Assessment of MRI issues at 3-Tesla for metallic surgical implants: findings applied to 61 additional skin closure staples and vessel ligation clips.
OBJECTIVE
Metallic 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.


METHODS
A 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.


RESULTS
Each 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.


CONCLUSIONS
The 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.
Biomedical Engineering Interdepartmental Program, University of California, Los Angeles, 420 Westwood Plaza, Engineering IV, 64-144, Los Angeles, CA 90095, USA.
Amreeta
A
Gill
Frank G
FG
Shellock
D016477:Artifacts; D004867:Equipment Design; D008026:Ligation; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000295:instrumentation; D008422:Materials Testing; D008670:Metals; D019047:Phantoms, Imaging; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment; D013525:Surgical Instruments / Q000009:adverse effects; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation*; D013537:Sutures / Q000009:adverse effects; D013696:Temperature; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*
D008670:Metals