Magnetic Field Interactions of Copper-Containing Intrauterine Devices in 3.0-Tesla Magnetic Resonance Imaging: In Vivo Study

OBJECTIVE: An ex vivo study found a copper-containing intrauterine device (IUD) to be safe for women undergoing an MRI examination at a 3.0-T field. No significant artifacts caused by the metallic implant were detected. However, there are still no in vivo data about these concerns. The aim of this study was to evaluate 3.0-T magnetic field interactions of copper-containing IUDs in vivo. MATERIALS AND METHODS: Magnetic field interactions and potential adverse events were evaluated in 33 women using a questionnaire-based telephone survey. Two experienced radiologists performed artifact evaluation on MR images of the pelvis. RESULTS: Eighteen patients were eligible for the survey. One patient reported a dislocation of the IUD after the MR examination. All other patients had no signs of field interactions. No IUD-related artifacts were found. CONCLUSION: MRI at 3.0-T is possible for women with copper-containing IUDs. However, consulting a gynecologist to check the correct position of the IUD and exclude complications after an MR examination is highly recommended. High-quality clinical imaging of the female pelvis can be performed without a loss in image quality.

Symtomatic relief precedes improvement of Myocardial blood flow in patients under spinal cord stimulation

Spinal cord electrical stimulation [SCS] has been shown to be a treatment option forpatients suffering from angina pectoris CCS III-IV although being on optimal medication and notsuitable for conventional treatment strategies, e.g. CABG or PTCA. Although many studiesdemonstrated a clear symptomatic relief under SCS therapy, there are only a few short-term studies that investigated alterations in cardiac ischemia. Therefore, doubts remain whether SCS has a direct effect on myocardial perfusion. A prospective study to investigate the short- and long-term effect of spinal cord stimulation [SCS] on myocardial ischemia in patients with refractory angina pectoris and coronary multivesseldisease was designed. Myocardial ischemia was measured by MIBI-SPECT scintigraphy 3 months and 12 months after the beginning of neurostimulation. To further examine the relation between cardiac perfusion and functional status of the patients, we measured exercise capacity [bicycle ergometry and 6-minute walk test], symptoms and quality of life [Seattle Angina Questionnaire [SAQ]], as well. 31 patients [65 +/- 11 SEM years; 25 male, 6 female] were included into the study. The average consumption of short acting nitrates [SAN] decreased rapidly from 12 +/- 1.6 times to 3 +/- 1 times per week. The walking distance and the maximum workload increased from 143 +/- 22 to 225 +/- 24 meters and 68 +/- 7 to 96 +/- 12 watt after 3 months. Quality of life increased [SAQ] significantly after 3 month compared to baseline, as well. No further improvement was observed after one year of treament. Despite the symptomatic relief and the improvement in maximal workload computer based analysis [Emory Cardiac Toolbox] of the MIBI-SPECT studies after 3 months of treatment did not showsignificant alterations of myocardial ischemia compared to baseline [16 patients idem, 7 with increase and 6 with decrease of ischemia, 2 patients dropped out during the initial test phase]. Interestingly, in the long-term follow up after one year, 16 patients [of 27 who completed the one year follow up] showed a clear decrease of myocardial ischemia and only one patient still had an increase of ischemia compared to baseline. Thus, spinal cord stimulation not only relieves symptoms, but reduces myocardial ischemia as well. However, since improvement in symptoms and exercise capacity starts much earlier, decreased myocardial ischemia might not be a direct effect of neurostimulation but rather be due to a better coronary collateralisation because of an enhanced physical activity of the patients. Heart Views. 2005;6[2]:63-70