title: 3T magnetic resonance imaging testing of externally programmable shunt valves.
abstract: BACKGROUND
  Exposure of externally programmable shunt-valves (EPS-valves) to magnetic resonance imaging (MRI) may lead to unexpected changes in shunt settings, or affect the ability to reprogram the valve. We undertook this study to examine the effect of exposure to a 3T MRI on a group of widely used EPS-valves.
  
  
  METHODS
  Evaluations were performed on first generation EPS-valves (those without a locking mechanism to prevent changes in shunt settings by external magnets other than the programmer) and second generation EPS-valves (those with a locking mechanisms). Fifteen new shunt-valves were divided into five groups of three identical valves each, and then exposed to a series of six simulated MRI scans. After each of the exposures, the valves were evaluated to determine if the valve settings had changed, and whether the valves could be reprogrammed. The study produced 18 evaluations for each line of shunt-valves.
  
  
  RESULTS
  Exposure of the first generation EPS-valves to a 3T magnetic field resulted in frequent changes in the valve settings; however, all valves retained their ability to be reprogrammed. Repeated exposure of the second generation EPS-valves has no effect on shunt valve settings, and all valves retained their ability to be interrogated and reprogrammed.
  
  
  CONCLUSIONS
  Second generation EPS-valves with locking mechanisms can be safely exposed to repeated 3T MRI systems, without evidence that shunt settings will change. The exposure of the first generation EPS-valves to 3T MRI results in frequent changes in shunt settings that necessitate re-evaluation soon after MRI to avoid complications.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Zabramski
authors.forename: Mark C
authors.initials: MC
authors.lastname: Preul
authors.forename: Josef
authors.initials: J
authors.lastname: Debbins
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: McCusker