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      MRI-induced artifact by a cochlear implant with a novel magnet system: an experimental cadaver study

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          Abstract

          Purposes

          To primarily evaluate MRI-induced effects for Ultra 3D cochlear implantation in human cadavers in terms of artifact generation and MR image quality.

          Methods

          Three human cadaveric heads were submitted to imaging after unilateral and bilateral cochlear implantation. The 1.5 T MR examination protocol was chosen in accordance with our institutional protocol for the assessment of brain pathology. The maximal signal void size was measured according to each sequence and plane. Two experienced neuro-radiologists and one experienced otoneurosurgeon independently evaluated the MR image quality findings. A 4-point scale was used to describe the diagnostic usefulness of 14 brain structures.

          Results

          Shape and size of the artifacts were found to be highly related to MRI sequences and acquisition planes. MRI sequences and processing algorithms affected the ability to assess anatomical visibility. Image quality appeared either high or assessable for diagnostic purposes in 9 out of 14 of the ipsilateral structures, in at least one plane. Anatomical structures contralateral to the cochlear implant were highly visible in all conditions. Artifact intrusion clearly improved after application of metal artifact-reduction techniques. In the case of bilateral cochlear implant, a mutual interaction between the two implant magnets produced an additional artifact.

          Conclusions

          We performed the first cadaver study aimed at systematically evaluating the MRI-induced artifacts produced by a cochlear implant with a novel four bar magnet system. Specific brain structures can be assessable for diagnostic purposes under 1.5 T MRI, with the cochlear implant magnet in place.

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          Most cited references22

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          The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK.

          Over an 18-month period, all incident cases of neurological disorders were ascertained prospectively in an unselected urban population based in 13 general practices in the London area by a General Practice Linkage Scheme with the National Hospital for Neurology and Neurosurgery. In three of these practices, the lifetime prevalence of neurological disorders was also assessed. A population of 100 230 patients registered with participating general practices was followed prospectively for the onset of neurological disorders. Multiple methods of case finding were used to maintain accuracy. The age- and sex-adjusted incidence rates of neurological disorders were calculated. The lifetime prevalence of neurological disorders was surveyed in 27 658 of the patients. The age- and sex-adjusted incidence rates were calculated for major neurological conditions. [These are expressed as rates per 100 000 persons per annum, with 95% confidence intervals (CI) in parentheses]. The commonest of these were first cerebrovascular events, 205 (CI: 183, 230); shingles, 140 (CI: 104, 184); diabetic polyneuropathy, 54 (CI: 33, 83); compressive neuropathies, 49 (CI: 39, 61); epilepsy, 46 (CI: 36, 60); Parkinson's disease, 19 (CI: 12, 27); peripheral neuropathies, 15 (CI: 9, 23); CNS infections, 12 (CI: 5, 13); post-herpetic neuralgia, 11 (CI: 6, 17); and major neurological injuries, 10 (CI: 4, 11). Lifetime prevalence rates are also reported (expressed as rate per 1000 persons with 95% CI). The most prevalent conditions were: completed stroke, 9 (CI: 8, 11); transient ischaemic attacks, 5 (CI: 4, 6); active epilepsy, 4 (CI: 4, 5); congenital neurological deficit, 3 (CI: 3, 4); Parkinson's disease, 2 (CI: 1, 3); multiple sclerosis, 2 (CI: 2, 3); diabetic polyneuropathy, 2 (CI: 1, 3); compressive mononeuropathies, 2 (CI: 2, 3); and sub-arachnoid haemorrhage, 1 (CI: 0.8, 2). Overall, the onset of 625 neurological disorders was observed per 100 000 population annually. Six percent of the population had at some time had a neurological disorder. This is the first study of the incidence and lifetime prevalence of neurological disorders in recent times; we found that these disorders give rise to significant morbidity in the community.
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            The cochlear implant: historical aspects and future prospects.

            The cochlear implant (CI) is the first effective treatment for deafness and severe losses in hearing. As such, the CI is now widely regarded as one of the great advances in modern medicine. This article reviews the key events and discoveries that led up to the current CI systems, and we review and present some among the many possibilities for further improvements in device design and performance. The past achievements include: (1) development of reliable devices that can be used over the lifetime of a patient; (2) development of arrays of implanted electrodes that can stimulate more than one site in the cochlea; and (3) progressive and large improvements in sound processing strategies for CIs. In addition, cooperation between research organizations and companies greatly accelerated the widespread availability and use of safe and effective devices. Possibilities for the future include: (1) use of otoprotective drugs; (2) further improvements in electrode designs and placements; (3) further improvements in sound processing strategies; (4) use of stem cells to replace lost sensory hair cells and neural structures in the cochlea; (5) gene therapy; (6) further reductions in the trauma caused by insertions of electrodes and other manipulations during implant surgeries; and (7) optical rather electrical stimulation of the auditory nerve. Each of these possibilities is the subject of active research. Although great progress has been made to date in the development of the CI, including the first substantial restoration of a human sense, much more progress seems likely and certainly would not be a surprise.
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              Adverse events and discomfort during magnetic resonance imaging in cochlear implant recipients.

              Patients with cochlear implants (CIs) should be fully informed before undergoing magnetic resonance imaging (MRI) about the possibility of discomfort or pain. Prior to an MRI scan, patients need to fully understand not only the potential complications but also the potential discomfort that they may experience during the scan.
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                Author and article information

                Contributors
                pietro.canzi@unipv.it
                Journal
                Eur Arch Otorhinolaryngol
                Eur Arch Otorhinolaryngol
                European Archives of Oto-Rhino-Laryngology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0937-4477
                1434-4726
                18 November 2020
                18 November 2020
                2021
                : 278
                : 10
                : 3753-3762
                Affiliations
                [1 ]Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico “San Matteo”, Viale Camillo Golgi, 19, 27100 Pavia, Italy
                [2 ]Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
                [3 ]GRID grid.8982.b, ISNI 0000 0004 1762 5736, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, , University of Pavia, ; Pavia, Italy
                [4 ]GRID grid.8982.b, ISNI 0000 0004 1762 5736, University of Pavia, ; Pavia, Italy
                [5 ]GRID grid.417284.c, ISNI 0000 0004 0398 9387, Clinical Application Specialist MR/ISP, ; Philips, The Netherlands
                [6 ]AB GmbH, European Research Centre ERC, Hannover, Germany
                Author information
                http://orcid.org/0000-0002-6471-5035
                http://orcid.org/0000-0001-6793-018X
                http://orcid.org/0000-0003-0289-6122
                http://orcid.org/0000-0001-7002-1972
                http://orcid.org/0000-0002-5872-0233
                http://orcid.org/0000-0003-0509-0044
                http://orcid.org/0000-0002-5129-2520
                http://orcid.org/0000-0002-7755-7726
                http://orcid.org/0000-0003-1639-3454
                http://orcid.org/0000-0002-2760-0124
                http://orcid.org/0000-0001-9953-6435
                http://orcid.org/0000-0002-6857-1729
                Article
                6464
                10.1007/s00405-020-06464-z
                8382638
                33206227
                2fe9ff83-27fe-48f4-b73d-6b2b8a9cc118
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 2 July 2020
                : 28 October 2020
                Funding
                Funded by: Università degli Studi di Pavia
                Categories
                Otology
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2021

                Otolaryngology
                cochlear implant,artifacts,magnetic resonance imaging,cadaver,ultra 3d
                Otolaryngology
                cochlear implant, artifacts, magnetic resonance imaging, cadaver, ultra 3d

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