背景:磁共振成像(MRI)是一种快速发展的模态,由于缺乏电离辐射,通常被认为是安全的。虽然MRI技术和技术正在改进,许多安全问题仍然与最初建立时相同。患者热损伤是最常见的不良事件,占食品和药物管理局(FDA)MRI事件的59%。调查表明,许多事件仍未报告。患者热损伤是可以预防的,并且已经发布了各种缓解方法。然而,建议可以是可变的,支离破碎和混乱。这项系统评价的目的是综合有关MRI安全性和相关皮肤损伤的证据,并为放射技师提供预防皮肤热损伤的综合建议。
方法:搜索了四个期刊数据库,寻找2010年1月至2023年5月发表的资料来源,提供了有关MRI安全性和热损伤的信息。
结果:在返回的26,801篇文章中,经过仔细筛选,并根据资格标准,仅包括79篇文章和另外19篇灰色文献来源(n=98)。使用主题分析检查了所包括的研究,以确定是否可以提供整体建议以帮助预防皮肤烧伤。通过实施上述建议,据估计,97%的皮肤烧伤可以预防。随着热损伤继续影响MRI的安全性,防止皮肤灼伤和发热的策略至关重要。评估个人风险,而不是一揽子政策,将有助于防止皮肤热损伤的发生,改善患者护理。
BACKGROUND: Magnetic resonance imaging (MRI) is a rapidly evolving modality, generally considered safe due to lack of ionising radiation. While MRI technology and techniques are improving, many of the safety concerns remain the same as when first established. Patient thermal injuries are the most frequently reported adverse event, accounting for 59% of MRI incidents to the Food and Drug Administration (FDA). Surveys indicate many incidents remain unreported. Patient thermal injuries are preventable and various methods for their mitigation have been published. However, recommendations can be variable, fragmented and confusing. The aim of this systematic review was to synthesise the evidence on MRI safety and associated skin injuries and offer comprehensive recommendations for radiographers to prevent skin thermal injuries.
METHODS: Four journal databases were searched for sources published January 2010-May 2023, presenting information on MRI safety and thermal injuries.
RESULTS: Of 26,801 articles returned, after careful screening and based on the eligibility criteria, only 79 articles and an additional 19 grey literature sources were included (n = 98). Included studies were examined using thematic analysis to determine if holistic recommendations can be provided to assist in preventing skin burns. This resulted in three simplified recommendations: Remove any electrically conductive items Insulate the patient to prevent any conductive loops or contact with objects Communicate regularly CONCLUSION: By implementing the above recommendations, it is estimated that 97% of skin burns could be prevented. With thermal injuries continuing to impact MRI safety, strategies to prevent skin burns and heating are essential. Assessing individual risks, rather than blanket policies, will help prevent skin thermal injuries occurring, improving patient care.