Clinical and Radiological Safety of Retained Implantable Doppler Devices Used for Free Flap Monitoring

2021 ◽  
pp. 229255032110065
Author(s):  
Lucas Kreutz-Rodrigues ◽  
Waleed Gibreel ◽  
Brian T. Carlsen ◽  
Matthew A. Frick ◽  
Samir Mardini ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Free Flap ◽  
Soft Tissues ◽  
Magnetic Resonance Images ◽  
Related Complication ◽  
Free Flap Monitoring ◽  
Mri Scans ◽  
Flap Monitoring ◽  
Mri Image

Introduction: Implantable Doppler devices are reliable adjuncts used for free flap monitoring. Occasionally, the probe/wire is not removed and remains in the soft tissues. The clinical safety of the retained probes and safety and compatibility with magnetic resonance imaging (MRI) have not been studied. We present a series of retained implantable Doppler probes examining clinic outcomes, safety and compatibility with MRI, and effect on MRI image quality. Methods: A retrospective review was conducted of patients who had an implantable Doppler device for free flap monitoring between July 2007 and August 2018. Routine post-operative imaging was reviewed for all patients to identify incidental findings of a retained probe. A subset of patients with retained implantable Doppler probes who underwent MRI was identified. Magnetic resonance images were reviewed to detect any degradation of image quality. Results: A total of 323 patients who had an implantable Doppler device placed were reviewed 18 (5.6%) patients were identified with a retained probe and were included in this study. Mean age was 49 years with mean follow-up of 34.4 months. One potential device-related complication occurred in 1 (5.6%) patient. A total of 32 MRI scans were performed in 8 patients with retained devices, including 6 patients who underwent a total of 21 MRIs of the surgical site. There were no complications related to the MRI scans, and we found no significant degradation of image quality. Conclusion: Retained implantable Doppler probes were not associated with substantial adverse clinical outcomes nor affected MRI image quality of the surgical site.

An emerging technology: Nuclear magnetic resonance microscopy

1988 ◽  
Vol 46 ◽  
pp. 1000-1001
Author(s):  
M.J. Hennessy ◽  
E. Kwok
Keyword(s):  
Nuclear Magnetic Resonance ◽  
Magnetic Resonance ◽  
Relaxation Times ◽  
Basic Research ◽  
Local Environment ◽  
Magnetic Resonance Images ◽  
Nmr Microscopy ◽  
Mri Scans ◽  
Temperature Relaxation ◽  
Nuclear Magnetic

Much progress in nuclear magnetic resonance microscope has been made in the last few years as a result of improved instrumentation and techniques being made available through basic research in magnetic resonance imaging (MRI) technologies for medicine. Nuclear magnetic resonance (NMR) was first observed in the hydrogen nucleus in water by Bloch, Purcell and Pound over 40 years ago. Today, in medicine, virtually all commercial MRI scans are made of water bound in tissue. This is also true for NMR microscopy, which has focussed mainly on biological applications. The reason water is the favored molecule for NMR is because water is,the most abundant molecule in biology. It is also the most NMR sensitive having the largest nuclear magnetic moment and having reasonable room temperature relaxation times (from 10 ms to 3 sec). The contrast seen in magnetic resonance images is due mostly to distribution of water relaxation times in sample which are extremely sensitive to the local environment.

Review of Flap Monitoring Technology in 2020

2020 ◽  
Vol 36 (06) ◽  
pp. 722-726
Author(s):  
Adam Jacobson ◽  
Oriana Cohen
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Loss Rate ◽  
Early Recognition ◽  
Postoperative Patient ◽  
Free Flap Monitoring ◽  
Improved Outcomes ◽  
Vascular Compromise ◽  
Flap Monitoring ◽  
Multiple Levels

AbstractAdvances in free flap reconstruction of complex head and neck defects have allowed for improved outcomes in the management of head and neck cancer. Technical refinements have decreased flap loss rate to less than 4%. However, the potential for flap failure exists at multiple levels, ranging from flap harvest and inset to pedicle lay and postoperative patient and positioning factors. While conventional methods of free flap monitoring (reliant on physical examination) remain the most frequently used, additional adjunctive methods have been developed. Herein we describe the various modalities of both invasive and noninvasive free flap monitoring available to date. Still, further prospective studies are needed to compare the various invasive and noninvasive technologies and to propel innovations to support the early recognition of vascular compromise with the goal of even greater rates of flap salvage.

Current Approaches to Free Flap Monitoring

2014 ◽  
Vol 34 (2) ◽  
pp. 52-56 ◽  
Author(s):  
Albert H. Chao ◽  
Susan Lamp
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

scholarly journals Reply: Refinements in Postoperative Free Flap Monitoring

2011 ◽  
Vol 127 (6) ◽  
pp. 2512
Author(s):  
Jeroen M. Smit ◽  
Clark J. Zeebregts ◽  
Rafael Acosta ◽  
Paul M. N. Werker
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

New prospects in postoperative free flap monitoring

2011 ◽  
Vol 40 (10) ◽  
pp. 1149
Author(s):  
B. Henault ◽  
A. Duvernay ◽  
M. Roche ◽  
N. Zwetyenga
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

Continuous free flap monitoring: a modification of the Licox catheter probe system

2003 ◽  
Vol 26 (3) ◽  
pp. 140-143
Author(s):  
L.-P. Kamolz ◽  
H. Lanm�ller ◽  
O. C. Aszmann ◽  
P. Giovanoli ◽  
R. Koller ◽  
...  
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Probe System ◽  
Flap Monitoring

scholarly journals Interobserver variability in quality assessment of magnetic resonance images

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rafal Obuchowicz ◽  
Mariusz Oszust ◽  
Adam Piorkowski
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Quality Assessment ◽  
Image Quality Assessment ◽  
Interobserver Variability ◽  
Poor Performance ◽  
Magnetic Resonance Images ◽  
Perceptual Quality ◽  
Mr Images

Abstract Background The perceptual quality of magnetic resonance (MR) images influences diagnosis and may compromise the treatment. The purpose of this study was to evaluate how the image quality changes influence the interobserver variability of their assessment. Methods For the variability evaluation, a dataset containing distorted MRI images was prepared and then assessed by 31 experienced medical professionals (radiologists). Differences between observers were analyzed using the Fleiss’ kappa. However, since the kappa evaluates the agreement among radiologists taking into account aggregated decisions, a typically employed criterion of the image quality assessment (IQA) performance was used to provide a more thorough analysis. The IQA performance of radiologists was evaluated by comparing the Spearman correlation coefficients, ρ, between individual scores with the mean opinion scores (MOS) composed of the subjective opinions of the remaining professionals. Results The experiments show that there is a significant agreement among radiologists (κ=0.12; 95% confidence interval [CI]: 0.118, 0.121; P<0.001) on the quality of the assessed images. The resulted κ is strongly affected by the subjectivity of the assigned scores, separately presenting close scores. Therefore, the ρ was used to identify poor performance cases and to confirm the consistency of the majority of collected scores (ρmean = 0.5706). The results for interns (ρmean = 0.6868) supports the finding that the quality assessment of MR images can be successfully taught. Conclusions The agreement observed among radiologists from different imaging centers confirms the subjectivity of the perception of MR images. It was shown that the image content and severity of distortions affect the IQA. Furthermore, the study highlights the importance of the psychosomatic condition of the observers and their attitude.

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