MRI-Induced Tissue Heating at Metallic Sutures (Cerclages)

Abstract

Magnetic resonance imaging (MRI) has become an important diagnostic tool with an ongoing dynamic development towards application of increasing static magnetic flux densities and consequently, exposures to electromagnetic fields (EMF) of increasing radio frequencies (RF). This raises particular concern metallic implants could lead to excess tissue heating and consequently, to thermal tissue damage. In thorax surgery the intersected sternum is reconnected by metallic sutures (cerclages). To investigate whether patients with such implants can be accepted for MRI and whether there may be limitations with regard to static magnetic fields, by numerical anatomical and thermal modelling MRI induced tissue heating was assessed for magnetic flux densities 1.5 T, 3 T, 4 T and 7 T. Results show that overall tissue temperature increased with increasing RF EMF frequency. However, even for setting MRI exposure parameters at maximum permissible level partial body heating remained marginally affected and even at local level the additional contribution of the presence of the metallic cerclage remained below 1˚C. This allows concluding that from a heating point of view metallic sutures as used to fix the sternum after thorax surgery are no contraindication for MRI with static magnetic flux densities up to 7 T.

Specific absorption rate in neonates undergoing magnetic resonance procedures at 1.5 T and 3 T

“…Although SAR is commonly used in RF safety assessments, it is the combination of excessive temperature and its duration that has the potential to cause tissue damage. Indeed, local SAR 10g values have been shown to be only weakly associated with local tissue changes . Limits to tissue temperature and temperature change are listed in Table .…”