Gushiramwo igisasu c'umuyagankuba wa MRI, ubuto bwo kuzimya vyihutirwa, n'ugusenyuka kw'umuyagankuba wa Cryogen¶

Ivyo bikoresho bikoreshwa mu gupima amashusho y’umuyagankuba (MRI) bikora bikoresheje amashusho y’umuyagankuba ashobora gutwara umuyagankuba cane cane afise uburemere bwa 1,5 Tesla (15.000 Gauss) canke 3,0 Tesla (30.000 Gauss), hakaba hariho ibice vy’ubushakashatsi vyihariye bishika kuri 7,0 Tesla (7.0,00) Uwo muyagankuba utaboneka (\(B_0\)) urakomeye incuro 30.000 gushika ku 60.000 kuruta umuyagankuba w’isi, kandi uguma ufunguye amasaha 24 ku musi, imisi 365 ku mwaka, mbere n’igihe igikoresho co gupima umuyagankuba kizimye canke kizimye. Iyo umuntu atasuzumwe, uwucungera, canke uwo mu muryango azanye igitereko c’umwuka w’icuma, igare ry’ibitaro, intebe y’ibimuga idakoreshwa na MR, igikoresho co gukingira hasi, canke ibikoresho bibiri vy’ugukemura ibikomere biva ku mbuga y’uruhome mu MRI Zone IV (icumba c’ivyuma), igitereko c’ivyuma ikintu c’icuma kiva mu minwe yabo maze kikacihutisha kija mu isocenter y’umugende w’amabuye y’agaciro nk’igisasu c’imbunda ku birometero 45 gushika kuri 70 kw’isaha (ibilometero 28 gushika kuri 45 kw’isaha) n’inguvu z’amajana canke ibihumbi z’ibilo vy’ugukwega.

Iyo umuntu afashwe imbere mu mfuruka y’umuyagankuba hagati y’inzu y’umusumari n’igikoresho co gutererako, intebe y’ibimuga, canke igitereko c’umwuka, nta mubare w’abarokozi bakomeye bashobora gukuraho ico kintu c’icuma n’amaboko, kandi kuzana ivyuma bimenyerewe canke amashoka y’umuriro mu cumba bizotuma habaho gusa ibindi bitero vy’urupfu. Kurekura umuntu ashobora gupfa imbere mu mfuruka bisaba gukanda ubuto bw’umutuku burindwa Emergency Magnet Rundown (Quench) Button, bushobora gusenyura n’ibigirankana ubushobozi burengeye ubw’amamagneti bwo gutwara umuyagankuba maze bugatera amazi ashika ku 1.500 gushika kuri 2.090 gallons y’amazi (400 to600 litres) y’amazi. degre z’ubushuhe (gukurwako degre 452 z’ubushuhe). Ariko rero, iyo umuyoboro w’inyuma w’umuyagankuba w’inyoni uzibiwe n’urubura, ivyari vy’inyoni, canke n’ugusenyuka kw’ibarafu, iyo helium y’amazi itetse iragwira incuro 757 mu bwinshi imbere mu cumba c’ugupima, igatuma haba icumba gifise umukazo mwinshi, gikonja, gifise umwuka mwiza cane. Kumenya igihe co gukanda buto itukura ya Electrical Emergency Power Off n’ubuto butukura bwa Magnet Quench, ingene wokuraho umuyoboro wo kuzimya wacitse, n’ingene wozura umurwayi afise umutima uhagaze mu kumukura mu karere ka IV akamujana mu karere ka III imbere yo kuzana igikarito c’umuyagankuba n’ubuzima bw’umuyagankuba; Gumana ivy'aho uba inomero z'ivyihutirwa witeguye, kandi usubiremwo gazi ipfutse umuvuduko w'amazi n'ugusohoka kw'amazi, gupfumeka mu kibanza gifunze, na ubushuhe n'ubukonje ubutabazi bwa mbere.

Ivyo ubikore ubu¶

1. NTUKIGEZE winjira mu cumba co gupima MRI (Zone IV) utwaye ikintu cose c’icuma canke c’icuma kitazwi, mbere no mu gihe umutima w’umurwayi uhagaze canke umuriro. Ico gikoresho gishobora gutuma umuriro ugenda neza cane KIRIHO mbere n’igihe mudasobwa n’amatara yo mu cumba ari mu mwijima rwose; gukuraho imfunguruzo zose, ama pager, amatelefone, umukasi, ama stethoscope, ama tanki y’umwuka, n’amapaki y’abazimya umuriro SCBA imbere yo kujabuka umurongo w’akaga wo hasi utukura ukaja mu karere ka IV.
2. Iyo umurwayi ahagaritse umutima, ahagaritse impwemu, canke anaphylaxie imbere mu gikoresho co gupima MRI, NTUZANE igare ry’impanuka canke defibrillateur mu cumba co gupima, kandi NTUZIME umusumari. Ubwo nyene utere buto y’imeza y’i muhira/y’ugurekura (canke ukure ubuto bw’imeza bwo gusubira mu nzu/ubwo kurekura (canke ukureho igikoresho c’amaboko co gupima umurwayi ku meza sto-decoupling non-ferromagnetic gurney, hanyuma ukazizingira ISOHOKA ry’akarere ka IV mu karere ka III canke akarere ka II (ahantu ho kurindirira/gufata) mu masegonda 15 gushika kuri 30 kugira ngo umugwi w’abakozi ba code ushobore gukuraho umutima no gutera umutima ata nkomanzi hanze y’aho umuyagankuba uhagaze.
3. Kanda buto y’umutuku irindwa MAGNET QUENCH (Emergency Magnet Rundown) GUSA ku bibazo bibiri vyihutirwa vy’ubuzima canke urupfu: (a) umuntu afashwe ku mubiri canke akajanjagurwa n’ikintu c’umuyagankuba ku muyagankuba gishobora gutera ubwoba ubuzima canke igihimba c’umubiri, canke (b) winjire n’ivyuma. Ntukigere uzimya umusumari kugira ngo ubohore ikintu kitagira ubuzima (nk’igipfukisho co hasi gifatanye canke intebe y’ibimuga iri ubusa) iyo ata muntu akomeretse canke afashwe; abakozi b’abahinga barashobora gutera iyo magnete hasi ata nkomanzi batayitetse iyo helium.
4. THE INSTANT a Magnet Quench begins (yaba ivyuriwe n'ubuto canke bishika ubwavyo n'ijwi rirenga ry'ugusemerera n'uguboroga), VACURA umuntu wese mu cumba ca MRI scan ubwo nyene. Ntutegereze imbere mu cumba kugira ngo umuyagankuba ugwe mu cumba c'umuyagankuba canke iyo uwo muntu ashobora gukurwako inzu y’umuyagankuba; umuyoboro w’umuyaga wo kuzimya ucitse canke uzibiye wuzuza mu cumba gaze ya helium ipfuka n’umuvuduko mwiza mu masegonda atarenga 30.
5. Iyo urugi rwa MRI ruzunguruka imbere rwugarijwe ruvuye imbere n’umuvuduko mwiza w’umuyagankuba mu gihe c’uguzimya (uguhuha mu cumba), uce umena idirisha ry’umuringa ry’icumba co kwihweza ukoresheje ikintu kiremereye kitagira umuyagankuba (nk’igitanda c’umuyagankuba, umuvuduko w’umuringa, umuringa) escape. Igihe umukazo uzoba ungana kw’idirisha ryavunitse, urugi rw’icumba co gupima ruzokwiguruka bitagoranye.
6. Ku muriro w’umuyagankuba, umugozi w’umuyagankuba, canke umuyagankuba w’imeza aho ata n’umwe afise umuyagankuba, kanda buto y’umuyagankuba (EPO) aho gukanda buto ya Magnet Quench. Buto ya EPO ica yica ubwo nyene amashanyarazi yose y’amavolte 480 AC, ububasha bw’umuyagankuba, n’imeza y’umurwayi ikoreshwa n’imoteri ata gusohora umuyagankuba utwara umuriro mwinshi canke gusohora amazi y’umuyagankuba yitwa helium.
7. Hamagara umugwi wawe w’abahinga mu vy’ubuvuzi n’inomero y’ivyihutirwa yo mu karere kawe (911 muri Leta Zunze Ubumwe za Amerika na Canada, 112 mu bihugu vyose vy’Ubumwe bw’Uburaya, 999 mu Bwongereza) maze ugabishe abazimya umuriro n’abaganga bashika ku muryango wo hanze wa Zone III ko umuyagankuba wa MRI uriho. Shira umukozi yiyemeje nk’intambamyi yo kwinjira mu nzu y’injira y’abantu ku muryango wa Zone IV a amabarabara, ibidengeri vy’icuma vy’amazi vyitwa SCBA, n’ibikoresho vy’umwuka w’ikirere bifise ubunini bwa D, bica bihagarika abaje gutabara ivyihutirwa bariko barashika imbere y’uko begera umuryango.

Igiti c'ingingo: MRI scanner mu cumba c'ugutoranya vyihutirwa¶

flowchart TD
    Start["Ivyihutirwa Imbere canke Ikikuje Icumba co Gupima MRI (Akarere ka IV)"] --> Scenario{"Ni ingorane iyihe iriko iraba ubu?"}
    Scenario -->|"Itegeko ry'ubuvuzi bw'umurwayi (Umutima uhagaze, Gufatwa n'intandara, Inyishu itandukanye)"| MedCode["1. NTUZANE igare ry’impanuka, itangi ry’icuma rya O2, canke AED mu karere ka IV; 2. NTUKANDA kuri buto ya Magnet Quench; 3. Gukuraho/kurekura imeza y’umurwayi no gutera umurwayi OUT mu Zone III/II ubwo nyene; 4. Tangira CPR n’ugusubiza ubuzima mu buryo bushitse hanze y’ibarabara ry’umuyagankuba"]
    Scenario -->|"Ikintu c'umuyagankuba gikwezwe mu mfuruka y'umuyagankuba"| PinCheck{"Mbega umuntu yoba afatwa, akajanjagurwa canke akamanikwa?"}
    PinCheck -->|"EGO: Umuntu afise ingorane zo mu buzima/amaguru n'amaboko"| QuenchNow["1. Hindukiza igikingirizo c’ipulasitike maze ukande buto ya RED MAGNET QUENCH ubwo nyene; 2. Urabe igihu cera canke helium ivuza induru imbere mu cumba (ugusenyuka kw’impwemu); 3. Fata ikintu c’icuma kiremereye kugira ngo ntikigwe ku murwayi nk’uko umurima utonyanga (60 gushika 120 sec); 4. Kura uwagirizwa n'ikintu maze uce uva mu cumba ubwo nyene"]
    PinCheck -->|"OYA: Ibikoresho Vyonyene Vyafatanye (Nta N’umwe Yafashwe)"| NoQuench["1. NTUKANDA kuri buto ya Magnet Quench; 2. NTUgerageze gukuraho ikintu ukoresheje ibikoresho vy’icuma; 3. Kuva mu cumba, ufunge urugi, hanyuma uhamagare injeniyeri w’umuhinguzi wa MRI kugira ngo agenzure inzira yo guca hasi"]
    Scenario -->|"Gutontomera cane / Igihu cera / Kuzima kwihuta canke gusohoka kwa Cryogen"| CryoLeak["1. Gukura umurwayi n’abakozi muri Zone IV UBWO nyene; 2. Gufungura umuyagankuba w’umuyagankuba wo mu cumba ca MRI mu cumba co gucungera; 3. Nimba urugi ruzunguruka imbere rufatanye n’umuvuduko wo mu cumba, umena idirisha ry’ubugenzuzi kugira ngo umuvuduko w’impwemu usohoke; 4. Ntuzosubire kwinjira mu cumba cuzuye igihu ata SCBA (akaga ko gupfa)"]
    Scenario -->|"Umwotsi w'umuyagankuba, igikoresho co gutera umuriro, canke igikoresho co gufata ku meza"| ElecEPO["1. Kanda buto y’UKUZIMYA AMASHANYARAZI (EPO) (SI buto ya Quench); 2. Gukura igikoresho co kurekura ameza n’amaboko maze ukure umurwayi mu karere ka IV; 3. Koresha GUSA ikizimya umuriro c’umweru/icatsi kibisi MR-Safe kidakoreshwa n’amabuye y’agaciro iyo hari umuriro mutoyi"]

Fizike y'umuyagankuba utwara umuriro mwinshi cane: Kubera iki umurima utigera uzima¶

Umurima udahinduka (\(B_0\)) n'umurima w'umuyagankuba (\(dB/dx\))¶

Igikoresho co gupima uburemere bwa 1,5-Tesla canke 3,0-Tesla gitanga ubushobozi bwaco buhambaye bw’umuyagankuba (\(B_0\)) mu gukoresha amajana y’ama ampere y’umuyagankuba utaziguye biciye mu nzira y’umuriro w’umuyagankuba (\(\text{NbTi}\)) ushobora gutwara umuyagankuba mwinshi cane, ushizwe mu mazi y’umuyagankuba (liquid Kevinl2lius). degre Celsius / gukurako degre 452 z’ubushuhe)** imbere mu gikoresho c’ubusa. Kubera ko niobium-titanium ifise zero electrical resistance ku bushuhe bwa helium y’amazi, iyo injeniyeri amaze gutera umuriro mu coil mu gihe co gushiramwo, uwo muriro urazunguruka mu nzira ipfutse ubuziraherezo ata nguvu zo hanze. Naho ibitaro vyotakaza ubushobozi bwo gukoresha amazi n’amashanyarazi y’inyuma, iyo magnete iguma ifise inkomezi zishitse za 1.5T canke 3.0T.

Inkomezi zibiri z’umuyagankuba zikora icarimwe ku kintu cose c’umuyagankuba (icuma, icuma c’umuyagankuba, nickel, cobalt, n’icuma c’umuyagankuba c’umuyagankuba) cinjira mu karere ka IV:

1. Inguvu z’uguzunguruka (zihuye na \(B_0\)): Igihugu c’inyuma gihindura umurongo muremure w’ikintu c’icuma ku buryo bukomeye kugira ngo kijane n’imirongo y’uruja n’uruza y’uburaruko n’ubumanuko bw’ico kinogo. Umukasi w’icuma, amafunguro canke amacylindre y’umwuka w’ikirere biragobeka bifise uburemere bushika ku incuro 40 z’uburemere bw’ikintu, bikamenagura ukuntu ufata imbere y’uko uvyikurako.
2. Inguvu zikwegeranya z’ubuhinduzi (ingaruka y’igisasu, zihuye n’ \(B_0 \incuro \frac{dB}{dx}\)): Igikwegera ikintu c’icuma mu kirere nk’igisasu ni ibara ry’umuyagankuba wo mu kirere ($\frac{dB}{dx centre at get clo kurambira.
3. Kubera ko ama scanner ya MRI yo muri iki gihe akinzwe neza n’ibipfukisho bishobora gukingira ibikomere kugira ngo amabarabara y’ibitaro agume afise umutekano, urashobora guhagarara ku muryango wa Zone IV metero 3 (amafuti 10) uvuye kuri scanner ifashe itangi ry’icuma maze ukumva zero pull. Ku metero 2 (amafuti 6,5), wumva gusa umuyaga w’ikilo 1 (amapawundi 2,2) w’ubugwaneza.
4. Ariko rero, ugukingira bikora bifatanya inzira yose y’itongo ikaja mu mpera metero 1,0 gushika kuri 1,5 (amafuti 3,3 gushika kuri 5) hanze y’ibarabara. Gutera intambwe imwe gusa y'inyongera imbere (sentimetero 30 gushika kuri 50 / inches 12 gushika kuri 20) ujabuka "urutare ruteye igomwe." Mu gihe kitarenga igice c’isegonda, inguvu zikwegera zisimbuka ziva ku bilo 2 zija ku bilo 100 zija ku bilo 500 (amapawundi 220 gushika ku 1.100), zigatabura ico kintu mu minwe yawe ku 10 gushika ku 30 G zigaca zitera mu mfuruka y’ibilometero 60 kw’isaha (40 miles) ku isaha.

Inguvu z'inyigisho n'inguvu z'ugufatanya imbere mu mfuruka y'uburebure bwa 1.5T na 3.0T¶

Ivyo bice bine vy'umutekano vya ACR MRI n'ugukoresha itegeko ry'ubuvuzi hanze y'Igice ca IV .¶

Igitabo c’Ishure ryisumbuye ry’Amerika ry’Ivy’Ivyuma (ACR) ku bijanye n’Umutekano wa MR (n’ingingo ngenderwako zingana na MHRA na RANZCR) kigabanya ikigo cose c’Ivyuma mu bice bine:

• Zone I: Amabarabara y’ibitaro vya Leta hanze y’ibarabara rya MRI.
• Zone II: Aho kwakira abarwayi, ivyumba vyo kwambara, ahantu ho gusuzumirwa, n’aho bafata abarwayi. Zone II niho amagare y'impanuka n'abaganga bashika.
• Akarere ka III: Ahantu h’ubugenzuzi hafunze cane hanze y’icumba c’amamagneti. Abakozi basuzumwe n’abarwayi bagenzurwa ni bo bonyene bashobora kwinjira muri Zone III.
• Zone IV: Icumba c'amamagnete ya MRI ubwaco** gikingijwe, gifise ikimenyetso kigaragaza umuco "AMAMAGNETE IRAHORA" n'umurongo w'akaga wo hasi utukura.

Intambwe ku yindi igihe umurwayi akora code imbere mu mfuruka¶

Iyo umurwayi ari mu mugende wa MRI ahagaze umutima, anaphylaxie contraste, canke afashwe n’indwara y’umutima, imigwi y’abahinga mu vy’amakode itasuzumwe ntishobora kwigera yihuta mu karere ka IV n’igare ry’icuma ry’ugutera, defibrillateur canke igikoresho c’icuma co gutera umwuka:

1. NTUKIGEZE uzimya umuyagankuba kugira ngo ubone kode y’ubuvuzi, kandi NTUZIGEZE uzane ibikoresho vyo gusubiza ubuzima mu mubiri mu karere ka IV: Kuzimya bifata amasegonda 60 gushika kuri 180 kandi bishobora gutuma umuntu apfa, bigatuma umuntu atakaza iminota myinshi mu gihe umutima uhagaze.
2. Kubita ku meza "Ingoro / Rapid Eject" buto canke ukureho igikoresho co kurekura c'amaboko:
3. Imeza yose ya MRI ifise igikoresho co gukuraho amaboko canke igikoresho co gufata kibohora hejuru y’imeza mu masegonda makeyi 2 mbere ata nguvu.
4. Nimushire umurwayi ku gitereko c’ivyuma MR-Safe kitagira amabuye y’agaciro kigumye hanze y’akarere ka IV.
5. Mushire umurwayi muri Zone III canke Zone II hanyuma mushire SLAM ku rugi rw'icumba c'amamagneti rwa Zone IV:
6. Gukura umurwayi mu mfuruka ngo amushire muri Zone II bifata amasegonda 20 gushika kuri 30.
7. Gukora ibikorwa vy’ugufatanya igifu n’amaboko gusa ku gitereko c’ibirenge MR-Safe kigenda kizunguruka mu gihe uriko uriruka; reba CPR.
8. Funga kandi ufunge urugi rwa Zone IV ubwo nyene kugira abaganga n’abaganga bashika ntibashobora kwiruka kukurenga ngo baje mu cumba c’amamagneti y’ubuzima.
9. Kora igikorwa co gufasha umutima mu buryo bushitse (ACLS) mu karere ka II: Umaze kuva hanze y’umurongo wa 5-Gauss urugi rw’umuyagankuba rwugarijwe, ushireko ata nkomanzi ibikoresho vyo gufasha umutima, ibikoresho vyo gupima amajwi, n’ibikoresho vyo gupima umwuka w’ikirere.

Amabuto abiri atandukanye y'umutuku: Guzima kw'amashanyarazi mu gihe c'ivyihutirwa (EPO) n'uguzima kw'umuyagankuba¶

Igikoresho cose ca MRI gifise amabuto abiri atandukanye rwose y’umutuku w’ivyihutirwa ku ruhome. Kubitera urujijo bishobora kunanirwa gukuraho umuntu yafashwe canke bikaba bitera ububabare bw’amazi y’umuriro w’amazi bitari ngombwa:

Intambwe ku yindi gukiza umuntu iyo afashwe imbere mu gitereko ca MRI¶

Intambwe ya 1: Suzuma inzira y’impwemu, uguhema, n’ugushikama kw’ivyuma mu masegonda 5 ya mbere¶

1. Ushire ubusa mu mifuko yose imbere yo gutera intambwe muri Zone IV.
2. Suzuma nimba uwo muntu ashobora gusohoka ATAZIMYE:
3. Iyo intebe y’ibimuga canke buffer ijabutse urufunguruzo rw’imbere ataco ikoze ku murwayi, kandi ushobora gusohora umurwayi mu urufunguruzo rw’inyuma rw’ibarabara utababaje icuma, banza ukureho umurwayi utakoze kuri Quench.
4. Uhejeje gukanda Quench, intebe y’ibimuga y’icuma y’ibilo 70 (155 pounds) ifashwe imanitswe hejuru y’ico kinogo n’ububasha bw’umuyagankuba, izoca igwa bukwi na bukwi igororotse hasi ku murwayi uko umurima ugenda ubora.
5. Nimba uwo muntu AFITE umubiri, ajanjaguwe, canke afashwe n’umutego: Ntutaze umwanya ukurura n’ukuboko. Ku 1.5T gushika kuri 3.0T, gurney y’icuma ifatwa n’inguvu 400 gushika kuri 2.500 (amapawundi 900 gushika kuri 5.500), kandi iyo uyikoresheje gatoyi bituma isubira inyuma nk’umutego w’idubu.

Intambwe ya 2: Kanda buto ya Magnet Quench itukura irindwa maze ushire umuzigo ku gutonyanga kw’uburemere bw’isi¶

1. Ufungure igipfukisho c'ipulasitike gitomoye kiri ku buto butukura bwa "MAGNET STOP / QUENCH" (buri ku ruhome rw'icumba co gupima no mu karere ka III) hanyuma ugikande cane.
2. Tahura idirisha ry'ukubora ry'amasegonda 30 gushika kuri 120:
3. Igikoresho co gushushanya co mu mutima gishushanya iyo nzira y’amazi yitwa niobium-titanium hejuru ya 9,3 Kelvin (kugabanya degre 263,8) mu masegonda 2 gushika kuri 5, kigatuma iyo nzira y’amazi ishobora guhangana n’amazi maze kigateka iyo nzira y’amazi y’amazi y’umuyagankuba.
4. Uzokwumva ijwi ry’ivyuma ry’agaciro, rikurikirwa n’ijwi ry’ivyuma ry’indege ritera amatwi** igihe gaze ya helium itera hejuru y’umuyoboro wo kuzimya umwuka wo ku gisenge.
5. IBIMENYETSO: Gushigikira no gukura inyuma ikintu c’icuma kiremereye uko umurima usenyuka (amasegonda 20 gushika kuri 90 umaze gukanda buto):
6. Abarokozi babiri bafise igikingirizo bategerezwa gufata ku kintu (canke bagakwega inyuma n’umugozi w’inylon udafise amabuye y’agaciro) mu gihe umugozi w’amabuye y’agaciro uzimya kugira ngo uburemere bw’isi ntibutere igiti c’icuma c’ibilo 80 ku mutwe canke ku gikiriza c’uwagirizwa iyo umugozi w’amabuye y’agaciro ugoyagoya.
7. Kura uwo muntu ku gitereko ca MR-Safe igihe igikoresho co kumufata kirekuye maze uce uva mu karere ka IV ubwo nyene. Vuza ibikomere vy’ugujanjagurwa, ibikomere vyo mu gikiriza, n’amaraso ava mu karere ka II; reba amagufa avunitse n'ibikomere, gukomereka mu mutwe, na kuva amaraso.

Igihombo c'umuyoboro wo kuzimya cryogen: Igihe amazi ateka helium aseseka mu cumba co gupima¶

Kubera iki umuyoboro wo kuzimya umuriro wamenetse canke uzibiye uhindura Zone IV umutego w’umuvuduko urenze urugero¶

Iyo umuyagankuba usanzwe ukoreshwa mu kwoga uzimye, litiro 1 y’amazi y’umuyagankuba ku bushuhe bwa degre 269 (degre 452 Fahrenheit) iragwira ikagira litiro 757 za gaze. Guteka litiro 1.500 z’amazi ya helium bitanga litiro zirenga miliyoni 1,1 (40.000 cubic feet) za gaze mu masegonda atarenga 90, bihagije kugira ngo yuzuze icumba co gupima incuro 8 gushika kuri 10.

Iyo umuyoboro wo kuzimya igisenge wo hanze uzibiwe n’urubura canke ivyari vy’inyoni, canke iyo ubushuhe buvunitse urutugu ruri hejuru y’igisenge c’inzu, iyo gazi y’umuriro iraturikira mu cumba co gupima, igatuma umuntu agira ingorane zitatu icarimwe:

1. Urugi rw'umuvuduko mwiza rwo gufunga (inzugi zizunguruka imbere zipfutse):
2. Inzugi nyinshi za MRI zikingiwe na RF zizunguruka IMBERE zija mu cumba co gupima.
3. Mbere na 0,07 gushika kuri 0,14 bar (1 gushika kuri 2 psi) y’umuvuduko munini wo mu cumba ukoresha ibilo 1.800 gushika kuri 3.600 (amapawundi 4.000 gushika kuri 8.000) vy’inguvu ku mubiri w’ingurube ufise uburebure bwa metero 1,2 ku 2,1 (amafuti 4 ku 7) udashobora gukora canke gutera rirafunguka.
4. Igikorwa co kurokoka ubwo nyene: Ushireko Igikoresho co gusohora umwuka w’ivyihutirwa ca MRI ubwo nyene. Iyo urugi ruzunguruka ruja imbere rwugarijwe n’umuvuduko wo mu cumba mu gihe umuntu ari imbere, menagura idirisha ry’ikiyo ryo kwihweza hagati y’icumba co kugenzura (Akarere ka III) n’icumba co gupima (Akarere ka IV) ukoresheje intebe y’aluminium canke igikoresho co kuzimya umuriro c’umuringa. Guca idirisha bica bituma umuyaga wo mu cumba usohoka ku buryo urugi ruca rufunguka.
5. Igihu cera gihuma amaso n'ubukonje bukomeye:
6. Ico gikoresho gifise ubushuhe bwa degre 269 gica gitera ubukonje bwo mu cumba igihu cera kitaboneka neza kandi gishobora gutonyanga umwuka w’ikirere/azote (ubushuhe bwa degre 183 gushika kuri degre 196) uva ku nzu y’icuma itagira ikintu.
7. Gumana hasi munsi y’igisenge kiduga, uyobore igitanda c’umurwayi hanze mu kwumva ku nzira yo hasi, kandi ususurutse igikonyozi cose co mu mazi 37 gushika kuri 39 degre Celsius (98,6 gushika kuri 102,2 degrees Fahrenheit); reba ubushuhe n'ubukonje ubutabazi bwa mbere.
8. Ugupfa kwihuta kw'umuyagankuba udakora:
9. Uko helium ihindura umwuka w’ikirere uri munsi ya 6 gushika ku 10 kw’ijana, abashikirwa n’ico kiza bumva inzara y’ikirere y’umuyaga w’ikirere; ijwi ryabo rihinduka ryinshi mu gihe c’isegonda ry’iburyo imbere y’uko ukubura ubwenge kubaho mu impwemu 1 gushika kuri 2; Raba gazi ipfutse umuvuduko w'amazi n'ugusohoka kw'amazi. Ntukigere usubira kwinjira mu cumba ca MRI cuzuye igihu ata SCBA y’umuvuduko mwiza (kandi ntukigere wambara ibidengeri vy’icuma vya SCBA mu karere ka IV gushika igihe co kuzimya kirangiye).

Ubushuhe buva ku maradiyo (RF) burasha imbere mu mfuruka ya MRI¶

Ivyuma bifise ubushobozi bwinshi Ivyuma bitanga amakuru y’amajwi (RF) (64 MHz ku 1.5T canke 128 MHz ku 3.0T) bitera amashanyarazi mu mubiri atera uguturika kw’incuro ya kabiri canke ya gatatu biciye mu buryo butatu:

1. Imirongo y’urukoba n’urukoba n’ugukorana n’uruhome rw’uruhome: Kujabuka amaguru atagira ikintu, gufata ibiganza bitagira ikintu hejuru y’umubiri, canke kureka amatako atagira ikintu akora ku mubiri bituma haba inzira y’amazi ipfutse aho umuriro wa RF uca ku ntumbero ntoyi y’urukoba, ugashushanya umubiri uri hejuru ya 60 degrees Fael14us) Ibitugu canke intugu zitagira ikintu zifatanye ataco zitwaye ku ruhome rw’imbere ata igipande c’ifu c’amasentimetero 1 gushika kuri 2 (0,5 gushika kuri 1 inch) na zo nyene zirasha cane.
2. Ivyuma vy'ivyuma bihishijwe n'ibipande vy'imiti bica mu ruhu: Imyambaro y'imikino irwanya imigera canke "ikoreshwa n'umuringa" irimwo indodo z'ifeza canke z'umuringa zishuha ningoga. Ivyo bikoresho vy’imiti bifashijwe n’ivyuma (fentanyl, nikotine, nitroglycérine, canke scopolamine) biraturira urukoba maze bikavyura imiti myinshi y’ubushuhe ikaja mu mitsi y’urukoba yagutse.
3. Ico umuntu yokora ubwo nyene iyo umurwayi afashe urumuri rw’inkengeri kugira ngo asusuruke: Hagarika scanner ubwo nyene ku raporo ya mbere y’ugutera ububabare canke ubushuhe. Shira umurwayi hanze, ukureho impuzu canke ibipande bishushe, hanyuma ukonjeshe ubushuhe bwose buturitse munsi y’amazi atemba mu Zone II mu minota **20 Raba guturika no gusha ubutabazi bwa mbere.

Urutonde rw'igenzura ry'umutekano wa MRI imbere yo kwinjira¶

Imbere y’uko umuntu canke igikoresho cose kijabuka kiva mu karere ka III kija mu karere ka IV:

• Hindura umurwayi wese mu mpuzu y’ibitaro idafise ivyuma vy’ipampa 100%: Kura imyambaro yose yo mu nzira, imyambaro y’imikino irwanya imigera, ama bras yo munsi y’umubiri, ibipande vy’imiti bifise ivyuma, amabuye y’agaciro, amapine y’imisatsi, ibikoresho bipima isukari, n’amapompo ya insuline mu karere ka II.
• Suzuma uwusubiza wese n’umushyitsi wese mu majambo no mu nkingi y’ivyuma (FMDS): Suzuma ko ata bikoresho bifasha umutima, ICD, ibikoresho bitera umutima, ibikoresho bifata umutima, intwaro zihishijwe, canke inkweto zifise amano y’icuma zijabuka umuryango.
• Hagarika igikoresho co gukura abantu kidakoreshwa n’amabuye y’agaciro (MR-Safe) ubwo nyene hanze y’umuryango wa Zone IV: Imenyereze gukura umurwayi w’ikode yigishijwe mu mfuruka ukaja mu karere ka II mu amasegonda 30.
• Shira ibipande vy’ifu (uburebure bwa cm 1 gushika kuri 2) hagati y’urukoba rw’umurwayi n’uruhome rw’imboga, amabombo ya RF, n’amaguru atagira ikintu: Burinda ibipfukisho vy’urukoba n’urukoba bitagira ikintu (amaguru ajabutse canke ibiganza bikora ku bibero) imbere mu gitobo.
• Suzuma umuyoboro wo guzimya umwuka wo hanze wo mu gisenge n’igikoresho co kugenzura ukuntu umwuka w’ikirere wo mu cumba (ODM) buri gice c’umwaka: Suzuma ko igikingira igisenge c’ikirere kidafise urubura canke ivyari vy’inyoni be n’uko inkengeri za ODM zo mu cumba ziri munsi ya 19,5 kw’ijana y’umwuka w’ikirere.

Inomero z'ivyihutirwa zo mu karere n'amategeko y'ibigo¶

Igihe uhamagara abafasha umuriro canke abafasha mu vy’ubuvuzi mu gihe c’ugutera MRI canke cryogen leak, nuhe uwugurungika igitigiri nyaco ca Tesla be n’uko umusumari wazimye:

• Leta Zunze Ubumwe za Amerika na Canada: Hamagara 911 (ushizeko n’ibitaro vyo mu mutima Code Blue / Injeniyeri). Gusaba Igisata c'Ubutabazi bw'Umuriro na HAZMAT ku bijanye n'ugutera canke guzimya amazi asohoka mu nzu. Irongowe na Ikigo ca FDA kijejwe ibikoresho n’ubuzima bw’amaradiyo, Igitabo c’Ishure ryisumbuye ry’Amaradiyo ry’Amerika (ACR) ku bijanye n’umutekano wa MR, Komisiyo y’Ihuriro (TJC), na NFPA 99.
• Ubwongereza: Hamagara 999 canke 112 (canke 2222 ku mirwi y’imbere mu gihugu ya NHS). Menyesha umukuru w’ivy’umuriro n’ubutabazi muri Zone III nimba iyo magneti iriho. Irongowe na Ikigo kijejwe gucungera imiti n’ibikoresho vyo kwivuza (MHRA) hamwe n’Ikigo kijejwe gucungera ubuzima n’umutekano (HSE).
• Ubumwe bw'Uburayi: Hamagara 112. Itegekanijwe hakurikijwe Itegeko ry’Ubumwe bw’Uburayi 2013/35/EU ku bijanye n’ibice vy’umuyagankuba na IEC 60601-2-33.
• Ostraliya na Nouvelle-Zélande: Hamagara kuri 000 muri Australiya canke 111 muri Nouvelle-Zélande. Igenzurwa na Ishure ry’Ubwami ry’Abahinga mu vy’Ivyuma vy’Ivyuma (RANZCR) ryerekeye umutekano wa MRI na AS/NZS IEC 60601.2.33.
• Ubuhindi na Aziya-Pasifike: Hamagara 112 mu Buhindi, 119 mu Buyapani na Koreya y’Epfo, canke 995 muri Singapore. Gumana ivyuma vyose vy’umwuka w’umwuka w’ivyuma vy’ambulance ya komine hanze ya Zone III.

Ibibazo bikunda kubazwa¶

Mbega kuzimya umuriro mukuru w’umuyagankuba wo mu cumba ca MRI vyoba bizimya ubushobozi bw’umuyagankuba?¶

Oya. Kubera ko iyo nsinga idafise ubushobozi bwo guhangana n’umuyagankuba muri ubwo bushuhe, iyo nzira y’umuyagankuba iguma ifise inkomezi 100 kw’ijana amasaha 24 ku musi ata muyagankuba uri ku ruhome. Gukanda kuri buto itukura yitwa "Emergency Power Off" (EPO) bizimya gusa ameza y'umurwayi afise imoteri, mudasobwa, n'amatara yo mu cumba; iyo magnete izoguma ikwega itangi ry’icuma ry’umwuka w’ikirere canke intebe y’ibimuga mu cumba ku giciro c’ibilometero 60 kw’isaha. Gukanda gusa kuri buto y'umutuku irindwa "Magnet Quench" bikuraho ubushobozi bw'umuyagankuba mu guteka amazi y'umuyagankuba mu masegonda 30 gushika ku 120.

Iyo umurwayi afise indwara y’umutima imbere mu gikoresho co gupima umutima (MRI), ni kuki abakozi ba code badakwiye kuzana igare ry’ugutera umutima n’igikoresho co gupima umutima mu cumba?¶

Kuzana igare ry’icuma ry’ugutera impanuka, igikoresho co gupima amajwi, igikoresho co gupima amajwi canke igikoresho co gupima umwuka w’icuma c’icatsi kibisi mu cumba co gupima (Zone IV) bituma ububasha bw’umuyagankuba butaburura ivyo bintu biremerera mu minwe y’abasubiza maze bikabitera mu mfuruka, bigamenagura umurwayi n’abakozi. Kuzimya umusumari bifata iminota 1 canke 3 y’ingenzi kandi bishobora gutuma umuntu apfa. Ahubwo, reka umusumari uriko urakora, ugumize igare ry’impanuka mu karere ka II, ushireho imeza ya MRI ubwo nyene, ushire umurwayi ku gitereko kitagira umusumari MR-Safe, hanyuma umukure mu karere ka IV mu masegonda atarenga 30 imbere y’uko ufunga urugi maze ugatangura gukura umutima no gukura umutima hanze y’aho umusumari uhagaze.

Ni ryari mu vy’ukuri nkwiye gukanda buto ya MRI Magnet Quench itukura, kandi ni ryari NTAKORA kuyikanda?¶

Kanda buto ya Magnet Quench (Emergency Magnet Rundown) itukura irindwa GUSA igihe umuntu afashwe ku mubiri, ajanjaguwe, canke amanitswe n’ikintu c’umuyagankuba ku mubiri w’umuyagankuba gishobora gutera ubwoba ubuzima canke igihimba c’umubiri, canke igihe umuriro udashobora gucungerwa uri mu cumba co gupima umuriro usaba ko umuntu akoresha umuriro w’umuyagankuba. Ntukigere ukanda buto ya Quench iyo intebe y’ibimuga, buffer, canke igikoresho kiri ubusa bifatanye ata n’umwe akomeretse (umuhinga mu vy’ubuhinga bwa MRI arashobora gutera umuyagankuba hasi ata nkomanzi), kandi ntukigere ukanda kugira ngo umuyagankuba canke moteri y’imeza ihagarare (koresha buto ya Electrical Emergency Power Off aho gukoresha buto ya Electrical Emergency Power Off).

Ni kuki ari akaga iyo igihu cera gitangura gusuka mu cumba ca MRI mu gihe c’uguzimya umuyagankuba?¶

Mu gihe c’uguzimya, litiro 1.500 gushika ku 2.000 z’amazi y’umuyagankuba ku bushuhe bwa degre 269 (degre 452 Fahrenheit) zica zihinduka litiro zirenga imiliyoni 1,1 z’umuyagankuba. Iyo umuyoboro wo hanze wo gusohoka umwuka wo mu gisenge ucitse canke ukaba uzibiwe n’urubura canke urusenga rw’inyoni, helium ikonjeje iraturikira mu cumba co gupima gipfutse, igatuma ubukonje buhinduka igihu cera gihuma amaso. Mu masegonda 30, iyo gazi iriko iragwira irakuraho umwuka w’ikirere ushobora guhumeka (igatuma umuntu abura ubwenge mu guhumeka 1 canke 2 ata nzara y’umuyaga afise) maze igatuma haba umukazo mwiza wo mu cumba utuma inzugi zizunguruka imbere zifunga. Iyo igihu cera cinjiye mu cumba, nuce uvayo ubwo nyene, ufungure umuyaga wo gusohora umwuka mu gihe c’ivyihutirwa, hanyuma umenagure idirisha ry’ivyumba vyo kwihwezamwo nimba umukazo utuma urugi ruzunguruka ruja imbere rufunga.

Ni kubera iki gufata intebe y’ibimuga canke igitereko c’ibimuga gipfutse mu gihe umuntu ariko arazimya umuriro bishobora gutuma umurwayi adakomereka ubwa kabiri?¶

Iyo umuntu akwegereye intebe y’ibimuga canke igitereko c’icuma mu mfuruka ya MRI, akenshi iyo nzira y’umuyagankuba ifata iyo nkoko y’icuma y’ibilo 50 gushika ku bilo 90 (amapawundi 110 gushika ku 200) imanitswe mu buryo buringaniye hejuru y’isonga ry’ico kinogo kiri hejuru y’umutwe n’igikiriza c’umurwayi. Uhejeje gukanda buto ya Magnet Quench, iyo nzira y’umuyagankuba irabora mu masegonda 30 gushika ku 120. Iyo ata n’umwe ariko arashigikira canke ariko arakwegera inyuma ku gicapo c’icuma igihe uburemere bw’umuyagankuba bumanuka munsi y’uburemere bwaco, uburemere bw’isi buraca bukwi na bukwi buca bumanuka ku gicapo kiremereye kigororotse ku murwayi ari munsi yaco.

Ni gute abarwayi bashobora guturika cane urukoba imbere muri MRI kandi ata kintu na kimwe kiri muri scanner kirumva gishushe?¶

Ico gikoresho citwa MRI kiratanga amajwi y’ububasha bwinshi (RF) atuma umuyagankuba ugenda mu bihimba vy’umuyagankuba. Iyo umurwayi ajabutse amaguru ata co yambaye, akora ibiganza ata co yambaye gushika mu bibero, canke akanda urukoba ata co yambaye ku ruhome rw’aho hantu ata n’impuzu y’impuzu, amashanyarazi aratera aho akora maze agatuma umuntu aturika cane mu masegonda makeyi. Ivyo guturika na vyo nyene biva ku mpuzu z’abakinnyi zirimwo intsinga z’ifeza canke z’umuringa zihishijwe zirwanya umunuko canke imiti ikoreshwa n’ivyuma (nk’imiti yitwa fentanyl canke nikotine). Hagarika scanner ubwo nyene iyo umurwayi apfutse itara ry’uguhamagara rimenyesha ubushuhe canke ububabare.

Iyi nkuru itanga ubuyobozi bw’umutekano w’ivyihutirwa n’inyishu y’ihungabana ry’ugutera ibisasu vya MRI, ivy’uguzimya kw’amamagneti, n’ugusohoka kw’ivyuma vy’umuyagankuba kandi ntisubirira inyigisho z’umutekano wa MRI zo ku rwego rwa 1 canke rwa 2 canke amategeko y’ubuvuzi y’inzego. Niwiyumvire gufata inyigisho y’ubuhinga bwo gusubiza umutima mu nda be n’ubufasha bwa mbere n’ishirahamwe ry’umusaraba utukura, St John Ambulance, canke ishirahamwe ry’ubuvuzi bw’ivyihutirwa ryo mu karere kawe.

Inyobora zifitaniye isano¶

• Gazi ipfutse umuvuduko w'amazi, igitero c'ibisasu, n'amazi y'azote avuza
• Ugupima mu kibanza gikingijwe: imyobo, amasilo, n'ibidengeri
• Ubutabazi bwa mbere bw'ubushuhe n'ubukonje
• Guturika no gusha ubutabazi bwa mbere

Amasoko n'ubuyobozi buzwi¶

• Ishure ryisumbuye ry’Abanyamerika ry’Ivy’Ivyuma (ACR, Leta Zunze Ubumwe za Amerika): Igitabo ca ACR ku Mutekano wa MR (Igitabu co mu 2024, Komite y’Umutekano wa MR)
• Ishirahamwe ry’Amerika ryitaho ivy’ibifungurwa n’imiti (Ikigo ca FDA kijejwe ibikoresho n’ubuzima bw’imirasire, Leta Zunze Ubumwe za Amerika): Amafoto yerekeye umutekano wa MRI, ukwirinda ibisasu, n’imburi zijanye n’uguturika kw’ubushuhe
• Ikigo kijejwe gucungera imiti n’ibikoresho vyo kwivuza (MHRA, Ubwongereza): Amabwirizwa yerekeye umutekano w’ibikoresho vyo gupima amashusho bikoreshwa mu buvuzi
• Ishirahamwe ry’igihugu ry’ugukingira umuriro (NFPA, Leta Zunze Ubumwe za Amerika) na Komisiyo mpuzamakungu y’ubuhinga bw’amashanyarazi (IEC): Itegeko ry’ibigo vy’ubuvuzi rya NFPA 99 na IEC 60601-2-33 Ibisabwa vyihariye ku bijanye n’umutekano w’ishimikiro n’ibikorwa vy’ingenzi vy’ibikoresho vy’ubuhinga bw’amashanyarazi
• Ishure ryisumbuye ry’abahinga mu vy’amaradiyo ryo muri Ostraliya na Nouvelle-Zélande (RANZCR, Australiya na Nouvelle-Zélande): Amabwirizwa yerekeye umutekano wa MRI n’amategeko agenga ivy’uguzimya ivyihutirwa / gusohora umwuka