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ClaustrophobiaForum -
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A psychological reaction to being confined in a relatively small area.
This is a very real psychological danger for some individuals during the MRI procedure. A small percentage of patients is claustrophobic and cannot tolerate the confined space within a closed MRI magnet. Claustrophobia, panic attacks and other psychological stress situations have been reported in about 1-4% of cases as a reason to interrupt the MRI examination. Principally short and wide open MRI devices are advantageous because the percentage of claustrophobic incidents drops significantly.
Detailed explanation of the MRI procedure, careful attention and special equipment (mirrors to look outside the machine, emergency bells) help to reduce claustrophobia significantly. The majority of claustrophobic patients will be sufficiently relaxed with orally or intravenous sedatives.
See also Open MRI.

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• For this and other aspects of MRI safety see our InfoSheet about MRI Safety.
• Patient-related information is collected in our MRI Patient Information.

 
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• Related Searches:
    • Low Field MRI
    • Adverse Reaction
    • MRI Scan
    • Magnetic Resonance Imaging MRI
    • Contraindications
 
Further Reading:
  Basics:
Open MRI scanners reduce anxiety in patients
Thursday, 8 September 2011   by www.mtbeurope.info    
  News & More:
The MRI is a source of anxiety — and musical inspiration
Tuesday, 10 December 2013   by www.newsworks.org    
Searchterm 'Claustrophobia' was also found in the following services: 
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Ultrasound  (1) Open this link in a new windowMarket  (2) Open this link in a new window
MRI Procedure
 
The MRI device is located within a specially shielded room (Faraday cage) to avoid outside interference, caused by the use of radio waves very close in frequency to those of ordinary FM radio stations.
The MRI procedure can easily be performed through clothing and bones, but attention must be paid to ferromagnetic items, because they will be attracted from the magnetic field. A hospital gown is appropriate, or the patient should wear clothing without metal fasteners and remove any metallic objects like hairpins, jewelry, eyeglasses, clocks, hearing aids, any removable dental work, lighters, coins etc., not only for MRI safety reasons. Metal in or around the scanned area can also cause errors in the reconstructed images (artifacts). Because the strong magnetic field can displace, or disrupt metallic objects, people with an implanted active device like a cardiac pacemaker cannot be scanned under normal circumstances and should not enter the MRI area.
The MRI machine can look like a short tunnel or has an open MRI design and the magnet does not completely surround the patient. Usually the patient lies on a comfortable motorized table, which slides into the scanner, depending on the MRI device, patients may be also able to sit up. If a contrast agent is to be administered, intravenous access will be placed. A technologist will operate the MRI machine and observe the patient during the examination from an adjacent room. Several sets of images are usually required, each taking some minutes. A typical MRI scan includes three to nine imaging sequences and may take up to one hour. Improved MRI devices with powerful magnets, newer software, and advanced sequences may complete the process in less time and better image quality.
Before and after the most MRI procedures no special preparation, diet, reduced activity, and extra medication is necessary. The magnetic field and radio waves are not felt and no pain is to expect.
Movement can blur MRI images and cause certain artifacts. A possible problem is the claustrophobia that some patients experience from being inside a tunnel-like scanner. If someone is very anxious or has difficulty to lie still, a sedative agent may be given. Earplugs and/or headphones are usually given to the patient to reduce the loud acoustic noise, which the machine produces during normal operation. A technologist observes the patient during the test. Some MRI scanners are equipped with televisions and music to help the examination time pass.
MRI is not a cheap examination, however cost effective by eliminating the need for invasive radiographic procedures, biopsies, and exploratory surgery. MRI scans can also save money while minimizing patient risk and discomfort. For example, MRI can reduce the need for X-ray angiography and myelography, and can eliminate unnecessary diagnostic procedures that miss occult disease.
See also Magnetic Resonance Imaging MRI, Medical Imaging, Cervical Spine MRI, Claustrophobia, MRI Risks and Pregnancy.
For Ultrasound Imaging (USI) see Ultrasound Imaging Procedures at US-TIP.com.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'
 
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• View the NEWS results for 'MRI Procedure' (6).Open this link in a new window.
MRI Safety Resources 
Cochlear Implant - Pacemaker - Stent - Breast Implant - Implant and Prosthesis pool
 
Open MRIForum -
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Open MRI scanners have been developed for people who are anxious or obese or for examination of small parts of the body, such as the extremities (knee, shoulder). In addition, some systems offer imaging in different positions and sequences of movements. The basic technology of an open MRI machine is similar to that of a traditional MRI device. The major difference for the patient is that instead of lying in a narrow tunnel, the imaging table has more space around the body so that the magnet does not completely surround the person being tested.
Types of constructions:
Semi open high field MRI scanners provide an ultra short bore (tunnel) and widely flared ends. In this type of MRI systems, patients lie with the head in the space outside the bore, if for example the hips are examined.
Open low field MRI machines have often a wide open design, e.g. an open C-arm scanner is shaped like two large discs separated by a large pillar. Patients have an open sided feeling and more space around them allows a wider range of positions.
Advanced open MRI scanners combine the advantages of both, the high field strength, newest gradient technology and wide open design. Even scans of patients in upright, weight-bearing positions are possible (e.g. Upright™ MRI formerly Stand-Up MRI).

Difficulties with a traditional MRI scan include claustrophobia and patient size or, for health related reasons, patients who are not able to receive this type of diagnostic test. The MRI unit is a limited space, and some patients may be too large to fit in a narrow tunnel. In addition, weight limits can restrict the use of some scanners. The open MRI magnet has become the best option for those patients.
All of the highest resolution MRI scanners are tunnels and tend to accentuate the claustrophobic reaction. While patients may find the open MRI scanners easier to tolerate, some machines use a lower field magnet and generates lower image quality or have longer scan time. The better performance of an advanced open MRI scanner allows good image quality caused by the higher signal to noise ratio with maximum patient comfort.
See also Claustrophobia, MRI scan and Knee MRI.
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• View the DATABASE results for 'Open MRI' (37).Open this link in a new window


• View the NEWS results for 'Open MRI' (16).Open this link in a new window.
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Adverse Reaction
 
Any abnormal reaction of a patient to an examination or procedure, like for example claustrophobia or side effects of MRI contrast agents.
A claustrophobic attack is MRI scanner dependent and more rare with an open MRI. An adverse reaction with magnetic resonance imaging contrast medium is very infrequent. In general, adverse reactions increase with the quantity of contrast media (usual dose of paramagnetic contrast agents is 0.1 mmol/kg) and also with the osmolarity of the compound.
Most frequently encountered adverse reactions are heat sensation, dizziness, nausea, hypotension due to vasodilatation, which can progress to hypotensive shock and anaphylactic reactions.
See also MRI Safety, Contrast Enhanced MRI, Breast MRI, and Cardiac MR imaging.
Radiology-tip.comSafety of Contrast Agents,  Anaphylactoid Reaction
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Radiology-tip.comUltrasound Contrast Agent Safety
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• View the DATABASE results for 'Adverse Reaction' (8).Open this link in a new window

 
Further Reading:
  Basics:
Contrast Agents: Safety Profile
   by www.clinical-mri.com    
  News & More:
Questions and Answers on Gadolinium-Based Contrast Agents
Friday, 9 January 2009   by www.fda.gov    
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ContraindicationsForum -
related threadsMRI Resource Directory:
 - Safety -
 
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
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
cardiac pacemakers
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:
cochlear implants
other pacemakers, e.g. for the carotid sinus
insulin pumps and nerve stimulators
lead wires or similar wires (MRI Safety risk)
prosthetic heart valves (in high fields, if dehiscence is suspected)
haemostatic clips (body)
non-ferromagnetic stapedial implants
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.

Radiology-tip.comRadiation Safety,  As Low As Reasonably Achievable
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Radiology-tip.comUltrasound Safety
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• View the DATABASE results for 'Contraindications' (11).Open this link in a new window

 
Further Reading:
  Basics:
Newer Heart Devices Safe During MRI
Monday, 23 August 2004   by www.hospimedica.com    
Physics of MRI Safety
   by www.aapm.org    
  News & More:
Modern Implantable Heart Devices Safe For Use In MRI Scans
Wednesday, 16 March 2005   by www.sciencedaily.com    
MRI Resources 
Implant and Prosthesis - Image Quality - Directories - Pediatric and Fetal MRI - Stimulator pool - Supplies
 
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