KRANİAL MRG İNCELEMESİ SONRASI POSTURAL STABİLİTENİN BİODEKS DENGE SİSTEMİ İLE DEĞERLENDİRİLMESİ

Amaç: Çalışmamızın amacı manyetik rezonans görüntüleme (MRG) çekimi sırasında güçlü manyetik alana maruz kalan hastalarda meydanagelebilecek olası postural stabilite değişikliklerinin Biodeks denge sistemi ile (BDS) ile kantitatif olarak değerlendirilmesidir.Materyal ve Metot: Çalışmaya alınan hastalar Radyoloji kliniğine beyin MRG tetkiki için başvuran hastalar arasından seçildi. Postural stabilitedebozukluğa sebep olabilecek herhangi bir ortopedik, nörolojik, görsel, işitsel ve sistemik hastalığı olan kişiler ve MR çekimi sonrasında kranial birpatoloji saptananlar çalışma dışı bırakıldı. Postural stabilite, hem statik hem dinamik değerlendirme yapılabilen hem de kantitatif ölçüm imkanıveren BDS ile değerlendirildi. Ölçümler MRG çekiminin öncesinde ve hemen sonrasında yapıldı. BDS ile mediolateral, anteroposterior ve genelstabilite indeksleri ile düşme riski indeksi değerleri ölçüldü. MRG çekimi öncesi ve sonrası değerler arasında istatistiksel açıdan anlamlı farklılıkolup olmadığı değerlendirildi.Bulgular: Çalışmaya toplam 40 hasta dahil edildi. Hastaların 18 tanesi kadın, 22 tanesi erkekti. Ortalama yaş: 41,3±17,3 idi. MRG çekimi öncesive sonrası denge ölçüm değerleri karşılaştırıldığında mediolateral stabilite ve düşme riski indeksi değerlerinde anlamlı bir artış bulundu (pdeğerleri sırasıyla p=0,03, p=0,01). Genel stabilite ve anteroposterior stabilite indeks değerleri arasında ise anlamlı bir fark elde edilmedi (p>0,05).Sonuç: Beyin MRG çekimi ile yüksek manyetik alana maruz kalan hastalarda postural stabilitenin niceleyici olarak değerlendirilmesindemediolateral stabilite ve düşme riski indeksi parameterlerinde artış meydana gelmektedir. Kranial MRG çekimi öncesi özellikle yüksek risklihastaları postural stabilitenin bozulabileceği yönünde uyarmanın faydalı olacağı kanaatindeyiz.

Evaluation of Postural Stability with a Biodex Balance System After Cranial MRI Examination

Aim: The aim of this study was assess the postural stability of patients exposed to strong magnetic fields during magnetic resonance imaging (MRI) quantitatively with biodex stability system (BSS). Materials and Methods: Patients included in the study were selected among the patients who applied to the radiology clinic for brain MRI. Patients with any orthopedic, neurological, visual, auditory and systemic diseases that may cause postural stability disorder were excluded from the study. Postural stability was evaluated by BSS, which can be used for both static and dynamic evaluation and also provides quantitative measurement. Evaluation was performed before and immediately after MRI. Mediodateral, anteroposterior, general stability indices and fall risk index values were measured with BSS. It was evaluated whether there was a statistically significant difference between the values obtained before and after MRI. Results: Forty patients were included in the study. Of these patients, 18 were male and 22 were female. The mean age was 41.3 ± 17.3 years. When postural stability measurement values were compared before and after MRI, a significant increase was found in mediolateral stability and fall risk index values (p = 0,03, p = 0,01, respectively). There was no significant difference between general stability and anteroposterior stability index values (p> 0.05). Conclusion: Mediolateral stability and fall risk index parameters increase in quantitative evaluation of postural stability in patients exposed to high magnetic field by cranial MRI. We think it is helpful to warn especially high-risk patients that postural stability may deteriorate after cranial MRI.

PDF

___

1. van Nierop LE, Slottje P, Kingma H, Kromhout H. MRI-related static magnetic stray fields and postural body sway: a double-blind randomized crossover study. Magn Reson Med. 2013;70:232-40.
2. Acri G, Inferrera P, Denaro L, Sansotta C, Ruello E, Anfuso C, et al. dB/dt Evaluation in MRI Sites: Is ICNIRP Threshold Limit (for Workers) Exceeded? Int J Environ Res Public Health. 2018;21:15(7). pii: E1298.
3. Heilmaier C, Theysohn JM, Maderwald S, Kraff O, Ladd ME, Ladd SC. A large-scale study on subjective perception of discomfort during 7 and 1.5 T MRI examinations. Bioelectromagnetics. 2011;32:610-9.
4. Korkmaz H, Akbulut M. Vasküler Stentli Hastalarda Manyetik Rezonans Görüntüleme Güvenliği. Fırat Tıp Dergisi 2010;15(4): 164-7
5. Levine GN, Gomes AS, Arai AE, Bluemke DA, Flamm SD, Kanal E, et al. Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention: endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance. Circulation 2007; 116: 2878-91.
6. Magnetic resonance diagnostic device; panel recommendation and report on petitions for magnetic resonance reclassification and codification of reclassification-FDA. Final rule. Fed Regist 1989;54:5077-8.
7. Mian, O.S, Li, Y, Antunes A, Glover PM, Day, BL. On the vertigo due to static magnetic fields. PLoS One 2013;8:e78748.
8. Inanır A, Okan S, Filiz B. Evaluation of Postural Stability and Fall Risk in Patients with with Ankylosing Spondylitis. Cukurova Med J 2013;38:86-91.
9. Baldwin SL, Van Arnam TW, Ploutz-Snyder LL. Reliability of dynamic bilateral postural stability on the Biodex Stability System in older adults. Med Sci Sport Exerc. 2004;36:530.
10. Aydog ST, Aydog EC, Akci A, Doral MN. Reproducibility of postural stability score in blind athletes. Isokinetic Exerc Sci. 2004;12:229–32.
11. Hinman MR. Factors affecting reliability of the Biodex balance system:
12. a summary of four studies. J Sport Rehabil. 2000;9(3):240‐52.
13. Glover PM, Cavin I, Qian W, Bowtell R, Gowland PA. Magnetic-field-induced vertigo: a theoretical and experimental investigation. Bioelectromagnetics. 2007;28:349–61
14. Roberts DC, Marcelli V, Gillen JS, Carey JP, Della Santina CC, Zee DS MRI magnetic field stimulates rotational sensors of the brain. Curr Biol. 2011;21:1635–40
15. Glover PM, Li Y, Antunes A, Mian OS, Day BL. A dynamic model of the eye nystagmus response to high magnetic fields. Phys Med Biol. 2014;59:631-45.
16. Otero-Millan J, Zee DS, Schubert M, Roberts DC, Ward BK. Three-dimensional eye movement recordings during magnetic vestibular stimulation. J Neurol. 2017;264(Suppl 1):7-12.
17. Zigmund AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361-370.
18. Aydemir Ö, Güvenir T, Küey L. Validity and realibility of Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry. 1997;8:280-7.
19. 18. Cachupe JCW, Shifflet B, Kahanov L, Wughalter EH. Reliability of biodex balance system measures. Meas Phys Edu Exerc Sci.2001;5:97-108
20. Aydog E, Bal A, Aydog ST, Cakci A. Evaluation of dynamic postural balance using the biodex stability system in rheumatoid arthritis patients. Clin. Rheumatol.2006;25:462–7.
21. İnanır A, Okan S, Filiz B, Kuyucu E. Hemiplejili hastalarda konvansiyonel rehabilitasyon tedavisinin postüral denge ve klinik üzerine etkinliği. Cukurova Medical Journal. 2013;38:446-55.
22. Rode G, Tiliket C, Boisson D. Predominance of postural imbalance in left hemiparetic patients. Scand J Rehab Med. 1997;29:1-6
23. Wu SH, Huang HT, Lin CF, Chen MH. Effects of a program on symmetrical posture in patients with hemiplegia: a singlesubject design. Am J Occup Ther. 1996;50:17-23
24. Cakar E, Durmus O, Tekin L, Dincer U, Kiralp MZ. The ankle-foot orthosis improves balance and reduces fall risk of chronic spastic hemiparetic patients. Eur J Phys Rehabil Med. 2010;46:363-8.
25. İnanır A, Okan S, Filiz B, Kuyucu E. Evaluation of Postural Stability and Fall Risk in Patients with Ankylosing Spondylitis Cukurova Medical Journal. 2013;38:86-91.