Common Safety Issues For MRI

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COMMON SAFETY ISSUES FOR MRI
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By Vikki Harmonay
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There are 40 million MRIs done annually in the
United States, so it makes sense that
establishing safety protocols and guidelines in
MRI environments is important. According to
Emanuel Kanal, M.D. and Professor of Radiology
and Neuroradiology and Director of MR Education
and MR Services at the University of Pittsburgh
Medical Center, its often the lack of knowledge
about safety protocols and guidelines that lead
to incidents.
He said, Unlike most surgery or many
medications, MRI, while complex, carries very
little risk, is relatively safe, and is
invaluable to the diagnosis and treatment of
patients. However, when someone is hurt during
MRI, the injury was almost always avoidable.
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Reducing the Incidents of MRI Burns
Being able to prevent MRI injuries involves
understanding the modality and how it can cause
harm. When it comes to MRI, the most frequent
injury is second-degree burns. These burns can
occur in a variety of ways, but it is especially
common when a patient comes in contact with the
bore during an MRI scan. Robert E. Watson, Jr.,
MD, PhD, Associate Professor of Radiology at Mayo
Clinic, Rochester, MN, Chair of the American
Board of MR Safety (ABMRS), and Chair of the
American College of Radiology (ACR) MR Safety
Committee said, A bedsheet alone wont protect a
patient from near field burns
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you must use insulated pads that are about an
inch thick to ensure the patient isnt burned due
to unsafe proximity to the bore. He continued,
This is especially important if the patient is
under anesthesia. If insulating padding slips out
of place as when the patient is being advanced
into the magnet, a body part could contact the
bore and a severe burn could result, especially
since the anesthetized patient wont react to the
heating.
Watson reminds technologists and radiologists to
make sure patients thighs or other body parts
arent touching because points of skin-to-skin
contact can be sites of heating and burns due to
RF energy-induced current loops within a body.
This is also true if leads or wires in the bore
touch the patients skin.
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MRI burns also occur when patients dont change
into gowns approved by hospitals before entering
the MRI Scanner. Colin Segovis, MD, PhD, Director
of MRI Quality and Safety and Assistant Professor
of Radiology and Imaging Sciences at Emory
University School of Medicine, Atlanta said
Today, fabrics used for undergarments and
athletic clothing are made with copper fibers
meant to hide odor, Segovis explained. In the
MRI, metallic fibers burn patients, so it is
important that they put on approved clothing
prior to a scan.
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Reducing Projectile Incidents in MRI
Projectiles are another cause of MR-related
deaths and injuries. These incidents can occur
when ferromagnetic objects are pulled across the
room toward an MRI scanner at high speeds and
collide with someone in the room. This can be an
oxygen cannister or other ferromagnetic
object. Segovis added, An MRI scanner is an
incredibly powerful magnet, and the magnet is
always on even if the machine isnt running. This
is such an important awareness and safety concept
to ensure that anyone who works in the imaging
suite understands.
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Watson also pointed out the importance of
establishing protocols around MRI safety zones.
These four zones are
MRI Zone 1 These areas are freely accessible to
the health care team members, the general public
and patients without supervision. The magnetic
fringe fields in these areas are very low to none.
MRI Zone 2 This is also a public area. Its
usually for MRI patient screening and preparation
but is getting closer to Zones 3 and 4.
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MRI Zone 3 This is a restricted area with access
for screened patients and health care team
members only. Its near the magnet room and can
potentially present a physical hazard to those
unscreened.
MRI Zone 4 This is often called the magnet
room, and houses the MRI. It has the highest
strength magnet fields as well as the greatest
risk for hazards.
Watson added, Zone 4 houses the MRI itself, and
it can be thought of as the magnet room and the
projectile zone. If someone walks into Zone 3
with an unsafe ferromagnetic object and the door
to Zone 4 is open and unprotected, this sets the
stage for a serious projectile incident.
Appropriate use of ferromagnetic detection
systems can help lessen this risk.
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Implanted Devices Are Also A Concern
Its important for radiologists to be aware of
devices that are implanted in a patients body,
as they can endanger a patients life. When you
consider that up to 75 of patients with cardiac
implanted devices like defibrillators and
pacemaker will need an MRI during their lifetime,
its obvious that radiologists must have safety
protocols in place for MR.
There are three types of implanted devices MRI
Safe, MRI Unsafe and MRI Conditional. Many of
these devices have been MRI Unsafe in the past,
but newer ones have MRI conditional labeling now.
And there is actually growing evidence that
patients with cardiac devices labeled MRI Unsafe
could be scanned in a controlled environment.
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Stephanie Tan, MD, a thoracic radiologist at the
Montreal Heart Institute, said, In order to
enter Zone 4, pacemakers need to be set to
MRI-safe mode. Hospitals and imaging centers
should have protocols in place where the
cardiologist adjusts the settings on patients
pacemakers before and after each scan to ensure
patient safety.
MRI Safety Awareness Is Key
Burns, projectiles and implanted devices are the
most reported causes of MRI-related injuries and
deaths. Many radiologists believe that the real
underlying danger is the lack of MRI safety
education, communication and standardization.
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The RSNA and many organizations and societies now
include dedicated MR safety sessions in their
annual meetings. In addition, the ACR MR Safety
Committee updates its Manual on MR Safety and the
American Board of Magnetic Resonance Safety
provides formal exams for candidates to
demonstrate their knowledge regarding specific MR
safety roles. Kanal added, Although injuries
rarely happen, when they do, people are injured
unnecessarily. The key to avoiding these risks is
education and standardization.
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Talk To An Expert
Do you need a new MRI Scanner or other medical
imaging equipment? Talk to the experts at
Atlantis Worldwide. Oftentimes a refurbished or
used system can provide the performance you want
at a much lower price pointand still deliver a
great service warranty. Atlantis Worldwide has
been helping healthcare providers, clinics,
hospitals, urgent cares and veterinary clinics
with medical imaging solutions for almost 30
years and wed love to help you.
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