title: The safety of magnetic resonance imaging in patients with programmable implanted intrathecal drug delivery systems: a 3-year prospective study.
abstract: BACKGROUND
  It is common clinical practice to perform magnetic resonance imaging (MRI) in patients with indwelling programmable intrathecal drug delivery (IDD) systems, although the safety of the procedure has never been documented. We performed a single-center, 3-year, prospective evaluation in patients with a programmable implanted IDD to assess patient discomfort, IDD technical failures, and adverse effects during and after exposure to MRI.
  
  
  METHODS
  Forty-three consecutive patients with an implanted programmable IDD system (SynchroMed® EL Implantable Infusion Pump, Model 8626L-18, and SynchroMed® II Model 8637-20, 8637-40; Medtronic, Inc., Minneapolis, MN) requiring a scheduled MRI evaluation were studied during a 3-year period. All MRI scans were performed with a 1.5-tesla clinical use magnet and a specific absorption rate of no more than 0.9 W/kg. Radiograph control was used to confirm postexposure pump rotor movement and detect system dislocations. IDD system failures, patient satisfaction, and discomfort were recorded.
  
  
  RESULTS
  None of the patients experienced signs of drug overinfusion that could lead to hemodynamic, respiratory, or neurologic alterations. Radiologic evaluation after MRI revealed no spatial displacements of the intrathecal catheter tip or body pump, and programmer telemetry confirmed the infusion recovery. Patients' satisfaction after the procedure was high.
  
  
  CONCLUSIONS
  Performing an MRI scan with the proposed protocol in patients with an implanted Medtronic programmable IDD system resulted in virtually no technical or medical complications.
authors.affiliation: FIPP, Department of Anesthesiology, Critical Care, and Pain Management, Valencia University General Hospital, Avda. Tres Cruces s/n, 46014 Valencia, Spain. deandres_jos@gva.es
authors.forename: Jose
authors.initials: J
authors.lastname: De Andres
authors.forename: Vicente
authors.initials: V
authors.lastname: Villanueva
authors.forename: Stefano
authors.initials: S
authors.lastname: Palmisani
authors.forename: German
authors.initials: G
authors.lastname: Cerda-Olmedo
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Lopez-Alarcon
authors.forename: Vicente
authors.initials: V
authors.lastname: Monsalve
authors.forename: Ana
authors.initials: A
authors.lastname: Minguez
authors.forename: Vicente
authors.initials: V
authors.lastname: Martinez-Sanjuan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects; D060186:Infusions, Spinal; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D013030:Spain; D013686:Telemetry; D013997:Time Factors