Honce, Justin M.

Objective: To evaluate magnetic resonance (MR) imaging artifact and image distortion associated with the Oticon Medical Sentio Ti bone conduction implant (BCI) and identify optimized imaging techniques. Study design: Cadaveric study. Intervention: One cadaveric head specimen was unilaterally implanted with Sentio Ti BCI according to the manufacturer's instructions. Main outcome measures: Imaging was performed with a Siemens 1.5 Tesla MR machine on XA60 software before and after implantation. Imaging was performed with both standard and metal mitigation techniques. Image scoring (diagnostic vs. nondiagnostic) and qualitative assessment of anatomic subsites were performed by 2 experienced neuroradiologists. Results: Image distortion and artifact were noted in all postimplant sequences. For all sequences, imaging of the ipsilateral middle ear, mastoid, and internal auditory canal (IAC) was nondiagnostic. The axial T1 turbo spin echo high bandwidth sequence had the best artifact reduction; however, the ipsilateral temporal bone remained nondiagnostic. Notably, nonecho planar diffusion-weighted imaging (non-EPI DWI) was nondiagnostic for both the ipsilateral temporal bone and the contralateral IAC and middle ear. Conclusions: After implantation of the Sentio Ti BCI, imaging of the ipsilateral temporal bone is rendered nondiagnostic on all MR sequences due to artifact despite the use of metal mitigation techniques. Importantly, the non-EPI DWI HASTE sequence, which is used for cholesteatoma surveillance, is nondiagnostic for all ipsilateral and most contralateral temporal bone subsites, making cholesteatoma surveillance challenging with an implant in place. This finding is critical for clinical decision-making, as rehabilitation of conductive hearing loss in the setting of chronic otitis media is among the most common indications for use of a BCI.

Abstract Positive patient care and healthcare facility outcomes are associated with using various psychological interventions during magnetic resonance imaging and interventional radiology procedures. Interventions such as hypnosis, relaxation, guided imagery, and empathic communication can improve anxiety, pain, and hemodynamic stability during procedures, as well as improve claustrophobia and anxiety during magnetic resonance imaging. Little is understood as to the potential underlying mechanisms of how these interventions operate and contribute to positive outcomes. Thus, this article seeks to address that question by integrating autonomic nervous system functioning, neuropsychological concepts, and common factors theory of psychotherapy as potential underlying mechanisms. Opportunities for future directions in the field are also included.