I-MRI Magnet Projectile Pinning, Inkinobho Yokucima Okuphuthumayo, kanye Nokwehluleka Kwe-Cryogen Vent¶

Izikena ze-Clinical imaging resonance resonance (MRI) scanner zisebenza zisebenzisa ozibuthe abakhulu abalinganiselwe ngokuyinhloko kokuthi 1.5 Tesla (15,000 Gauss) noma 3.0 Tesla (30,000 Gauss), namayunithi akhethekile ocwaningo afinyelela ku-7.0 Tesla (70,000 Gauss). Leyo nkambu yakazibuthe emile engabonakali (\(B_0\)) inamandla ngokuphindwe izikhathi ezingu-30,000 kuya kwezingu-60,000 kunezibuthe zemvelo Zomhlaba, futhi ihlala ivuliwe amahora angu-24 ngosuku, izinsuku ezingu-365 ngonyaka, ngisho nalapho ikhonsoli yesikena ivaliwe, phakathi kweziguli, noma phakathi nokucisha kukagesi kwesibhedlela okuphelele. Uma umphenduli, umnakekeli, noma ilungu lomndeni elingahluziwe liletha isilinda somoya-mpilo sensimbi eyi-ferromagnetic, inqola yokuphahlazeka yasesibhedlela, isihlalo sabakhubazekile esingesona i-MR-conditional, isigcinalwazi esiphansi, noma amashekeli ensimbi awela umbundu angene MRI Zone IV (igumbi likazibuthe), umqansa uphakamisa into ewuzibuthe yendawo evula igrediyenti yensimbi eduze nendawo yayo yensimbi evula izandla. I-isocenter yomhubhe uzibuthe njengegobolondo lenganono ku-45 ukuya kumakhilomitha angu-70 ngehora (amamayela angu-28 kuya kwangu-45 ngehora) elinamakhulu noma izinkulungwane zamakhilogremu amandla okudonsa.

Lapho umuntu ephiniwe ngaphakathi kwe-MRI bore phakathi kwendlu kazibuthe kanye nesiteleka sensimbi, isihlalo sabakhubazekile, noma isilinda komoyampilo, alikho inani labatakuli abaqinile elingadonsa leyo nto yensimbi ngesandla, futhi ukuletha ama-pry bar ensimbi ajwayelekile noma izimbazo zomlilo kuzodala ama-projectiles abulalayo engeziwe. Ukukhulula ukuphina komuntu okusongela ukuphila ngaphakathi kwebhore kudinga ukucindezela Inkinobho egadiwe ebomvu Inkinobho Yezimo Eziphuthumayo Yezimo Eziphuthumayo (Cisha), ecekela phansi ngamabomu amandla amakhulu amakhoyili kazibuthe futhi ibilise kufika ku 1,500 kuya ku-2,000 amalitha (400 kuya ku-530 kuya ku-530 ku-530 amagremu angu-4 ku-5 minus minus 2 degrees Celsius) Fahrenheit). Kodwa-ke, uma ipayipi le-cryogenic quench langaphandle livinjwe iqhwa, izidleke zezinyoni, noma ukwehluleka kwediski ephukile, leyo helium ewuketshezi ebilayo inweba izikhathi ezingama-757 ngevolumu ngqo ngaphakathi kwegumbi lokuskena elivaliwe, lidale igumbi elinokucindezela ngokweqile, elibanda kakhulu, eliphelelwa umoya-mpilo elibamba abangaphakathi ngokubamba iminyango ejikayo ngaphakathi ivaliwe. Ukwazi ukuthi kufanele ucindezele nini inkinobho ebomvu Yokuvala Amandla Ezimo Eziphuthumayo ngokumelene nenkinobho ebomvu Yokuvala I-Magnet, indlela yokukhipha ukuphulwa kwepayipi lokucisha eliphukile, kanye nendlela yokuvusa isiguli esibanjwe inhliziyo ngokusikhipha ** ngaphandle kwe-Zone IV ku-Zone III** ngaphambi kokuletha inqola yokuphahlazeka kanye ne-defibrillator kusindisa izimpilo; gcina indawo yangakini izinombolo eziphuthumayo lungile, futhi ubuyekeze I-valve ye-valve yegesi ecindezelwe kanye nokuvuza kwe-cryogenic, ukuphelelwa umoya endaweni evalekile, futhi i-hypothermia kanye ne-frostbite usizo lokuqala.

Yenza lokhu manje¶

1. UNGALOKOTHI ungene ekamelweni le-MRI scan (Zone IV) uphethe noma iyiphi insimbi noma into yensimbi engaziwa, ngisho nalapho inhliziyo yesiguli ibambekile noma umlilo. Uzibuthe osebenza kakhulu UHLALA UVULA ngisho nalapho amakhompyutha nezibani zegumbi kumnyama bhuqe; khipha bonke okhiye, ama-pager, amafoni, isikele, ama-stethoscopes, amathangi omoya-mpilo, namaphakethe e-SCBA esicishamlilo ngaphambi kokuwela umugqa wengozi obomvu ungene ku-Zone IV.
2. Uma isiguli siba nokuboshwa kwenhliziyo, ukuboshwa kokuphefumula, noma i-anaphylaxis ngaphakathi kwesikena se-MRI, UNGALETHI inqola yokuphahlazeka noma i-defibrillator ekamelweni lokuskena, futhi UNGAYIcishi uzibuthe. Ngokushesha cindezela inkinobho yetafula ekhaya/khulula (noma donsa isibambo sokuqaqa ithebula lomshini), slayide isiguli ku-nonfer-roli ye-nonferney-R I-Zone IV ibe i-Zone III noma i-Zone II** (indawo yokulinda/ yokubamba) phakathi kwamasekhondi angu-15 kuya kwangu-30 ukuze ithimba lekhodi lingakwazi ukuqaqa i-fibrillate futhi lingene ngokuphephile ngaphandle kwendawo kazibuthe.
3. *Cindezela inkinobho ethi I-MAGNET QUENCH egadiwe ebomvu (I-Emergency Magnet Rundown) KUPHELA ngezimo eziphuthumayo ezimbili zokuphila noma ukufa: (a) umuntu uphiniwe ngokoqobo noma uchotshozwa into eyi-ferromagnetic ngokumelene uzibuthe ngokusongela impilo noma esithweni, noma (b) umlilo ongalawuleki egumbini lokuskena udinga ukufaka izinto ezicisha umlilo ezingenalutho. (okufana ne-bafa yaphansi enamathele noma isihlalo sabakhubazekile esingenalutho) lapho kungekho muntu olimele noma ovaleleke; izisebenzi zesevisi yobunjiniyela zingaginqa uzibuthe phansi ngokuphepha ngaphandle kokubilisa i-helium.
4. NGAPHO Ukucima Uzibuthe kuqala (kungakhathaliseki ukuthi kucushwe inkinobho noma kwenzeka ngokuzenzakalelayo ngokuhayiza okukhulu nokubhonga), KHIPHA wonke umuntu egumbini lokuskena le-MRI ngokushesha. Ungalindi ngaphakathi ekamelweni ukuze ugesi uzibuthe wehle uma isisulu singakhululwa noma uma inkungu ebandayo emhlophe eminyene iqala ukutheleka ekamelweni ivela endlini kazibuthe; ipayipi lokucisha eliphukile noma elivinjiwe ligcwalisa igumbi ngegesi ye-helium ephefumulayo kanye nokucindezela okuhle ngaphansi kwamasekhondi angu-30.
5. *Uma isicabha se-MRI esijikela ngaphakathi sivalwa ngaphakathi ngenxa yokucindezela kwegesi okuhle ngesikhathi sokucisha okuhlulekile (ukushaywa kwegumbi), phula iwindi lokubuka elivikelwe ngethusi elinesivikelo se-copper-mesh ngokushesha usebenzisa into esindayo engeyona enozibuthe (njengesihlalo se-aluminium, isicishamlilo sethusi, noma ipulastiki elingemuva) ukuze ukhulule ingcindezi ewindini eliphukile, ukushwiba iwindi. kalula.
6. Ngomlilo kagesi, ikhebuli evuthayo, noma iphinikhodi yetafula lapho kungekho muntu ophiniwe khona ngozibuthe, cindezela inkinobho kagesi EMERGENCY POWER OFF (EPO) esikhundleni senkinobho ye-Magnet Quench. Inkinobho ye-EPO ibulala ngokushesha wonke amandla kagesi angu-480-volt AC kuma-gradient amplifiers, radiofrequency (RF) supermitters (RF) ngaphandle kokukhipha izixhumi zetafula eziwuketshezi, kanye ne-discharging motor table. i-helium.
7. Shayela ithimba lakho lekhodi yendawo kanye nenombolo yendawo yezimo eziphuthumayo (911 e-United States nase-Canada, 112 ngaphesheya kwe-European Union, 999 e-United Kingdom) futhi uxwayise izicishamlilo ezifikayo kanye nabezimo eziphuthumayo emnyango ongaphandle we-Zone III ukuthi uzibuthe we-MRI UBUKHOMA. Thumela isisebenzi esizinikele njengesivimbeli somuntu emnyango we-Zone IV ukuze ukhumule izimbazo zensimbi ze-DBA, insimbi ye-DBA nezimbazo ze-oxygen. amasilinda avale abezimo eziphuthumayo abafikayo ngaphambi kokuba basondele emnyango.

Isihlahla sesinqumo: Igumbi lokuskena i-MRI ukuhlolwa kwezimo eziphuthumayo¶

flowchart TD
    Start["Isimo Esiphuthumayo Ngaphakathi noma Ngaphakathi kwe-MRI Scan Room (Zone IV)"] --> Scenario{"Hlobo luni lwenhlekelele eyenzekayo njengamanje?"}
    Scenario -->|"Ikhodi Yezokwelapha Yesiguli (Ukuboshwa Kwenhliziyo, Ukubanjwa, Ukusabela Okuphambene)"| MedCode["1. UNGALETHI inqola yokuphahlazeka, ithangi lensimbi i-O2, noma i-AED ku-Zone IV; 2. UNGACINDI inkinobho yokucisha uMazibuthe; 3. Khipha/khulula ithebula lesiguli bese ukhipha isiguli ku-Zone III/II ngokushesha; 4. Qala i-CPR kanye nokuvuselela okugcwele kwe-ACLS ngaphandle kwendawo kazibuthe"]
    Scenario -->|"Into Ye-Ferromagnetic Edwetshwe Ku-Magnet Bore"| PinCheck{"Ingabe umuntu ubethelwe, uchotshoziwe, noma ubethelwe?"}
    PinCheck -->|"YEBO: Umuntu Ophiniwe Nge-Life/Limb Threat"| QuenchNow["1. Phenya unogada wepulasitiki bese ucindezela inkinobho ethi RED MAGNET QUENCH ngokushesha; 2. Bheka inkungu emhlophe noma i-helium ebhongayo ngaphakathi kwegumbi (ukuhluleka kokuphefumula); 3. Bambelela entweni yensimbi esindayo ukuze ingaweli esigulini njengoba iwa ensimini (amasekhondi angu-60 kuya kwangu-120); 4. Donsa isisulu nento ecacile futhi uphume ekamelweni ngokushesha"]
    PinCheck -->|"CHA: Impahla Kuphela Ebhajwe (Akekho Obambekile)"| NoQuench["1. UNGACINDI inkinobho yokucisha uMazibuthe; 2. UNGAZAMI ukucisha into ngamathuluzi ensimbi; 3. Phuma egumbini, vala umnyango, futhi ushayele unjiniyela womkhiqizi we-MRI ukuze uthole irempu eliphansi elilawulwayo"]
    Scenario -->|"Ukubhonga Okukhulu / Inkungu Emhlophe / Ukucisha Okuzenzakalelayo noma Ukuvuza Kwe-Cryogen"| CryoLeak["1. Khipha isiguli nabasebenzi ku-Zone IV NGOKUSHESHA; 2. Vula igumbi le-MRI Iswishi Yefeni Yezimo Eziphuthumayo egumbini lokulawula; 3. Uma umnyango ojikela ngaphakathi ubhajwe ukucindezela kwegumbi, phula iwindi lokulawula ukuze ukhiphe umfutho; 4. Ungaphinde ungene egunjini eligcwele inkungu ngaphandle kwe-SCBA (ingozi yokuphefumula)"]
    Scenario -->|"Intuthu Kagesi, Ikhoyili Eqhumayo, noma Iphinikhodi ye-Table Mechanical"| ElecEPO["1. Cindezela inkinobho ethi Electrical EMERGENCY POWER OFF (EPO) (HHAYI inkinobho yokucisha); 2. Donsa isibambo sokukhishwa kwetafula esenziwa ngesandla futhi ukhiphe isiguli ku-Zone IV; 3. Sebenzisa KUPHELA isicishamlilo esimhlophe/ esiluhlaza MR-Safe non-magnetic fire uma kukhona umlilo omncane"]

I-Physics of the superconducting magnet: Kungani insimu ingacimi¶

Inkambu emile (\(B_0\)) iqhathaniswa negradient yenkundla kazibuthe (\(dB/dx\))¶

Iskena somtholampilo esingu-1.5-Tesla noma i-3.0-Tesla MRI sikhiqiza inkambu yaso yamagnetic emile (\(B_0\)) ngokusebenzisa amakhulukhulu ama-ampere wamanje oqondile nge-niobium-titanium (\(\text{NbTi}\)) i-superconducting wire ecwiliswe ku-liquid helium ku-4.222 minus 4 degrees Celsius /52 minus minus degrees 4 Fahrenheit) ngaphakathi kwe-vacuum cryostat. Ngenxa yokuthi i-niobium-titanium ine iziro ukumelana kukagesi emazingeni okushisa e-helium ewuketshezi, uma unjiniyela ejova i-current kukhoyili phakathi nokuyifaka, leyo yamanje izungeza iluphu evaliwe ngokungapheli ngaphandle kwamandla angaphandle. Ngisho noma isibhedlela silahlekelwa kokubili amandla okusebenza ayinhloko namajeneretha ayisipele, uzibuthe uhlala ekumandla agcwele angu-1.5T noma angu-3.0T.

Amandla kazibuthe amabili asebenza ngesikhathi esisodwa kunoma iyiphi into ye-ferromagnetic (insimbi, i-carbon steel, nickel, i-cobalt, ne-martensitic stainless steel) engena ku-Zone IV:

1. I-torque ejikelezayo (ngokulingana no-\(B_0\)): Inkambu yomphetho isonta i-eksisi ende yento yensimbi ngobudlova ukuze iqondaniswe ngokuhambisana nemigqa egelezayo esenyakatho naseningizimu yebhore. Izikele zensimbi, ama-wrenches, noma amasilinda komoyampilo asonteka kufika ku-40 wesisindo sento, aphule ukubamba kwakho ngaphambi kokusuka.
2. Amandla ahehayo ahumushayo (umphumela we-projectile missile, ngokulingana ne-\(B_0 \izikhathi \frac{dB}{dx}\)): Okudonsa into yensimbi emoyeni njengomcibisholo i- spatial magnetic field gradient (\(\frac{dB}{dx}\)), izinga lapho inkambu iba namandla khona ngaphezu kwesentimitha ngalinye eduze nesentimitha.
3. Ngenxa yokuthi izikena ze-MRI zesimanje ** zivikelwe** ngamakhoyili avikela amanxeba ukuze kugcinwe amaphasishi esibhedlela ephephile, ungama emnyango we-Zone IV 3 amamitha (amafidi angu-10) ukusuka kusithwebuli ubambe ithangi lensimbi futhi uzwe ukudonsa ziro. Ku-2 wamamitha (amafidi angu-6.5), uzwa kuphela ukudonsa okuthambile okungu-1 kilogram (2.2-pound).
4. Kodwa-ke, ukuvikela okusebenzayo kucindezela yonke inkambu yokuguquka ibe endaweni yokugcina 1.0 ukuya ku-1.5 amamitha (3.3 kuya ku-5 amafidi) ngaphandle kwebhore. Ukuthatha nje isinyathelo esisodwa esengeziwe ukuya phambili (amasentimitha angama-30 kuye kwangama-50 / amayintshi angu-12 ukuya kwangu-20) weqa "idwala legradient." Esikhathini esingaphansi kwesigamu sesekhondi, amandla okudonsa agxuma esuka ku-2 kilograms aye ku-*100 kuya ku-500 kilograms (220 kuya ku-1,100 pounds)**, aklebhule into ezandleni zakho ku-10 kuya ku-30 ​​G bese eyishaya ebhoreni ku amakhilomitha angu-60 ngehora (amamayela angu-40 ngehora).

Amandla e-Kinetic namandla okuphina ngaphakathi kwe-1.5T ne-3.0T bore¶

Izindawo zokuphepha ezine ze-ACR MRI kanye nokusebenzisa ikhodi yezokwelapha ngaphandle kweZone IV¶

I-American College of Radiology (ACR) Manual on MR Safety (kanye neziqondiso ezifanayo ze-MHRA kanye ne-RANZCR) ihlukanisa zonke izikhungo ze-MRI zibe izingxenye ezine:

• Indawo I: Imigwaqo yesibhedlela sikahulumeni ngaphandle kwendawo ye-MRI.
• Indawo II: Indawo yokwamukela izivakashi, amagumbi okugqokisa, indawo yokuhlola, nezindawo zokubamba iziguli. I-Zone II ilapho amakalishi aphahlazeka khona kanye nesiteji sabezimo eziphuthumayo abafikayo.
• I-Zone III: Indawo yekhonsoli yokulawula ekhiywe ngokuqinile ngokushesha ngaphandle kwegumbi likazibuthe. Izisebenzi ezihloliwe kuphela neziguli ezigadiwe ezingangena ku-Zone III.
• Indawo IV: Igumbi likazibuthe* le-MRI elivikelwe ngokwalo**, elimakwe ngophawu "UMAZIBUTHE UHLALA Uvuliwe" kanye nomugqa obomvu wengozi.

Iphrothokholi yesinyathelo ngesinyathelo lapho isiguli sibhala ngaphakathi kwebhore¶

Lapho isiguli esingaphakathi emhubheni we-MRI sihlushwa inhliziyo, i-anaphylaxis ehlukile, noma ukuquleka, amaqembu amakhodi angahloliwe akumele agijimele ku-Zone IV ngenqola yokuphahlazeka yensimbi, i-defibrillator, noma isilinda somoya-mpilo wensimbi:

1. UNGALOKOTHI ucime uzibuthe ukuze uthole ikhodi yezokwelapha, futhi UNGALINGE ulethe igiya lokuvuselela ku-Zone IV: Ukucisha kuthatha *amasekhondi angu-60 kuya kwangu-180 futhi kubeke engcupheni ukuphefumula kwe-helium, umoshe imizuzu ebucayi phakathi nokuboshwa kwenhliziyo.
2. Chofoza inkinobho ethi "Ikhaya / Ukukhipha Ngokushesha" noma udonse isibambo sokukhipha imishini:
3. Lonke ithebula le-MRI line-inyawo lokuqhafaza lomshini noma isibambo esikhulula itop top ngaphansi kwamasekhondi angu- 2 ngisho ngaphandle kwamandla.
4. Shelelezisa isiguli kokuthi MR-Safe non-ferromagnetic aluminium/plastic stretcher egcinwe ngaphandle kweZone IV.
5. Gingqela isiguli ku-Zone III noma ku-Zone II bese u-SLAM uvale umnyango kazibuthe wegumbi le-Zone IV:
6. Ukukhipha isiguli endaweni ebhorekile usiyise ku-Zone II kuthatha ngaphansi kwamasekhondi angu-20 kuya kwangu-30.
7. Yenza ukucindezelwa kwesifuba ngezandla kuphela ku-rolling MR-Safe stretcher ngenkathi uhamba; bona CPR.
8. Vala futhi ubophe umnyango we-Zone IV ngokushesha ukuze odokotela abafika beqembu lekhodi kanye nabezimo eziphuthumayo bangakwazi ukukushesha badlule kuwe egumbini likakazibuthe bukhoma.
9. Yenza Ukusekela Okuthuthukisiwe Kwempilo Yenhliziyo (ACLS) ku-Zone II: Uma ungaphandle kolayini we-5-Gauss nomnyango uzibuthe uvaliwe, sebenzisa ngokuphephile amaphedi e-defibrillator, ama-laryngoscope, namasilinda oksijini ajwayelekile.

Izinkinobho ezimbili ezibomvu ezihlukene: Ukucinywa Kwezimo Eziphuthumayo Kagesi (EPO) vs. Ukucisha Magnet¶

Yonke i-MRI suite ine izinkinobho ezibomvu ezibomvu ezihluke ngokuphelele odongeni. Ukuwadida kungahle kuhluleke ukukhulula isisulu esiphiniwe noma kubilisa kungenasidingo kubhavu ye-helium:

Isinyathelo ngesinyathelo ukutakula lapho umuntu ephiniwe ngaphakathi kwe-MRI bore¶

Isinyathelo 1: Hlola indlela yokuphefumula, ukuphefumula, nokuphina kumasekhondi okuqala angu-5¶

1. Thulula wonke amaphakethe ngaphambi kokungena ku-Zone IV.
2. Hlola ukuthi umuntu angakwazi yini ukushelela ngaphandle NGAPHANDLE kokucisha:
3. Uma isihlalo sabakhubazekile noma ibhuloho lebhafa liwela imbobo engaphambili ngaphandle kokuthinta isiguli, futhi ungakwazi ukushelela isiguli usikhiphe imbobo engemuva yebhore ngaphandle kokuphazamisa insimbi, khipha isiguli kuqala ngaphandle kokucindezela Cisha.
4. Uma usucindezela u-Quench, isihlalo sabakhubazekile sensimbi esingamakhilogremu angu-70 (amakhilogremu angu-155) esilengiswe phezulu kwebhore ngozibuthe sizowela ngqo esigulini** njengoba insimu ibola.
5. Uma umuntu Ephiniwe ngokomzimba, Echotshoziwe, noma Evaleleke: Ungachithi isikhathi udonsa ngesandla. Ku-1.5T kuya ku-3.0T, i-gurney yensimbi ibanjwe 400 kuya ku-2,500 kilograms (900 kuya ku-5,500 pounds) yamandla, futhi ukuyihambisa kancane kuyibangela ukuba ihlehle njengogibe lwebhere.

Isinyathelo sesi-2: Cindezela inkinobho egadiwe ye-Magnet Quench bese uqinisa umthwalo wokwehla kwamandla adonsela phansi¶

1. Phenya uvule ikhava yepulasitiki ecacile enkinobho ebomvu ethi "MAGNET STOP / QUENCH" (esodongeni lwegumbi lokuskena naku-Zone III) bese uyicindezela ngokuqinile.
2. Qonda iwindi lokubola lokucisha imizuzwana engama-30 kuye kwayi-120:
3. I-heater yangaphakathi ifudumeza ikhoyili ye-niobium-titanium ngaphezu kuka-9.3 Kelvin (minus 263.8 degrees Celsius)* phakathi kwamasekhondi angu-2 kuya kwangu-5*, iphendule ikhoyili ekwazi ukumelana ne-superconducting bese ibilisa ukugeza okuwuketshezi kwe-helium.
4. Uzozwai-pop yensimbi enkulu, elandelwa ukubhonga kwe-injini yejethi evala izindlebe njengoba igesi ye-helium iqhumisa ipayipi lokukhipha umoya ophahleni.
5. OKUBALULEKILE: Sekela futhi uhlehle entweni enensimbi esindayo njengoba inkundla iwa (amasekhondi angu-20 kuya kwangu-90 ngemva kokucindezela inkinobho):
6. Abatakuli ababili abahloliwe kufanele babambelele entweni (noma badonsele emuva ngebhande lenayiloni elingelona uzibuthe) kuyilapho uzibuthe ucisha ukuze amandla adonsela phansi angawisi uhlaka lwensimbi lwamakhilogremu angu-80 ekhanda noma esifubeni somuntu ohlukunyeziwe lapho ukudonsa kazibuthe kuba buthaka.
7. Donsela isisulu ku-MR-Safe stretcher ngesikhathi i-grip idedela futhi uphume ku-Zone IV ngokushesha. Yelapha ukuhlukumezeka okuphukile, ukulimala esifubeni, nokopha ku-Zone II; bona amathambo aphukile kanye nama-sprains, ukulimala ekhanda, futhi ukopha.

Ukuhluleka kwepayipi lokucisha i-Cryogen: Uma i-helium ewuketshezi ebilayo igcwala igumbi lokuskena¶

Kungani ipayipi lokucisha elidabukile noma elivinjiwe liphendula i-Zone IV ibe yisicupho esicindezeleke ngokweqile¶

Uma uzibuthe we-MRI opholile okugeza ojwayelekile ucisha, 1 ilitha le-helium ewuketshezi ekususeni okungu-269 degrees Celsius (minus 452 degrees Fahrenheit) inweba ibe amalitha angu-757 egesi. Ukubilisa amalitha angu-1,500 e-helium ewuketshezi kukhiqiza amalitha angaphezu kwesigidi esingu-1.1 (40,000 cubic feet) egesi ngaphansi kwamasekhondi angu-90, anele ukugcwalisa igumbi lokuskena izikhathi ezingu-8 kuya kwezingu-10 ngaphezu.

Uma ipayipi lokucisha ophahleni lwangaphandle livinjwe iqhwa noma izidleke zezinyoni, noma uma ukushaqeka okushisayo kugqashuka indololwane ngaphezu kosilingi okwehlayo, leyo gesi ekhalayo iqhuma ngqo egumbini lokuskena elivalekile, lidale izinsongo ezintathu zokuphila ngasikhathi sinye:

1. Ukukhiya komnyango wengcindezi eqondile (iminyango ejikayo ngaphakathi ivaliwe):
2. Iminyango eminingi ye-MRI evikelwe nge-RF shwibeka NGAPHAKATHI egumbini lokuskena.
3. Ngisho 0.07 kuya ku-0.14 ibha (1 kuya ku-2 psi) yokucindezela kwegumbi ngokweqile 1,800 kuya ku-3,600 kilograms (4,000 kuya ku-8,000 amakhilogremu) ngokumelene nemitha engu-1.2 by-2.1-(4-by-7-foot) umnyango owuvulayo, ukuphina ukuvala umnyango.
4. Isenzo esisheshayo sokusinda: Vula i-MRI Emergency Exhaust Fan ngokushesha. Uma umnyango ojikela ngaphakathi uphiniwe uvalwa ukucindezela kwegumbi kuyilapho othile engaphakathi, phihliza iwindi lokubuka ingilazi phakathi kwegumbi lokulawula (Indawo III) negumbi lokuskena (Indawo IV) usebenzisa isihlalo se-aluminium noma isisekelo sesicisha-mlilo sethusi. Ukuphula iwindi ngokushesha kukhipha ukucindezela kwegumbi ukuze umnyango uvuleke.
5. Inkungu emhlophe ephuphuthekisayo kanye nesithwathwa esicryogenic:
6. I-minus-269-degree-Celsius plume ihlanganisa umswakama wegumbi ube inkungu emhlophe engabonakali futhi ingaconsisela umoya-mpilo owuketshezi/initrogen (minus 183 to minus 196 degrees Celsius) isuka ku-turret yensimbi engenalutho.
7. Hlala phansi ngaphansi kongqimba lukasilingi olukhuphukayo, qondisa i-stretch yesiguli ngokuzwa ithrekhi yaphansi, futhi ufudumale noma iyiphi i-cryogenic frostbite ku-37 kuya ku-39 degrees Celsius (98.6 kuya ku-102.2 degrees Fahrenheit)* emanzini; bona i-hypothermia kanye ne-frostbite usizo lokuqala.
8. Ukuhogela ngokushesha kwe-inert-gas:
9. Njengoba i-helium ikhipha umoya-mpilo ngaphansi kumaphesenti angu-6 kuye kwayi-10, izisulu zizwa indlala ye-carbon dioxide emoyeni engekho; izwi labo liphenduka libe phezulu okwesibili kwesokudla ngaphambi kokuquleka ku- **1 kuya ku-2 ukuphefumula **; bona I-valve ye-valve yegesi ecindezelwe kanye nokuvuza kwe-cryogenic. Ungalokothi uphinde ungene egumbini le-MRI eligcwele inkungu ngaphandle kwe-SCBA enengcindezi (futhi ungalokothi ugqoke amathangi ensimbi e-SCBA ku-Zone IV kuze kuqedwe ukucisha).

I-Radiofrequency (RF) ukushisa okushisayo ngaphakathi kwe-MRI bore¶

Amandla aphezulu Amakhoyili e-Radiofrequency (RF) transmitter (64 MHz ku-1.5T noma 128 MHz ku-3.0T) enza ama-eddy currents kagesi emzimbeni abangela ukusha ** kwesibili noma kwesithathu** ngezindlela ezintathu:

1. Izihibe eziqhubayo zesikhumba ziye esikhumbeni kanye nokuthintana kodonga: Ukuwela amaqakala angenalutho, ukuhlanganisa izandla ezingenalutho phezu komzimba, noma ukuvumela amathanga angenalutho ukuthinta kudala iluphu eqhubayo evalekile lapho i-RF yamanje ihlangana endaweni encane yokuxhumana yesikhumba, ukushisa izicubu ezingaphezu kuka-*60 degrees Celsius (140 degrees Fahrenheit)**. Izindololwane ezingenalutho noma amahlombe acindezelwe ngokuqondile odongeni lwebhore elingaphakathi ngaphandle kwephedi yegwebu engu- 1-to-2-centimeter (0.5-to-1-intshi) nawo ahlushwa ukusha okujulile kwe-RF.
2. Ama-microfiber ensimbi afihliwe namapheshana ezidakamizwa ze-transdermal: Ukugqokwa kwe-antimicrobial noma "okufakwe ithusi" kuqukethe imicu yesiliva encane noma yethusi eshisisa ngokushesha. Amapheshana emithi asekelwe ngensimbi (fentanyl, nicotine, nitroglycerin, noma i-scopolamine) ashisa isikhumba futhi abangele isidakamizwa esishisayo esinamandla sibe ama-capillaries esikhumba anwetshiwe.
3. Isinyathelo esisheshayo lapho isiguli sicindezela isibani se-alamu ukuze sithole ukufudumala: Misa ukuskena ngokushesha embikweni wokuqala wokuluma okugxilile noma ukushisa. Shelelezisa isiguli usikhiphe, khipha izingubo ezifudumele noma amapeshi, bese upholisa noma yikuphi ukusha okushisayo ngaphansi kwamanzi agelezayo ku-Zone II imizuzu engu-20; bona ukusha nokushiswa kosizo lokuqala.

Uhlu lokuhlola ukuhlolwa kokuphepha kwe-MRI ngaphambi kokungena¶

Ngaphambi kokuthi noma yimuphi umuntu noma okokusebenza kuwele ku-Zone III kuya ku-Zone IV:

• Shintsha sonke isiguli sibe ngu-100% ingubo yasesibhedlela engenawo insimbi kakotini: Susa zonke izingubo zasemgwaqweni, okugqokwa yi-antimicrobial athletic, obra bangaphansi kocingo, amapetshi ezidakamizwa ane-metallic, ubucwebe, iziphini zezinwele, iziqapha ze-glucose, namaphampu e-insulin ku-Zone II.
• Bhekisisa wonke umuntu ophendulayo nesivakashi ngomlomo nangensika yomusho we-ferromagnetic (FMDS): Qinisekisa ukuthi awekho ama-pacemakers enhliziyo, ama-ICD, izifakelo ze-cochlear, iziqeshana ze-aneurysm, izibhamu ezifihliwe, noma amabhuzu ensimbi awela emnyango.
• Paka i-MR-Safe non-magnetic evacuation gurney ngokushesha ngaphandle komnyango we-Zone IV: Zijwayeze ukukhipha isiguli esilingisa ikhodi esitokisini siye ku-Zone II ngaphansi kwamasekhondi angu-30.
• Beka ama-foam pads (ugqinsi olu-1 kuye ku-2 cm) phakathi kwesikhumba sesiguli kanye nodonga olubhobokileyo, amakhoyili e-RF, nezitho ezingenalutho: Vimbela izihibe ezingenalutho zesikhumba kuya esikhumbeni (amaqakala aphambanayo noma izandla ezithinta okhalo) ngaphakathi kwebhore.
• Hlola ipayipi lokukhipha umoya ophahleni lwangaphandle kanye negumbi le-Oxygen Depletion Monitor (ODM) kancane ngonyaka: Qinisekisa ukuthi isikrini sesimo sezulu esisophahleni sigcwele iqhwa noma izidleke zezinyoni kanye nama-alamu e-ODM egumbi angezansi 19.5 iphesenti komoyampilo.

Izinombolo zezimo eziphuthumayo zesifunda kanye nezinqubomgomo ze-ejensi¶

Uma ucela usizo lwangaphandle lokuhlenga umlilo noma usizo lwezokwelapha ngesikhathi sokuphina kwe-MRI noma ukuvuza kwe-cryogen, nikeza othumelayo isilinganiso esiqondile sika-Tesla nokuthi uzibuthe ucishiwe yini:

• I-United States neCanada: Shayela u-911* (kanye neKhodi Yesibhedlela Esiluhlaza / Ubunjiniyela). Cela Ukutakulwa Kwezobuchwepheshe Komnyango Wezomlilo kanye ne-HAZMAT yokuphina noma ukucisha ukuvuza kwangaphakathi. Ibuswa Isikhungo Se-FDA Samadivayisi Nezempilo Ye-Radiological, Imanuwali ye-American College of Radiology (ACR) mayelana nokuphepha kuka-MR, Ikhomishini Ehlangene (TJC), kanye ne-NFPA 99.
• E-United Kingdom: Shayela u-999* noma u-112 (noma 2222 ngamaqembu angaphakathi okuphahlazeka e-NHS). Yazisa Umphathi Wesigameko Somlilo Nokuhlenga e-Zone III ukuthi ingabe uzibuthe ubukhoma. Ibuswa I-Medicines and Healthcare products Regulatory Agency (MHRA) kanye Nesikhulu Sezempilo Nokuphepha (HSE).
• I-European Union: Shayela 112. Ilawulwa ngaphansi kwe-klzzwxh:0128 inkambini ze-electromagnetic kanye IEC 60601-2-33.
• I-Australia ne-New Zealand: Shayela u-000* e-Australia noma 111 eNew Zealand. Ibuswa I-Royal Australian ne-New Zealand College of Radiologists (RANZCR) Izinkombandlela Zokuphepha ze-MRI kanye AS/NZS IEC 60601.2.33.
• I-India ne-Asia-Pacific: Shayela u-112* e-India, 119 e-Japan naseNingizimu Korea, noma 995 e-Singapore. Gcina wonke ama-ambulensi ensimbi kamasipala amasilinda ngaphandle kweZone III.

Imibuzo ejwayelekile ukubuzwa¶

Ingabe ukuvala iswishi yamandla kagesi eyinhloko egumbini le-MRI kuyayivala inkambu kazibuthe?¶

Cha. I-1.5-Tesla noma i-3.0-Tesla superconducting MRI uzibuthe isebenzisa ukujikeleza kwamanje kuluphu evaliwe yentambo ye-niobium-titanium epholile ukuze isuse ku-269 degrees Celsius (minus 452 degrees Fahrenheit) ku-helium ewuketshezi. Ngenxa yokuthi ucingo alukwazi ukumelana nogesi kulelo zinga lokushisa, amandla kazibuthe ahlala kumandla angamaphesenti angu-100 amahora angu-24 ngosuku ngaphandle kukagesi odongeni. Ukucindezela inkinobho ebomvu ethi "Emergency Power Off" (EPO) kucisha kuphela itafula lesiguli elinenjini, amakhompyutha, nezibani zegumbi; uzibuthe usazodonsa ithangi lensimbi lomoya-mpilo noma isihlalo sabakhubazekile sinqamule igumbi ngamakhilomitha angama-60 ngehora (amamayela angama-40 ngehora). Ukucindezela kuphela inkinobho ebomvu egadiwe ethi "Magnet Quench" kuqeda amandla kazibuthe ngokubilisa i-helium ewuketshezi ngaphezu kwamasekhondi angu-30 kuya kwangu-120.

Uma isiguli sinesifo senhliziyo ngaphakathi kwesithwebuli se-MRI, kungani ithimba lekhodi kungafanele ilethe inqola yokuphahlazeka kanye ne-defibrillator ekamelweni?¶

Ukuletha inqola yensimbi yokuphahlazeka, i-defibrillator, i-laryngoscope, noma isilinda se-oksijini yensimbi eluhlaza egunjini le-MRI scan (I-Zone IV) kubangela amandla kazibuthe ukuthi aklebhule lezo zinto ezinzima ezandleni zabaphenduli futhi azifake ku-bore, aphihlize isiguli nabasebenzi. Ukucisha imfucuza kazibuthe imizuzu engu-1 kuye kwemi-3 ebalulekile futhi kubeke engcupheni i-helium asphyxiation. Kunalokho, shiya uzibuthe, gcina inqola yokuphahlazeka ku-Zone II, ukhiphe ithebula le-MRI ngokushesha, udlulisele isiguli ku-non-magnetic MR-Safe stretcher, futhi usikhiphe ku-Zone IV ngaphansi kwamasekhondi angu-30 ngaphambi kokuvala umnyango futhi uqale i-defibrillation kanye ne-CPR ngaphandle kwendawo kazibuthe.

Kufanele ngicindezele nini ngempela inkinobho ebomvu ye-MRI Magnet Quench, futhi NGINGAMELE ngiyicindezele nini?¶

Cindezela inkinobho egadiwe yokucisha iMagnet Quench (I-Emergency Magnet Rundown) KUPHELA lapho umuntu ephiniwe ngokomzimba, echotshoziwe, noma ebethelwe into ye-ferromagnetic ngokumelene uzibuthe ngokusongela ukuphila noma esithweni, noma lapho umlilo ongalawuleki egumbini lokuskena udinga izicishamlilo ezifake izinto zensimbi ukuze zingene. Ungalokothi ucindezele inkinobho Yokucima uma isihlalo esinamasondo esingenalutho, ibhafa, noma ithuluzi libhajwa kungekho muntu olimele (unjiniyela we-MRI angakwazi ukuhlehlisa uzibuthe ngokuphephile), futhi ungalokothi uyicindezele ukuze uthole inhlansi kagesi noma ujamu wemoto yetafula (sebenzisa inkinobho Yokuvala Amandla Esimo Esiphuthumayo esikhundleni salokho).

Kungani kuyingozi uma inkungu emhlophe iqala ukuthululela ekamelweni le-MRI ngesikhathi sokucisha uzibuthe?¶

Ngesikhathi sokucisha amanzi, amalitha angu-1,500 kuya kwangu-2,000 e-helium ewuketshezi esezingeni elingu-269 degrees Celsius (minus 452 degrees Fahrenheit) abilisa amalitha egesi angaphezu kwesigidi esingu-1.1. Uma ipayipi lokungenisa umoya ophahleni langaphandle ligqabuka noma livinjwe iqhwa noma isidleke sezinyoni, i-helium eqandisayo iqhumisa ngqo kugumbi lokuskena elivaliwe, lijiye umswakama ube inkungu emhlophe ephuphuthekisayo. Emasekhondini angu-30, igesi ekhulayo isusa umoya-mpilo ophefumulayo (okubangela ukuquleka ngokuphefumula oku-1 kuya kwemibili ngaphandle kokulamba komoya) futhi yakhe ukucindezela okuhle kwegumbi okuvala iminyango eshwibeka ngaphakathi. Uma inkungu emhlophe ingena egumbini, phuma ngokushesha, vula isiphephetha-moya sesimo esiphuthumayo, bese uphihliza iwindi lokubuka legumbi lokulawula uma ukucindezela kubambe umnyango ongene ngaphakathi uvaliwe.

Kungani ukubamba isihlalo sabakhubazekile esiphiniwe noma i-gurney ngesikhathi sokucisha kungavimbela ukulimala kwesibili esigulini?¶

Lapho isihlalo esinamasondo sensimbi noma uhlaka ludonselwa ku-MRI bore, inkambu kazibuthe ivamise ukubamba uhlaka lwensimbi olusukela ku-50 kuya ku-90 kilogram (110-to-200-pound) lulengiswe phezulu phezulu emhubheni ngenhla kwekhanda nesifuba sesiguli. Ngemva kokucindezela inkinobho Yokucisha Magnet, indawo kazibuthe ibola ngaphezu kwamasekhondi angu-30 kuya kwangu-120. Uma kungekho muntu oqinisayo noma obuyisela emuva ohlakeni lwensimbi lapho ukudonsa kazibuthe kwehlela ngaphansi kwesisindo sawo, amandla adonsela phansi kungazelelwe awisa uhlaka olusindayo luqonde esigulini ngaphansi kwalo.

Iziguli zithola kanjani ukusha okukhulu kwesikhumba ngaphakathi kwe-MRI kuyilapho kungekho lutho ngaphakathi kusithwebuli oluzwa kushisa?¶

I-MRI idlulisa ama-high-power radiofrequency (RF) ama-pulses aheha imisinga kagesi kumaluphu e-conductive. Uma isiguli sinqamula amaqakala angenalutho, sithinta izandla ezinqunu ezinqulwini, noma sicindezela isikhumba esingenalutho ngqo odongeni olubhorekile ngaphandle kwe-foam padding, ama-arcs amanje endaweni yokuxhumana futhi kubangela ukushisa okujulile okushisayo ngemizuzwana. Ukushiswa nakho kwenzeka ezimpahleni zezemidlalo eziqukethe isiliva efihliwe noma imicu yethusi evimbela iphunga noma amapheshana emithi asekelwe ngensimbi (njengama-fentanyl noma ama-nicotine patches). Misa ukuskena ngokushesha uma isiguli sicindezela isibani socingo esibika ukushisa okugxilile noma ukulunywa.

Lo mhlahlandlela unikeza ukuphepha kwezimo eziphuthumayo kanye nesiqondiso sokuphendula ngokuhlukumezeka kwe-MRI projectile pinning, izehlakalo zokucisha uzibuthe, nokuvuza kwe-cryogen futhi awuthathi indawo yokuqeqeshwa kokuphepha kwe-MRI eqinisekisiwe Yeleveli 1 noma Yeleveli 2 noma izivumelwano zomtholampilo zesikhungo. Cabangela ukuthatha i-CPR yezandla kanye nesifundo sosizo lokuqala esivela kwa-Red Cross, i-St John Ambulance, noma inhlangano yasendaweni yokuqeqesha izimo eziphuthumayo.

Iziqondiso ezihlobene¶

• I-valve ye-valve yegesi ecindezelwe, i-rocketing yethangi, nokuvuza kwe-nitrogen ewuketshezi
• Confined space asphyxiation: manholes, silos, and tanks
• I-Hypothermia kanye ne-frostbite usizo lokuqala
• Ukushiswa nokushiswa kosizo lokuqala

Imithombo neziqondiso ezisemthethweni¶

• I-American College of Radiology (ACR, United States): Imanuwali ye-ACR Yokuphepha kwe-MR (Ushicilelo lwango-2024, Ikomidi Lokuphepha kuka-MR)
• I-US Food and Drug Administration (FDA Center for Devices and Radiological Health, United States): Amaphosta Okuphepha e-MRI, Ukuvinjelwa Kwephrojekthi, kanye Nezaziso Zokushiswa Okushisayo
• I-Medicines and Healthcare Products Regulatory Agency (MHRA, United Kingdom): Imihlahlandlela Yokuphepha Yezisetshenziswa Zokuthwebula I-Magnetic Resonance Imaging Ekusetshenzisweni Komtholampilo
• I-National Fire Protection Association (NFPA, United States) kanye ne-International Electrotechnical Commission (IEC): I-NFPA 99 Health Care Facilities Code kanye ne-IEC 60601-2-33 Izidingo Ezikhethekile Zokuphepha Okuyisisekelo kanye Nokusebenza Okubalulekile Kwezisetshenziswa Zemagnetic Resonance
• I-Royal Australian ne-New Zealand College of Radiologists (i-RANZCR, i-Australia ne-New Zealand): Izinkombandlela Zokuphepha ze-MRI kanye Nezimo Eziphuthumayo Zokuvala / I-Cryogen Venting Protocols