In vitro study of magnetic resonance imaging artefacts of six supraglottic airway devices

Zaballos, M.; Bastida, E; Castillo, Toni; Villoria, Juan Guzman de; Jiménez, César Romero

doi:10.1111/j.1365-2044.2010.06299.x

Cited by 13 publications

(17 citation statements)

References 8 publications

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“…[14] In anesthetizing patients for MRI procedures (which is often done as a day case procedure), the i-gel is an ideal device as there are no artefacts with its use, compared with the artefacts with the LMA classic, unique and Supreme (even more pronounced with the LMA Proseal) related to ferromagnetic material in the pilot balloon valve. [15]…”

Section: Discussionmentioning

confidence: 99%

Use of extraglottic airways in patients undergoing ambulatory laparoscopic surgery without the need for tracheal intubation

Suhitharan

Teoh

2013

Saudi J Anaesth

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Background:Second generation extraglottic airway devices with gastric access and separate breathing channels have ushered in a new era where their use is increasingly prevalent in surgical patients who would have been traditionally intubated for general anesthesia. New innovations like the i-gel, which is constructed of a thermoplastic elastomer, provide an airtight seal around patient's perilaryngeal anatomy without the inflatable cuff mechanism found in the laryngeal mask airway supreme (LMAS).Methods:We conducted a randomized controlled trial comparing the LMAS with the i-gel in 70 anesthetized paralyzed patients undergoing laparoscopic female sterilization. Our primary outcome measure was the oropharyngeal leak pressure (OLP). We studied secondary outcomes of successful first attempt insertion rates, time and ease of the airway and gastric tube insertion, leak fractions and pharyngeal morbidity.Results:We found no difference in the OLP between LMAS and i-gel, 25.9 (4.2) versus 24.4 (4.3) s, P=0.153. Both devices had similar first attempt insertion rates (LMAS 94% vs. i-gel 91%) with similar ease and comparable times to achieve an effective airway, LMAS 14.7 (2.7) versus i-gel 16.5 (9.6) s, P=0.306, although gastric tube insertion was easier and faster for the LMAS, 7.9 (1.9) versus i-gel 14.8 (7.7) s, P<0.005. Intraoperatively, there was a significantly greater leak fraction with the i-gel of 0.06 (0.03) versus 0.04 (0.02) with the LMAS, P=0.013. Three patients (8.6%) with LMAS had mild sore throat; one patient (2.9%) had mucosal injury. No complications were documented in the i-gel group.Conclusions:Both these extraglottic airway devices offer similar OLPs, high insertion success rates at the first attempt with similar ease and insertion times (albeit longer gastric tube insertion with i-gel). Both provided effective ventilation despite a higher leak fraction with i-gel that was clinically inconsequential.

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Section: Discussionmentioning

confidence: 99%

Use of extraglottic airways in patients undergoing ambulatory laparoscopic surgery without the need for tracheal intubation

Suhitharan

Teoh

2013

Saudi J Anaesth

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“…General anesthesia with a supraglottic airway (SGA) or endotracheal tube (ETT) is used routinely in some hospitals to limit motion artifact and improve image quality during imaging studies of children. While SGAs are typically safe, effective airway devices for children undergoing general anesthesia for diagnostic studies, there is a paucity of literature describing their potential for producing in vivo magnetic resonance imaging (MRI) artifacts in children with neck, nasopharyngeal, and oropharyngeal masses …”

Section: Introductionmentioning

confidence: 99%

A retrospective study of the impact of supraglottic airway devices on the appearance of neck masses in children undergoing serial magnetic resonance imaging

Simpao

Obsekov

Gálvez

et al. 2018

Pediatric Anesthesia

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Summary Background General anesthesia and sedation are used routinely for magnetic resonance imaging (MRI) studies in children to optimize image quality. Airway devices such as supraglottic airways (SGAs) can alter the appearance of cervical soft tissue regions on an MRI and increase the risk of misdiagnosis. This phenomenon has not been well described in vivo. Aims We conducted this retrospective study to determine how often SGAs affected the appearance of neck masses in children who received multiple anesthetics for MRIs with and without an SGA. Methods We retrieved data on children 17 years old and younger who had multiple MRIs between January 2005 and January 2015. Inclusion criteria were patients with neck masses who had a SGA for at least one MRI and either a natural airway or endotracheal tube (ETT) for another MRI. We reviewed MRI images and imaging reports to determine if SGAs affected the appearance of neck masses. Results Twelve of the 921 patients who received anesthesia for neck MRIs during the study period met the inclusion criteria. SGAs affected the appearance of the neck mass in 11 of the 12 patients. Conclusions Supraglottic airways can significantly alter the appearance of neck masses in children undergoing MRIs and affect radiologists’ ability to assess those masses. Communication with the radiologist prior to the induction of anesthesia is crucial when using supraglottic devices in this patient population. It may be more prudent to use a different airway device and/or anesthetic technique when MRIs of these neck masses are undertaken.

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“…Neonates and infants are particularly at risk for airway obstruction and complications while under sedation for MRI . Anesthesiologists should always weigh the risks and benefits of airway device placement and anticipate how an airway device might cause imaging artifacts . This case and figure illustrate clearly how using laryngeal mask airways during neck imaging in children can create the potential for misdiagnosis.…”

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confidence: 96%

The vanishing neck mass: how using a laryngeal mask airway during magnetic resonance imaging of a child can cause misdiagnosis

Simpao

Pollock

McGinnis

et al. 2016

Pediatric Anesthesia

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In vitro study of magnetic resonance imaging artefacts of six supraglottic airway devices

Cited by 13 publications

References 8 publications

Use of extraglottic airways in patients undergoing ambulatory laparoscopic surgery without the need for tracheal intubation

Use of extraglottic airways in patients undergoing ambulatory laparoscopic surgery without the need for tracheal intubation

A retrospective study of the impact of supraglottic airway devices on the appearance of neck masses in children undergoing serial magnetic resonance imaging

The vanishing neck mass: how using a laryngeal mask airway during magnetic resonance imaging of a child can cause misdiagnosis

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