MRI following scoliosis surgery? An analysis of implant heating, displacement, torque, and susceptibility artifacts

Abstract

Objectives The implant constructs used in scoliosis surgery are often long with a high screw density. Therefore, it is generally believed that magnetic resonance imaging (MRI) should not be carried out after scoliosis surgery, with the result that computed tomography is often preferred despite the ionizing radiation involved. The objective of this study was to evaluate the MRI compatibility of long pedicle-screw-rod constructs at 1.5 T and 3 T using standardized methods of the American Society for Testing and Materials (ASTM). Methods Constructs between 130 and 430 mm long were systematically examined according to the ASTM standards F2182 (radio frequency–induced heating), F2119 (susceptibility artifacts), F2213 (magnetically induced torque), and F2052 (magnetically induced displacement force). Results The maximum heating in the magnetic field was 1.3 K. Heating was significantly influenced by magnetic field strength (p < 0.001), implant length (p = 0.048), and presence of cross-links (p = 0.001). The maximum artifact width for different lengths of the anatomically bent titanium rods with CoCr alloy ranged between 14.77 ± 2.93 mm (TSE) and 17.49 ± 1.82 mm (GRE) for 1.5 T and between 23.67 ± 2.39 mm (TSE) and 27.77 ± 2.37 mm (GRE) for 3 T. TiCP and TiAl showed the smallest and CoCr and CoCr Plus the largest artifact widths. The magnetically induced torque and displacement force were negligible. Conclusions MRI following scoliosis surgery with long implant constructs is safe with the patient in supine position. Although susceptibility artifacts can severely limit the diagnostic value, the examination of other regions is possible. Key Points • Large spinal implants are not necessarily a contraindication for MRI; MR conditional status can be examined according to the ASTM standards F2182, F2119, F2213, and F2052. • A metallic pedicle-screw-rod system could be reliably and safely examined in all combinations of length (130 to 430 mm), configuration, and material in a B0at 1.5 T and 3 T. • According to ASTM F2503, the examined pedicle-screw-rod system is MR conditional and especially the young patients can benefit from a non-ionizing radiation MRI examination.

Signal voids of active cardiac implants at 3.0 T CMR

“…In order to quantify the uncertainties of measurement regarding the signal void measurements, all implants were scanned three times with both sequences using an identical setup. Repetition of any prescans was omitted in order to avoid a potential influence of pre-scans used for optimization of imaging contrast during the clinical routine 23 , 24 .…”

A Survey of Methods and Technologies Used for Diagnosis of Scoliosis

“…Materials from which the implants are made include polyetheretherketone (PEEK), titanium [59], cobalt-chromium [60], or other materials, e.g., bio-absorbable materials. The former is transparent to X-rays; therefore, these implants contain small radiographic markers.…”

Application of metal artifact reduction algorithm in reducing metal artifacts in post-surgery pediatric low radiation dose spine computed tomography (CT) images

“…Computed tomography (CT) is a commonly used examination for spinal diseases ( 1 - 6 ), especially after posterior spinal fixation surgery with metal pedicle screws. The application of magnetic resonance (MR) is limited ( 7 , 8 ), and CT has become the most feasible tomographic imaging examination method. However, the display of structures around metals in CT images is often obstructed by the beam hardening artifacts caused by the high-density metals, affecting diagnosis.…”