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DBS MRI Resources for Radiology Professionals

Conducting an MRI

MRI Guidelines for Medtronic Deep Brain Stimulation Systems provides comprehensive safety information and instructions for MRI head-only scans and MRI full-body scans of patients implanted with DBS systems, including how to identify full-body and head-only eligible DBS systems, how to check and set the DBS system prior to the MRI, and what type of MRI machine and settings to use. Clinicians determining MRI scan-type eligibility must record scan eligibility and system preparation information on a separate MRI Eligibility Sheet and provide the MRI Eligibility Sheet to the patient's MRI facility before the scheduled MRI scan.
 

Using the Guidelines

It is important to read the guidelines in their entirety before conducting an MRI on a patient with any implanted Medtronic deep brain stimulation component. Contact a Medtronic representative for technical support or training related to the guidelines. 

Failure to follow all warnings and guidelines related to MRI can result in serious and permanent injury, including coma, paralysis, and death.

A responsible individual with expert knowledge about MRI, such as an MRI radiologist or MRI physicist, must assure all procedures in this guideline are followed and that the MRI scan parameters comply with the required settings, both for the prescan (tuning) and during the actual MRI examination. The responsible individual must verify that parameters entered into the MRI system meet the guidelines.


Contraindications/Warnings/Precautions

Use of a full body transmit radio-frequency (RF) coil, a receive-only head coil, or a head transmit coil that extends over the chest area is contraindicated for patients with the following implanted DBS systems or system components: Soletra Model 7426 Neurostimulator; Kinetra Model 7428 Neurostimulator; Activa SC Model 37602 Neurostimulator; and Model 64001 and Model 64002 pocket adaptors. Tissue lesions from component heating, especially at the lead electrodes, resulting in serious and permanent injury including coma, paralysis, or death, can occur if a contraindicated MRI scan is performed on a patient with these DBS systems. Other conditions that may cause excessive heating at the lead electrodes which can result in serious injury or death, or that may cause device damage, include: neurostimulator implant location other than pectoral and abdominal regions; unapproved MRI parameters; partial system explants (“abandoned systems”); misidentification of neurostimulator model numbers; and broken conductor wires (in the lead, extension or pocket adaptor). Active scan time >30 minutes within a 90 minute window, elevated core body temperature due to fever or use of blankets, or patient position within the MRI bore other than prone or supine, may cause excessive tissue heating. Leaving therapy on during the scan could increase the potential for uncomfortable, unintended stimulation. Failure to cap a lead-only system may result in unintended stimulation during the scan. External control devices such as the patient programmer, recharger, external neurostimulator and clinician programmer, are MR Unsafe and not allowed in the MRI scanner (magnet) room.


 

Determining Patient Eligibility

The clinician who manages the patient’s treatment with deep brain stimulation must determine whether the patient is eligible for an MRI scan, and communicate eligibility and instructions to the radiology center.

The deep brain stimulation system should be working, and the leads and extensions should be intact and undamaged. Performing an MRI on a patient with a broken conductor (in the lead, extension, or pocket adaptor) can result in serious and permanent injury, including coma, paralysis, and death.

Use the DBS MRI Eligibility Sheet to identify MRI scan-type eligibility and ensure the DBS system is prepared for the MRI scan.


Scanning Conditions: Full-Body Eligible Systems

Applicable devices: Activa® PC model 37601, Activa RC model 37612, Activa SC model 37603

Medtronic DBS systems eligible for MRI scans of the entire body (full-body eligible) must be scanned under the following conditions:

  • 1.5-tesla (T) horizontal closed bore
  • Maximum spatial gradient of 19 T/m (1900 gauss/cm)
  • RF transmit/receive body coil (built-in) or RF transmit/receive head coil
  • Maximum RF power of 2.0 µT B1+rms (B1+ root mean squared)
  • If B1+rms is not available, a maximum RF power of 0.1 W/kg (0.05 W/lb) whole body and head SAR (specific absorption rate). Using a SAR setting may result in a more restrictive MRI scan.
  • Gradient slew rate limited to 200 T/m/s

For a complete list of conditions and instructions for use, read and fully understand the MRI Guidelines for Medtronic Deep Brain Stimulation Systems and MRI Eligibility Sheet before conducting the MRI examination.


Scanning Conditions: Head-Only Eligible Systems

Applicable systems: Activa SC model 37602, Kinetra® model 7428, Soletra® model 7426

Medtronic DBS systems eligible only for MRI scans of the head must be scanned under the following conditions.

  • 1.5-tesla (T) horizontal closed bore
  • RF transmit/receive head coil only
  • Maximum RF power of 0.1 W/kg (0.05 W/lb) head SAR
  • Gradient slew rate limited to 200 T/m/s

For a complete list of conditions and instructions for use, read and fully understand the MRI Guidelines for Medtronic Deep Brain Stimulation Systems and MRI Eligibility Sheet before conducting the MRI examination.


Patient Preparation

Instruct the patient to bring to the MRI test:


After the MRI

The DBS system does not need to be checked after the MRI scan. If it was turned off for the MRI, it will need to be turned back on as instructed in the MRI guidelines. If the device was programmed in bipolar mode and remained on during the MRI scan, it may need to be set back to the patient’s normal programming.

*Medtronic DBS systems are MR Conditional and are safe for MRI scans under certain conditions. Refer to MRI Important Safety Information for a complete list of conditions and instructions for use.

United States