-magnetfeld-der-welt/​.​ Zugegriffen: 01. Feb. 2015
41.
Zurück zum Zitat Matthey S, Gardner JM, Schaefers G (2013) Clarification of MR interactions in practice for implants and devices used in MRI – rules of thumb (or when to expect less MR interaction). Proceedings of the 22nd Annual Meeting of the Section for Magnetic Resonance Technologists, Salt Lake City Matthey S, Gardner JM, Schaefers G (2013) Clarification of MR interactions in practice for implants and devices used in MRI – rules of thumb (or when to expect less MR interaction). Proceedings of the 22nd Annual Meeting of the Section for Magnetic Resonance Technologists, Salt Lake City
Metadaten
Titel
Physikalische Wechselwirkungen in der MRT
Einige Daumenregeln zu ihrer Reduktion
verfasst von
Dr. M. Mühlenweg
G. Schaefers
S. Trattnig
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Radiologie / Ausgabe 8/2015
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-015-2812-1

Weitere Artikel der Ausgabe 8/2015

Der Radiologe 8/2015 Zur Ausgabe

CME Zertifizierte Fortbildung

Orbita

Einführung zum Thema

Sicherheit in der Radiologie

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.