Does oxygen use during general anesthesia cause an artifact in magnetic resonance images?

Abstract

Objectives: In this study our aim was to compare possible effects of two different oxygen concentrations (100% vs. 50%) on hyperintense signal abnormality (HSA) in pediatric patients undergoing cranial magnetic resonance imaging (MRI) under sevoflurane anesthesia. Materials and methods: Thirty pediatric patients undergoing cranial MRI were studied. Sevoflurane was used for induction and maintenance of anesthesia with an MR-compatible anesthesia machine. Patients, whose airway patency was maintained with laryngeal mask, were divided randomly in two groups. 100% oxygen and 50% oxygen/50% nitrous oxide was used for maintenance of anesthesia in Group I and II, respectively. FLAIR sequence images were analyzed by a radiologist who was unaware of the groups and were evaluated for HSA in 11 different brain regions in cerebrospinal fluid neighborhood. A three-point scale was used for evaluation. Results: HSA was seen in all study patients at least in one brain region. However, no significant difference was obtained between two groups in almost all brain regions (p>0.05). Conclusions: Use of oxygen in pediatric patients undergoing cranial MRI under sevoflurane anesthesia caused a low grade HSA. However, concentration of oxygen had no significant effect on the severity of HSA.

Keywords

• Anesthesia, pediatric, brain, magnetic resonance imaging, cerebrospinal fluid, oxygen

Does oxygen use during general anesthesia cause an artifact in magnetic resonance images?

Öz

Amaç: Bu çalışmadaki amacımız sevofluran anestezisi altında kraniyal manyetik rezonans görüntüleme (MRG) işlemi uygulanacak pediatrik hastalarda, iki farklı oksijen konsantrasyonunun (%100 ve %50) hiperintens sinyal anomalisine (HSA) olası etkilerini karşılaştırmaktır. Gereç ve yöntem: Kraniyal MRG işlemi uygulanan 30 pediatrik hasta üzerinde çalışıldı. MR-uyumlu bir anestezi cihazı ile anestezi indüksiyon ve idamesinde sevofluran kullanıldı. Havayolu açıklığı larengeal maske ile sağlanan hastalar rastgele iki gruba ayrıldı. Anestezi idamesinde Grup I\'de %100 oksijen, Grup II\'de ise %50 oksijen/%50 azot protoksit kullanıldı. FLAIR sekansında elde edilen görüntüler çalışma gruplarına kör bir radyolog tarafından incelenerek beynin 11 ayrı bölgesinde beyin omurilik sıvısında HSA değerlendirildi. Değerlendirme için üç dereceli bir skala kullanıldı. Bulgular: Çalışmadaki tüm hastalarda beynin en az bir bölgesinde HSA izlendi. Ancak incelenen beyin alanlarının tamamına yakınında her iki grup arasında anlamlı bir fark saptanmadı (p>0,05). Sonuç: Sevofluran anestezisi altında kraniyal MRG işlemi uygulanacak pediatrik hastalarda oksijen kullanımı, düşük derecede de olsa HSA\'ya neden oldu. Ancak kullanılan oksijen konsantrasyonunun HSA derecesine anlamlı bir etkisi saptanmadı.

Anahtar Kelimeler

• Anestezi, pediatrik, beyin, manyetik rezonans görüntüleme, serebrospinal sıvı, oksijen

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