Cardiac devices and MRI safety

Q: All of the following devices are "MRI safe" except?

A) Coronary artery stents 
B) Mechanical cardiac valves 
C) Sternal wires 
D) Inferior vena cava filters 
E) Pulmonary artery catheters (PAC) (Swan-Ganz catheter)


Answer: E

Devices and implants have been divided into three categories 

 1) MR safe - no known hazards 
2) MR conditional - no known hazards in a specified MR imaging environment with specified conditions of use. 
3) MR unsafe - known to pose hazards 

 Most of the known devices including sternal wires in immediate post surgical patients in ICU are usually MR safe, but a very commonly used PAC is not! 

Other unsafe devices include temporary pacemaker external pulse generators and transvenous temporary pacing leads. 

 Patients with Permanent pacemakers and implantable cardioverter-defibrillators (AICD) may undergo programming changes, asynchronous pacing, decrease pacing output, and heating of lead wires in the MR environment.

#radiology
#cardiology
#patient-safety 



References: 

1. American Society for Testing and Materials (ASTM) International. ASTM F2503-05: Standard Practice for Marking Medical Devices and Other Itmes for Safety in the Magnetic Resonance Environment. ASTM International ,West Conshohocken, PA. 2005. Available at: http://www.astm.org. 

2. Levine GN, Gomes AS, Arai AE, et al. Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention: endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance. Circulation 2007; 116:2878. 

3. American College of Cardiology Foundation Task Force on Expert Consensus Documents, Hundley WG, Bluemke DA, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 2010; 55:2614.