Hasan YİĞİT, H. Volkan ACAR, Bayazit DİKMEN, Ayşegül CEYHAN, Pınar Nercis KOŞAR, Fatoş KORKULU

Genel anestezi sırasında oksijen kullanımı manyetik rezonans görüntülerde artefakta neden olur mu?

Amaç: Bu çalışmadaki amacımız sevofluran anestezisi altında kraniyal manyetik rezonans görüntüleme (MRG) işlemi uygulanacak pediatrik hastalarda, iki farklı oksijenkonsantrasyonunun (%100 ve %50) hiperintens sinyalanomalisine (HSA) olası etkilerini karşılaştırmaktır.Gereç ve yöntem: Kraniyal MRG işlemi uygulanan 30 pediatrik hasta üzerinde çalışıldı. MR-uyumlu bir anestezicihazı ile anestezi indüksiyon ve idamesinde sevofluran kullanıldı. Havayolu açıklığı larengeal maske ile sağlanan hastalar rastgele iki gruba ayrıldı. Anestezi idamesindeGrup I’de %100 oksijen, Grup II’de ise %50 oksijen/%50azot protoksit kullanıldı. FLAIR sekansında elde edilengörüntüler çalışma gruplarına kör bir radyolog tarafındanincelenerek beynin 11 ayrı bölgesinde beyin omurilik sıvı-sında 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 anlam- lı bir etkisi saptanmadı.

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

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% oxy- gen/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.

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