Central nervous system MRI and cardiac implantable electronic devices

As the population ages and indications for MRI increase, it is estimated that 50 to 75% of patients with a cardiac implantable electronic device (CIED) - pacemaker (PM) or implanted cardiac defibrillator (ICD) - will need an MRI during their CIED's lifetime. Three categories of materials are defined: MRI compatible, MRI non-compatible, and MRI conditional. MRI compatible CIEDs without electrodes have been developed, but do not allow battery changes, so that they are exclusively indicated for patients whose life expectancy is less than that of the battery (6-7years). For MRI conditional CIEDs, all manufacturers publish restrictions. These restrictions can relate to the patient (size, position in the MRI, body temperature), the MRI parameters (magnetic field), or the examination in itself (gradients, specific absorption rate, duration, isocenter). The neuroradiologist can expect to be confronted with the issue of MRI in patients with a CIED. The purpose of this review is to provide them with updated information on MRI and CIEDs.

Real-World Validation of Coregistration and Structured Reporting for Magnetic Resonance Imaging Monitoring in Multiple Sclerosis

OBJECTIVE

The objectives of this research were to assess the effectiveness of computer-assisted detection reading (CADR) and structured reports in monitoring patients with multiple sclerosis (MS) and to evaluate the role of radiology technicians in this context.

METHODS

Eighty-seven patients with MS who underwent at least 2 sequential magnetic resonance imaging (MRI) follow-ups analyzed by 2 radiologists and a technician. Progression of disease (POD) was identified through the emergence of T2 fluid-attenuated inversion recovery white matter hyperintensities or contrast enhancements and evaluated both qualitatively (progression vs stability) and quantitatively (count of new white matter hyperintensities).

RESULTS

CADR increased the accuracy by 11%, enhancing interobserver consensus on qualitative progression and saving approximately 2 minutes per examination. Although structured reports did not improve these metrics, it may improve clinical communication and permit technicians to achieve approximately 80% accuracy in MRI readings.

CONCLUSIONS

The use of CADR improves the accuracy, agreement, and interpretation time in MRI follow-ups of MS. With the help of computer tools, radiology technicians could represent a significant aid in the follow-up of these patients.