儿科MRI安全：五家美国儿童医院IV区安全事件频率、类型及严重程度
该回顾性研究分析了2017至2022年间五家美国大型儿童医院系统IV区发生的MRI安全事件，共约540,744次检查中报告146起事件，平均每万次检查2.5起。最常见类型为投射物（30%）、烧伤/热损伤（13%）和植入物相关（10%），6.8%为严重安全事件。60%的事件未正确遵循MRI安全流程，53%直接涉及患者。
要点
- 儿科MRI IV区安全事件发生率约2.5/10,000次检查，虽不常见但持续存在。
- 投射物是最常见类型（30%），其次为烧伤/热损伤（13%）和植入物相关（10%）。
- 60%事件因未正确遵循安全流程所致，提示流程执行是改进重点。
诊断标准与关键数值
- IV区MRI安全事件频率：平均每站点每年4.9起（范围1.0-8.5），或每10,000次MRI检查2.5起（范围0.9-3.7）。
- 146起事件中投射物44起（30%），烧伤或热损伤19起（13%），植入物相关14起（10%）。
- 严重安全事件10起（6.8%）。
- MRI安全流程未正确遵循88起（60%），直接涉及患者78起（53%）。
临床应用与阅片要点
- 阅片之外应关注IV区安全流程执行，尤其投射物筛查和植入物核对。
- 烧伤/热损伤事件提示需注意患者接触部位和线圈使用安全。
- 严重事件比例虽低但后果可能灾难性，报告安全事件有助于持续改进。
局限性
- 回顾性研究，依赖现有机构安全记录，可能存在漏报或记录不完整。
- 仅纳入五家儿童医院系统，结果外推需谨慎。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND: Data on the frequency and types of MRI safety events in pediatric imaging departments are limited.
OBJECTIVE: To assess the frequency, types, and severity of MRI safety events occurring in zone IV across five US pediatric imaging departments.
METHODS: This retrospective study reviewed MRI safety events that occurred in zone IV between 2017 and 2022 at five major US children's hospital systems. The frequency, types (eg, projectile, burn, implant related), and severities of events were recorded using existing institutional MRI safety records. Descriptive statistical analyses were conducted.
RESULTS: Over a 6-year period and approximately 540,744 MRI examinations, a total of 146 zone IV MRI safety events were reported across the five institutions. On average, each site experienced 4.9 events per year (range across sites: 1.0-8.5) or 2.5 events per 10,000 MRI examinations (range across sites: 0.9-3.7). Of the 146 events, 44 (30%) involved projectiles, 19 (13%) were burn or thermal injuries, and 14 (10%) were implant related. Ten events (6.8%) were classified as serious safety events. MRI safety protocols were not correctly followed in 88 of 146 events (60%), and 78 of 146 events (53%) directly involved patients.
CONCLUSION: Although uncommon, MRI safety incidents do occur in zone IV of pediatric imaging departments. Although most cause no serious harm, their persistence and potential for catastrophic outcomes highlight the need for continued vigilance and ongoing safety improvements.
引用
- Guan AS, Iyer RS, Barth RA, et al. Pediatric MRI Safety: Frequency, Types, and Severity of Zone IV MRI Safety Events at Five US Children's Hospitals. J Am Coll Radiol. 2026. PMID: 42107671. doi:10.1016/j.jacr.2026.05.013
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。