Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) 27 Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) MAGNETNO RESONANČNA VARNOST IN OBRAVNAVA PACIENTOV S VSTAVLJENIMI KARDIOVASKULARNIMI ELEKTRONSKIMI NAPRAVAMI: PREGLED NAJNOVEJŠE LITERATURE IN ŠTUDIJA PRIMERA MRI SAFETY AND MANAGEMENT OF PATIENTS WITH CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICES: LITERATURE REVIEW AND CASE PRESENTATION Matic Godec, Jani Izlakar, Gašper Podobnik Onkološki inštitut Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenija / Institute of Oncology Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia Korespondenca / Corresponding author: matic.godec@gmail.com Prejeto/Recived: 15. 3. 2022 Sprejeto/Accepted: 16. 3. 2022 ABSTRACT Introduction: MRI has long been contraindicated in patients with CIED devices due to the risk of adverse eff ects through electromagnetic interference. Recent developments in engineering have led to the introduction of the MRI Conditional CIED devices that do not cause signifi cant clinical harm to patients undergoing MRI, when specifi c imaging conditions are met. Safe access to MRI has become a crucial need for patients with CIED devices. Purpose: The purpose of this paper is to present an overview of managing patients with implanted CIED devices and to present a case report of a patient with CIED undergoing prostate MRI examination. Methods: This paper explores the MRI safety and management of patients with implanted CIED devices through an extensive literature review and case presentation. The literature search was conducted using medical scientifi c electronic databases such as PubMed, Cinahl, Wiley Online Library and ScienceDirect. We examined a patient with CIED device undergoing prostate MRI examination. Results and discussion: We performed the examination of the described patient in accordance with the guidelines presented in this paper. MR conditionality status was determined using device identifi cation card and manufacturers technical manual. The MRI examination of the patient was completed without complications, therefore; no adverse eff ects were reported. MRI images were without artefacts. Conclusion: Recent clinical studies and published guidelines suggest that MRI of the patients with either MRI conditional or MRI non-conditional CIED device is relatively safe under specifi c conditions. Multidisciplinary pre-procedure planning, strict screening process, monitoring and device evaluation protocols are of key importance for ensuring safe MRI imaging in patients with CIED. Keywords: magnetic resonance imaging, safety, cardiovascular electronic devices IZVLEČEK Uvod: Magnetna resonanca je dolgo časa veljala za absolutno kontraindikacijo pri MR preiskavah pacientov z vstavljenimi CIED napravami. Tehnološki napredek na področju razvoja CIED naprav je doprinesel k uveljavitvi MR pogojno varnih kardiovaskularnih elektronskih naprav v kliničnem okolju. MR pogojno varne CIED naprave ne predstavljajo kliničnega tveganja za paciente s tovrstnimi napravami, če so upoštevani specifi čni pogoji uporabe. Varna izvedba MR slikanja je postala ključnega pomena pri zdravljenju tovrstnih pacientov. Namen: Namen te raziskave je predstaviti pregled področja obravnave pacienta z vstavljeno CIED napravo med MR slikanjem in predstaviti primer MR slikanja prostate pri pacientu s CIED napravo. Metode: V študiji smo predstavili obsežen pregled literature na področju MR varnosti in obravnave pacientov z vstavljenimi CIED napravami. Predstavili smo tudi primer obravnave MR slikanja prostate pri pacientu s CIED napravo. Literaturo smo zbirali s pomočjo elektronskih podatkovnih baz PubMed, Cinahl, Wiley Online Library in ScienceDirect. Rezultati in razprava: Preiskavo smo izvedli v skladu s priporočili, predstavljenimi v tem dokumentu. MR status naprave smo ugotovili na podlagi pregleda identifi kacijske kartice naprave in proizvajalčevih priporočil o uporabi naprave v MR okolju. Preiskava je bila opravljena brez kliničnih zapletov. Na MR slikah ni bilo prisotnih popačenj zaradi prisotnosti CIED naprave. Zaključek: Najnovejše klinične študije in izdana priporočila ugotavljajo, da je MR slikanje pacientov s CIED napravami relativno varno v specifi čnih pogojih, ne glede na to, ali gre za MR pogojno varne naprave ali ne. Ključnega pomena pri zagotavljanju varnosti pri MR preiskavah tovrstnih pacientov je predhodno multidisciplinarno načrtovanje preiskave, natančen varnostni pregled oz. screening pacienta, kakovosten nadzor nad pacientom med preiskavo in ocena delovanja naprave po preiskavi. Ključne besede: magnetno resonančno slikanje, varnost, srčno žilne elektronske naprave 28 Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) LITERATURA / REFERENCES Abi-Samra F (2011). Cardiac Implantable Electrical Devices: Bioethics and Management Issues Near the End of Life. Ochsner J, Vol 11(4): 342-47. Bauer Rudolf W, Lau D, Wollmann C, McGavigan A, Mansourati J, Reiter T, et al. (2019). Clinical safety of ProMRI implantable cardioverter-defi brillator systems during head and lower lumbar magnetic resonance imaging at 1.5 Tesla. Sci Rep, Vol 9: 1-11. Blessberger H, Kiblboeck D, Reiter C, Lambert T, Kellermair J, Schmit P, et al. (2018). 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