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| | | | | | | MRI Safety | | |
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).
| | | • View the DATABASE results for 'MRI Safety' (42).
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| | | 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:
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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.
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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.
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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).
| | | • View the DATABASE results for 'MRI Risks' (9).
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| | | 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.
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:
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electronically, magnetically, and mechanically activated implants
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metallic splinters in the eye
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:
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other pacemakers, e.g. for the carotid sinus
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).
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