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Potential hazards and artifacts of ferromagnetic and nonferromagnetic surgical and dental materials and devices in nuclear magnetic resonance imaging.
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1983
Year
Nuclear ImagingMagnetic PropertiesEngineeringPet-mriMagnetic ResonanceSurgeryMagnetic Resonance ImagingDental RadiologyMagnetismCorrosionAneurysm ClipsRadiologyDental MaterialsMedical ImagingNeuroimagingPotential HazardsMri-guided Radiation TherapyImplantable DeviceMagnetic MaterialMetal Surgical ImplantsDental BiomechanicsDental AmalgamMedicine
The study examined the risks and imaging artifacts associated with metal surgical implants during NMR imaging. The authors tested 21 aneurysm and hemostatic clips along with other materials such as dental amalgam and 14‑karat gold. They found that 16 of the 21 clips experienced longitudinal forces and torques, with five generating forces capable of causing hemorrhage or injury; ferromagnetism correlated with alloy composition, and clips containing 10–14 % nickel were safe; imaging artifacts were larger for ferromagnetic materials but also present for non‑ferromagnetic metals, with dental amalgam and 14‑karat gold showing no artifacts while stainless steel dentures and braces caused extensive facial artifacts.
The risks to patients with metal surgical implants who are undergoing nuclear magnetic resonance (NMR) imaging and the artifacts caused by such implants were studied. Twenty-one aneurysm and other hemostatic clips and a variety of other materials (e.g., dental amalgam, 14 karat gold) were used. Longitudinal forces and torques were found to be exerted upon 16 of the 21 clips. With five aneurysm clips, forces and torques sufficient to produce risk of hemorrhage from dislocation of the clip from the vessel or aneurysm, or cerebral injury by clip displacement without dislodgement were identified. The induced ferromagnetism was shown to be related to the composition of the alloys from which the clips were manufactured. Clips with 10-14% nickel are evidently without sufficient induced ferromagnetism to cause hazard. The extent of NMR imaging artifacts was greater for materials with measurable ferromagnetic properties, but metals without measurable ferromagnetism in our tests also resulted in significant artifacts. Dental amalgam and 14 karat gold produced no imaging artifacts, but stainless steels in dentures and orthodontic braces produced extensive artifacts in the facial region.