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MRI Patient Information
 
  • Safety & Risks
 
 
 
MRI Safety 
There are different types of contraindications that would prevent a person from being examined with an MRI scanner. MRI systems use strong magnetic fields that attract any ferromagnetic objects with enormous force. Caused by the potential risk of heating, produced from the radio frequency pulses during the MRI procedure, metallic objects like wires, foreign bodies and other implants needs to be checked for compatibility. High field MRI requires particular safety precautions. In addition, any device or MRI equipment that enters the magnet room has to be MR compatible. MRI examinations are safe and harmless, if these MRI risks are observed and regulations are followed.

Safety concerns in magnetic resonance imaging include:
•
the magnetic field strength;
•
possible 'missile effects' caused by magnetic forces;
•
the potential for heating of body tissue due to the application of the radio frequency energy;
•
the effects on implanted active devices such as cardiac pacemakers or insulin pumps;
•
magnetic torque effects on indwelling metal (clips, etc.);
•
the audible acoustic noise;
•
danger due to cryogenic liquids;
•
the application of contrast medium;
mri safety guidance
MRI Safety Guidance
It is important to remember when working around a superconducting magnet that the magnetic field is always on. Under usual working conditions the field is never turned off. Attention must be paid to keep all ferromagnetic items at an adequate distance from the magnet. Ferromagnetic objects which came accidentally under the influence of these strong magnets can injure or kill individuals in or nearby the magnet, or can seriously damage every hardware, the magnet itself, the cooling system, etc.. See MRI resources Accidents.
The doors leading to a magnet room should be closed at all times except when entering or exiting the room. Every person working in or entering the magnet room or adjacent rooms with a magnetic field has to be instructed about the dangers. This should include the patient, intensive-care staff, and maintenance-, service- and cleaning personnel, etc..
The 5 Gauss limit defines the 'safe' level of static magnetic field exposure. The value of the absorbed dose is fixed by the authorities to avoid heating of the patient's tissue and is defined by the specific absorption rate. Leads or wires that are used in the magnet bore during imaging procedures, should not form large-radius wire loops. Leg-to-leg and leg-to-arm skin contact should be prevented in order to avoid the risk of burning due to the generation of high current loops if the legs or arms are allowed to touch. The patient's skin should not be in contact with the inner bore of the magnet.
The outflow from cryogens like liquid helium is improbable during normal operation and not a real danger for patients.
The safety of MRI contrast agents is tested in drug trials and they have a high compatibility with very few side effects. The variations of the side effects and possible contraindications are similar to X-ray contrast medium, but very rare. In general, an adverse reaction increases with the quantity of the MRI contrast medium and also with the osmolarity of the compound.

See also 5 Gauss Fringe Field, 5 Gauss Line, Cardiac Risks, Cardiac Stent, dB/dt, Legal Requirements, Low Field MRI, Magnetohydrodynamic Effect, MR Compatibility, MR Guided Interventions, Claustrophobia, MRI Risks and Shielding.

• View the NEWS results for 'MRI Safety' (13).Open this link in a new window.

• View the DATABASE results for 'MRI Safety' (42).Open this link in a new window

 
Further Reading:
  Basics:
MRI Safety
2001   by www.fda.gov    
What MRI Sequences Produce the Highest Specific Absorption Rate (SAR), and Is There Something We Should Be Doing to Reduce the SAR During Standard Examinations?
Thursday, 16 April 2015   by www.ajronline.org    
Contrast Agents: Safety Profile
   by www.clinical-mri.com    
  News & More:
How safe is 7T MRI for patients with neurosurgical implants?
Thursday, 17 November 2022   by healthimaging.com    
Newer Heart Devices Safe During MRI
Monday, 23 August 2004   by www.hospimedica.com    
Study: Face Masks Unsafe in MRI Machines
Wednesday, 13 July 2022   by www.laboratoryequipment.com    
COVID-19: Attention shifts to MRI infection control
Thursday, 9 July 2020   by https://www.auntminnieeurope.com/index.aspx?sec=ser§sub=def§pag=dis§ItemID=619012    
FDA Releases New Guidance On Establishing Safety, Compatibility Of Passive Implants In MR Environments
Tuesday, 16 December 2014   by www.meddeviceonline.com    
Modern Implantable Heart Devices Safe For Use In MRI Scans
Wednesday, 16 March 2005   by www.sciencedaily.com    
MRI Risks 
The subacute risks and side effects of magnetic and RF fields (for patients and staff) have been intensively examined for a long time, but there have been no long-term studies following persons who have been exposed to the static magnetic fields used in MRI. However, no permanent hazardous effects of a static magnetic field exposure upon human beings have yet been demonstrated.
Temporary possible side effects of high magnetic and RF fields:
•
Varying magnetic fields can induce so-called magnetic phosphenes that occur when an individual is subject to rapid changes of 2-5 T/s, which can produce a flashing sensation in the eyes. This temporary side effect does not seem to damage the eyes. Static field strengths used for clinical MRI examinations vary between 0.2 and 3.0 tesla;; field changes during the MRI scan vary in the dimension of mT/s. Experimental imaging units can use higher field strengths of up to 14.0 T, which are not approved for human use.
•
The Radio frequency pulses mainly produce heat, which is absorbed by the body tissue. If the power of the RF radiation is very high, the patient may be heated too much. To avoid this heating, the limit of RF exposure in MRI is up to the maximum specific absorption rate (SAR) of 4 W/kg whole body weight (can be different from country to country). For MRI safety reasons, the MRI machine starts no sequence, if the SAR limit is exceeded.
•
Very high static magnetic fields are needed to reduce the conductivity of nerves perceptibly. Augmentation of T waves is observed at fields used in standard imaging but this side effect in MRI is completely reversible upon removal from the magnet. Cardiac arrhythmia threshold is typically set to 7-10 tesla. The magnetohydrodynamic effect, which results from a voltage occurring across a vessel in a magnetic field and percolated by a saline solution such as blood, is irrelevant at the field strengths used.

The results of some animal and cellular studies suggest the possibility that electromagnetic fields may act as co-carcinogens or tumor promoters, but the data are inconclusive. Up to 45 tesla, no important effects on enzyme systems have been observed. Neither changes in enzyme kinetics, nor orientation changes in macromolecules have been conclusively demonstrated.
There are some publications associating an increase in the incidence of leukemia with the location of buildings close to high-current power lines with extremely low-frequency (ELF) electromagnetic radiation of 50-60 Hz, and industrial exposure to electric and magnetic fields but a transposition of such effects to MRI or MRS seems unlikely.
Under consideration of the MRI safety guidelines, real dangers or risks of an exposure with common MRI field strengths up to 3 tesla as well as the RF exposure during the MRI scan, are not to be expected.

For more MRI safety information see also Nerve Conductivity, Contraindications, Pregnancy and Specific Absorption Rate.

See also the related poll result: 'In 2010 your scanner will probably work with a field strength of'

• View the NEWS results for 'MRI Risks' (3).Open this link in a new window.

• View the DATABASE results for 'MRI Risks' (9).Open this link in a new window

 
Further Reading:
  Basics:
MRI in Patients with Implanted Devices: Current Controversies
Monday, 1 August 2016   by www.acc.org    
Working with MRI machines may cause vertigo: Study
Wednesday, 25 June 2014   by www.cos-mag.com    
Physics of MRI Safety
   by www.aapm.org    
When Your Kid Needs an MRI: Optimizing the Experience
Tuesday, 29 March 2016   by health.usnews.com    
  News & More:
How safe is 7T MRI for patients with neurosurgical implants?
Thursday, 17 November 2022   by healthimaging.com    
CT contrast reaction raises MRI contrast risk
Tuesday, 22 February 2022   by www.sciencedaily.com    
CSU study explores MRI distress and patient experience
Thursday, 7 May 2020   by www.portnews.com.au    
Noise from Magnetic Resonance Imaging Can Have Short-Term Impact on Hearing
Thursday, 22 February 2018   by www.diagnosticimaging.com    
Women with permanent make-up tattoos suffer horrific facial burns after going in for MRI scans - which create an electric current in the ink
Monday, 4 July 2016   by www.dailymail.co.uk    
FDA Dials in on MRI Safety of Passive Implantable Medical Devices
Wednesday, 24 June 2015   by www.raps.org    
Contraindications 
The principal contraindications of the MRI procedure are mostly related to the presence of metallic implants in a patient. The risks of MRI scans increase with the used field strength. In general, implants are becoming increasingly MR safe and an individual evaluation is carried out for each case.
mri safety guidance
MRI Safety Guidance
Some patients should not be examined in MRI machines, or come closer than the 5 Gauss line to the system.

Absolute Contraindications for the MRI scan:
•
electronically, magnetically, and mechanically activated implants
•
ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators
•
metallic splinters in the eye
•
ferromagnetic haemostatic clips in the central nervous system (CNS)

Patients with absolute contraindications should not be examined or only with special MRI safety precautions. Patients with an implanted cardiac pacemaker have been scanned on rare occasions, but pacemakers are generally considered an absolute contraindication. Relative contraindications may pose a relative hazard, and the type and location of an implant should be assessed prior to the MRI examination.

Relative Contraindications for the MRI scan:
•
other pacemakers, e.g. for the carotid sinus
•
lead wires or similar wires (MRI Safety risk)
•
prosthetic heart valves (in high fields, if dehiscence is suspected)
•
haemostatic clips (body)
•

Osteosynthesis material is usually anchored so well in the patients that no untoward effect will result. Another effect on metal parts in the patient's body is the heating of these parts through induction. In addition, image quality may be severely degraded. The presence of other metallic implants such as surgical clips etc. should be made known to the MRI operators. Most of these materials are non-magnetic, but if magnetic, they can pose a hazard.

See also MRI safety, Pregnancy, Claustrophobia and Tattoos.

• View the DATABASE results for 'Contraindications' (11).Open this link in a new window

 
Further Reading:
  Basics:
MRI in Patients with Implanted Devices: Current Controversies
Monday, 1 August 2016   by www.acc.org    
Newer Heart Devices Safe During MRI
Monday, 23 August 2004   by www.hospimedica.com    
Physics of MRI Safety
   by www.aapm.org    
FDA Releases New Guidance On Establishing Safety, Compatibility Of Passive Implants In MR Environments
Tuesday, 16 December 2014   by www.meddeviceonline.com    
  News & More:
Women with permanent make-up tattoos suffer horrific facial burns after going in for MRI scans - which create an electric current in the ink
Monday, 4 July 2016   by www.dailymail.co.uk    
Positive diagnosis for neural therapeutic implants
Tuesday, 19 April 2016   by medicalxpress.com    
Codman Neuro develops new MRI-resistant programmable valve for treatment of hydrocephalus
Tuesday, 22 September 2015   by www.news-medical.net    
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