Safety considerations in MR imaging.

@article{citeulike:574930, abstract = {The authors identify eight areas of potential safety concern during clinical magnetic resonance (MR) imaging. These include (a) biologic effects of the static magnetic field; (b) ferromagnetic attractive "projectile" effects of the static magnetic field; (c) potential effects of the relatively slowly time-varying magnetic field gradients; (d) effects of the rapidly varying radio-frequency (RF) magnetic fields, including RF power deposition concerns; (e) auditory considerations from noise caused by the rapidly pulsed magnetic field gradients; (f) safety considerations concerning superconductive systems, including quenches, use of cryogens, and cryogen storage and handling; (g) psychological effects, such as claustrophobia and anxiety induced because of the examination; and (h) possible effects of the intravenous use of the MR contrast agent gadopentetate dimeglumine. The concerns in each of these categories are elaborated upon, and the available data are presented to clarify their status.}, address = {Department of Radiology, University of Pittsburgh, PA 15213.}, author = {Kanal, E. and Shellock, F. G. and Talagala, L. }, citeulike-article-id = {574930}, comment = {Here's everything they have to say about psychological risk: "PSYCHOLOGICAL EFFECTS Claustrophobia and a number of other psychological problems, including depression, anxiety, and panic disorders, may be encountered by as many as 5\%-10\% of patients undergoing MR imaging (137-139). In our own institution, where patients undengo thorough preparation before the clinical examination, 1.4\% (182 of 12,945) of all patients imaged between July 1987 and June 1989 were unable to successfully complete their examinations because of claustrophobia. Such feelings originate from a variety of factors including the nestnictive dimensions of the imager, the duration of the examination, the noise associated with gradient switching (see Auditory Considerations section), and the ambient conditions within the magnet bore (138). Fortunately, adverse psychological responses to MR imaging are usually transient. However, there is a report of two patients with no prior history of claustrophobia who tolerated MR imaging with great difficulty, and they subsequently developed pensistent claustrophobia that required psychiatric treatment (139). Various maneuvers have been developed to alleviate the anxietyrelated problems of clinical MR examinations (140), including (a) educating the patient before the examination about the specific aspects of the MR examination, including the level of gradient noise to expect, magnet bore dimensions, and anticipated examination duration; (b) allowing a relative on friend to remain with the patient during the study; (c) maintaining physical or verbal contact with the patient during the examination; (d) placing the patient in a prone position when appropriate; (e) using mirrors mounted on the inside of the imager (some manufacturers [Nuclear Associates, Carle Place, NY] offer mirror on prism glasses to allow the patient to see out of the imager during the examination); (f) blindfolding the patient during the examination to preclude the patient from seeing the magnet bore; and (g) applying psychological “desensitization” techniques (138)."}, issn = {0033-8419}, journal = {Radiology}, keywords = {fear, mri, neuroethicsnet, pdfcopy, refusalstats, review, riskpaper}, month = {September}, number = {3}, pages = {593--606}, posted-at = {2006-04-03 23:12:57}, priority = {0}, title = {Safety considerations in MR imaging.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/2202008}, volume = {176}, year = {1990} }

TY - JOUR ID - citeulike:574930 L3 - citeulike-article-id:574930 TI - Safety considerations in MR imaging. JF - Radiology VL - 176 IS - 3 SP - 593 EP - 606 AD - Department of Radiology, University of Pittsburgh, PA 15213. SN - 0033-8419 N2 - The authors identify eight areas of potential safety concern during clinical magnetic resonance (MR) imaging. These include (a) biologic effects of the static magnetic field; (b) ferromagnetic attractive "projectile" effects of the static magnetic field; (c) potential effects of the relatively slowly time-varying magnetic field gradients; (d) effects of the rapidly varying radio-frequency (RF) magnetic fields, including RF power deposition concerns; (e) auditory considerations from noise caused by the rapidly pulsed magnetic field gradients; (f) safety considerations concerning superconductive systems, including quenches, use of cryogens, and cryogen storage and handling; (g) psychological effects, such as claustrophobia and anxiety induced because of the examination; and (h) possible effects of the intravenous use of the MR contrast agent gadopentetate dimeglumine. The concerns in each of these categories are elaborated upon, and the available data are presented to clarify their status. KW - fear KW - mri KW - neuroethicsnet KW - pdfcopy KW - refusalstats KW - review KW - riskpaper N1 - Here's everything they have to say about psychological risk: "PSYCHOLOGICAL EFFECTS Claustrophobia and a number of other psychological problems, including depression, anxiety, and panic disorders, may be encountered by as many as 5%-10% of patients undergoing MR imaging (137-139). In our own institution, where patients undengo thorough preparation before the clinical examination, 1.4% (182 of 12,945) of all patients imaged between July 1987 and June 1989 were unable to successfully complete their examinations because of claustrophobia. Such feelings originate from a variety of factors including the nestnictive dimensions of the imager, the duration of the examination, the noise associated with gradient switching (see Auditory Considerations section), and the ambient conditions within the magnet bore (138). Fortunately, adverse psychological responses to MR imaging are usually transient. However, there is a report of two patients with no prior history of claustrophobia who tolerated MR imaging with great difficulty, and they subsequently developed pensistent claustrophobia that required psychiatric treatment (139). Various maneuvers have been developed to alleviate the anxietyrelated problems of clinical MR examinations (140), including (a) educating the patient before the examination about the specific aspects of the MR examination, including the level of gradient noise to expect, magnet bore dimensions, and anticipated examination duration; (b) allowing a relative on friend to remain with the patient during the study; (c) maintaining physical or verbal contact with the patient during the examination; (d) placing the patient in a prone position when appropriate; (e) using mirrors mounted on the inside of the imager (some manufacturers [Nuclear Associates, Carle Place, NY] offer mirror on prism glasses to allow the patient to see out of the imager during the examination); (f) blindfolding the patient during the examination to preclude the patient from seeing the magnet bore; and (g) applying psychological “desensitization” techniques (138)." AU - Kanal, E AU - Shellock, FG AU - Talagala, L PY - 1990/09// UR - http://view.ncbi.nlm.nih.gov/pubmed/2202008 ER -