Abstract
PurposeMetallic skin closure staples and vessel ligation clips should be tested at 3-Tesla to characterize MRI issues in order to ensure patient safety. Therefore, metallic surgical implants were assessed at 3-Tesla for magnetic field interactions, MRI-related heating, and artifacts.MethodsA skin closure staple (Visistat Skin Stapler, staple, Polytetrafluoroethylene, PTFE, coated 316L/316LVM stainless steel; Teleflex Medical, Durham, NC) and a vessel ligation clip (Hemoclip Traditional, stainless steel; Teleflex Medical, Durham, NC) that represented the largest metallic sizes made from materials with the highest magnetic susceptibilities (i.e., based on material information) among 61 other surgical implants (52 metallic implants, 9 nonmetallic implants) underwent evaluation for magnetic field interactions, MRI-related heating, and artifacts using standardized techniques. MRI-related heating was assessed by placing each implant in a gelled-saline-filled phantom with MRI performed using a transmit/receive RF body coil at an MR system reported, whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were characterized using T1-weighted, SE and GRE pulse sequences.ResultsEach surgical implant showed minor magnetic field interactions (20- and 27-degrees, which is acceptable from a safety consideration). Heating was not substantial (highest temperature change, ≤ 1.6°C). Artifacts may create issues if the area of interest is in the same area or close to the respective surgical implant.ConclusionsThe results demonstrated that it would be acceptable for patients with these metallic surgical implants to undergo MRI at 3-Tesla or less. Because of the materials and dimensions of the surgical implants that underwent testing, these findings pertain to 61 additional similar implants.
Highlights
Surgical staples are specialized implants used in surgery in place of sutures and are commonly used to close skin wounds, as well as to connect or remove anatomic areas such as the bowels or lungs [1]
The test fixture incorporated a protractor with 1-degree graduated markings and the implant was suspended on this apparatus by a lightweight string (20-cm in length; weight, less than 1% of the weight of each implant) that was fixed at the 0-degree indicator of the protractor
“MR Safe” items are non-conducting, non-metallic, and non-magnetic items)[13,14]. The results from this investigation demonstrated that it would be acceptable for patients with these particular metallic surgical implants to undergo magnetic resonance imaging (MRI) at 3-Tesla or less
Summary
Surgical staples are specialized implants used in surgery in place of sutures and are commonly used to close skin wounds, as well as to connect or remove anatomic areas such as the bowels or lungs [1]. As the number of surgical procedures increase, there is a need to develop more efficient techniques and userfriendly tools that address the increasing time constraints and issues of patient satisfaction [2]. One of the issues for vascular procedures has been the labor intensive and time-consuming process of achieving hemostasis [2]. Vascular closure devices have been demonstrated to reduce time to hemostasis and potentially decrease the length of hospital stay [2]. Vascular clips have increasingly been used surgically for their hemostatic features
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