为监测接受迷走神经刺激治疗的结节性硬化症复合体患者的肾脏疾病而进行的腹部磁共振成像(MRI)的安全性概况:对接受迷走神经刺激的结节性硬化症患者进行磁共振成像的安全性。

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY
Ethan Sage , Asim F. Choudhri , Jorge A. Lee-Diaz , John Bissler , James W. Wheless
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引用次数: 0

摘要

导言结节性硬化症复合体(TSC)患者常伴有难治性癫痫,可能正在接受迷走神经刺激(VNS)治疗以控制癫痫发作。监测磁共振成像(MRI)是监控与 TSC 相关的肾血管肌脂肪瘤所必需的;但是,VNS 治疗患者的腹部磁共振成像尚未获得批准。我们有许多难治性癫痫的 TSC 患者,他们从 VNS 治疗中获益匪浅,因此我们制定了一种 MRI 方案,允许对这些患者的腹部进行 MRI 检查,以便对他们的肾脏进行安全成像。我们在此报告使用该方案的结果:我们对一个中心从 1997 年 1 月 1 日至 2022 年 1 月 10 日接诊的所有 TSC 患者进行了回顾性审查,以确定 VNS 植入情况。结果:16 名患者共接受了 48 次核磁共振成像检查:结果:16 名患者共进行了 48 次腹部 MRI 扫描:其中 34 例(71%)在镇静状态下进行扫描,14 例(29%)未使用镇静剂。所有患者均未报告任何不良反应(疼痛或不适)。在完成成像检查后立即对设备进行重新检测,或在随后的神经科复诊时,均未发现 VNS 功能障碍。所有磁共振成像扫描的解释质量良好:结论:在典型的 VNS 排除区进行腹部磁共振成像与不良事件或 VNS 功能障碍无关。我们相信这一方案是安全的,也是监测使用 VNS 的 TSC 患者肾脏疾病的最佳方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safety profile of abdominal magnetic resonance imaging (MRI) performed for renal disease surveillance in tuberous sclerosis complex patients with vagus nerve stimulation

Introduction

Individuals with tuberous sclerosis complex (TSC) often present with refractory epilepsy and may be undergoing treatment with vagus nerve stimulation (VNS) to control seizures. Surveillance magnetic resonance imaging (MRI) is necessary to monitor for the renal angiomyolipomas associated with TSC; however, MRI of the abdomen is not approved for patients withVNS therapy. We have many TSC patients with refractory epilelpsy who benefitted from VNS therapy, so we developed an MRI protocol that allows MRI of the abdomen to be performed in these patients to permit safe imaging of their kidneys. Here we report our results using this protocol.

Methods

We performed a retrospective review for all TSC patients seen from 01/01/1997 to 10/01/2022 at a single center to determine VNS implantation status. Patients with VNS implants and abdomen imaging performed according to the protocol for kidney surveillance were included.

Results

Sixteen patients with 48 total MRIs of the abdomen were found: 34 (71 %) scans were conducted under sedation and 14 (29 %) without sedation. None of the patients reported any adverse effects (pain or discomfort). No instances of VNS dysfunction were noted when re-interrogating the device immediately after completion of the imaging studies or at later neurology follow-up appointments. All MRI scans were of good quality for interpretation.

Conclusion

Abdominal MRIs performed in typical VNS exclusion zones were not associated with adverse events or VNS dysfunction. We believe this protocol is safe and permits the best method for monitoring renal disease in TSC patients with VNS.
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来源期刊
Seizure-European Journal of Epilepsy
Seizure-European Journal of Epilepsy 医学-临床神经学
CiteScore
5.60
自引率
6.70%
发文量
231
审稿时长
34 days
期刊介绍: Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.
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