MRI Safety and Patient Preparation Quiz
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Questions and Answers

Which action is essential for patient cooperation during an examination?

  • Using restraints if necessary
  • Providing sedatives before the procedure
  • Allowing the patient to wear makeup
  • Informing the patient about the procedure (correct)

Why should patients avoid wearing makeup during an MRI examination?

  • It might cause allergic reactions
  • Makeup may impair imaging quality
  • Makeup can block RF signals
  • Some makeup products may contain metallic particles (correct)

What is one of the first precautions to take before an MRI scan?

  • Ensure the patient is wearing loose clothing
  • Check for any patient history of allergies
  • Screen the patient and accompanying person for metallic objects (correct)
  • Prepare sedatives for patient control

What could happen if wires and coils touch the patient’s body during an MRI?

<p>Potential burns due to insulation failure (D)</p> Signup and view all the answers

What should be avoided to prevent loop formation during an MRI scan?

<p>Allowing the patient to cross their legs or arms (D)</p> Signup and view all the answers

In an emergency situation, what is the first priority?

<p>To remove the patient from the scanner room (C)</p> Signup and view all the answers

How does the computer ensure patient safety concerning tissue heating during an MRI?

<p>By estimating heating levels before scanning (D)</p> Signup and view all the answers

What is a known consequence of RF pulses in MRI scans?

<p>Causing tissue heating under specific conditions (D)</p> Signup and view all the answers

Why is it important to enter the patient’s weight correctly in an MRI estimate?

<p>To prevent excessive RF exposure. (C)</p> Signup and view all the answers

Which of the following factors can affect a patient's completion of an MRI scan?

<p>The type of scan used and method of entry. (D)</p> Signup and view all the answers

What is the recommended precaution for patients during an MRI scan due to acoustic noise?

<p>Offering ear protection to all patients. (A)</p> Signup and view all the answers

What should a patient do if they are pregnant and scheduled for an MRI scan?

<p>Inform their healthcare provider and MRI technologist. (A)</p> Signup and view all the answers

What are some methods to improve patient comfort during an MRI scan?

<p>Using bore lighting and ventilation. (B)</p> Signup and view all the answers

What action should be taken in case of a patient needing medical attention during an MRI scan?

<p>Press the emergency stop button on the console or magnet. (A)</p> Signup and view all the answers

What is the potential consequence of a magnet quench in an MRI facility?

<p>Several days of downtime for the magnet. (D)</p> Signup and view all the answers

What can vary widely in terms of patient anxiety triggering aborted MRI scans?

<p>The percentage of aborted scans reported. (A)</p> Signup and view all the answers

What should a patient remove before entering the MRI equipment room?

<p>Personal possessions such as jewelry (C)</p> Signup and view all the answers

Why is it important to check the patient's identity before any MRI examination?

<p>To avoid performing the scan on the wrong patient (A)</p> Signup and view all the answers

What type of attitude might patients exhibit due to anxiety before an MRI scan?

<p>Aggressive or apprehensive (C)</p> Signup and view all the answers

What is the role of the technologist in easing a patient's anxiety?

<p>Convincing them with a soft tone and providing comfort (A)</p> Signup and view all the answers

What should be done with wheelchairs and trolleys before the scan?

<p>They must be kept outside the magnet room (A)</p> Signup and view all the answers

During the MRI scan, how long does the procedure typically take?

<p>30 to 40 minutes (B)</p> Signup and view all the answers

What should patients do during the MRI scan to ensure quality images?

<p>Stay completely still and relaxed (D)</p> Signup and view all the answers

What is the primary concern regarding personal items like credit cards in the MRI room?

<p>The scanner may erase their information (D)</p> Signup and view all the answers

What is the primary safety precaution regarding laser alignment lights during MRI procedures?

<p>Patients should close their eyes during landmarking. (D)</p> Signup and view all the answers

What type of contrast agent is Gadolinium classified as?

<p>Positive relaxation agent. (A)</p> Signup and view all the answers

Which of the following conditions is a contraindication for the use of Gadolinium?

<p>Hematological disorders. (C)</p> Signup and view all the answers

What is the effective dosage of Gadolinium recommended per kilogram of body weight?

<p>0.1 mmol/kg. (D)</p> Signup and view all the answers

What is the primary mechanism by which iron oxide affects nearby hydrogen atoms?

<p>It shortens relaxation times of nearby hydrogen atoms. (D)</p> Signup and view all the answers

Which imaging technique benefits significantly from the use of Gadolinium due to its ability to cross the blood-brain barrier?

<p>MRI of the CNS. (B)</p> Signup and view all the answers

Which side effect is NOT associated with the use of iron oxide?

<p>Increased appetite (D)</p> Signup and view all the answers

What is a potential side effect of Gadolinium administration?

<p>Mild transitory headaches. (B)</p> Signup and view all the answers

Why is iron oxide contraindicated in certain patients?

<p>It can cause discoloration around the infusion site. (D)</p> Signup and view all the answers

How does Gadolinium function as a contrast agent in MRI imaging?

<p>It reduces T1 relaxation times of nearby water protons. (C)</p> Signup and view all the answers

What is the recommended dosage of iron oxide based on body weight?

<p>0.56 mg of iron per kg of body weight (B)</p> Signup and view all the answers

Which of the following is not a side effect associated with Gadolinium use?

<p>Insomnia. (C)</p> Signup and view all the answers

In which clinical application is iron oxide primarily used?

<p>Liver imaging (A)</p> Signup and view all the answers

Flashcards

MRI Patient Preparation

Steps to prepare a patient for a magnetic resonance imaging (MRI) scan. This includes identity verification, appropriate attire, removal of metal items, and ensuring patient comfort and cooperation.

Patient Identity Verification

Crucial step in MRI procedure to ensure the correct patient is being scanned, using identification checks.

MRI Scan Equipment Room

The room containing the MRI machine itself. Special rules apply to ensure safety within this room.

MRI Patient Attire

Patients must wear a hospital gown and remove all metal objects (watches, jewelry, etc.) before entering the MRI machine room.

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MRI Scan Procedure

The process of taking images of the body using a large powerful magnet in stages to generate images.

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Patient Movement

Retaining complete stillness during the scan is crucial to obtain high-quality images.

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Contrast Agents in MRI

Substances used to enhance the visibility of tissues on MRI scans, often categorized by relaxation effects on T1 or T2 signals.

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MRI Scan Duration

The time spent taking an MRI scan, varying from 30 to 40 minutes depending on factors like field strength and parameters.

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Claustrophobia and MRI

Fear of enclosed spaces can make MRI scans difficult. Patients may need sedation or alternative methods to complete the scan.

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MRI Scan Abortions

A significant percentage of MRI scans are aborted due to patient anxiety and claustrophobia. This varies depending on the scan type and entry method.

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MRI Comfort Techniques

Techniques like lighting, ventilation, and mirrors can be used to improve patient comfort during MRI scans.

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Emergency Preparedness in MRI

MRI facilities have specific emergency procedures in place, especially for metal objects entering the scanning room or medical emergencies.

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Pregnancy and MRI

MRI during the first trimester is generally avoided unless medically necessary, as the potential risks to the fetus are not fully understood.

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MRI Acoustic Noise

The loud noises during MRI scans are caused by the vibration of the magnetic coils. This noise increases with field strength and requires ear protection for all patients.

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MRI Magnet Quench

A magnet quench can damage the MRI machine and put the patient at risk, so the quench button should only be used in genuine emergencies.

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MRI Emergency Stop Button

If a patient needs immediate medical attention during an MRI scan, an emergency stop button on the control panel should be pressed, allowing the patient to be removed from the scan room.

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MRI Safety: Metallic Objects

Patients with certain metallic implants, like aneurysm clips or pacemakers, cannot undergo MRI scans due to the strong magnetic field, which can cause harm.

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MRI Safety: Loop Formation

Wires and cables used for monitoring (like pulse ox or ECG) should never form loops near the magnet, as this can induce electrical currents and cause burns.

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Why do some patients wear hospital gowns?

Patients must wear a gown and remove all metal objects (watches, jewelry etc.) before entering the MRI room to avoid interference with the magnetic field.

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Why is patient comfort important for MRI?

Patients need to remain still for the duration of the scan. If they're uncomfortable or in pain, it's harder to obtain clear images.

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What is the first step if an emergency occurs in the MRI room?

The patient must be removed from the scanner room as quickly as possible to start resuscitation.

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MRI Safety: Instructions before the scan

Patients must be given clear instructions about breathing and swallowing to avoid movement during the scan.

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How does MRI heat tissue?

The radiofrequency pulses used in MRI can cause tissues to absorb energy and heat up. The amount of heating depends on factors like the patient's size and scan parameters.

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What happens if the MRI scanner estimates too much tissue heating?

The computer adjusts the scan settings before starting the scan to ensure the patient isn't exposed to excessive radiation.

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Iron Oxide Contrast Agent

A substance injected into the body to alter the contrast of MRI images by shortening the relaxation times of nearby hydrogen atoms, resulting in signal loss, particularly on T2-weighted images.

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Iron Oxide Side Effects

Common side effects include mild to severe pain in the back, legs, and groin. Digestive issues like nausea, vomiting, and diarrhea also occur. Less common but serious reactions include anaphylaxis and hypotension.

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Iron Oxide Contraindications

Iron Oxide is contraindicated in patients with known allergies to iron or hypersensitivity. Extravasation can cause skin discoloration due to the dark color of the infused solution.

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Gastrointestinal Contrast Agents

Used to enhance bowel visualization, these agents include barium, ferromagnetic substances, and fatty materials. However, their effectiveness can be hindered by bowel motion artifacts.

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Other Contrast Agents: Helium

Inhaled helium assists in the evaluation of lung perfusion, helping to assess blood flow through the lungs.

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Laser Alignment Lights

Lights used to align the MRI machine, posing a risk of eye injury if viewed directly. Patients are instructed to close their eyes during landmarking to avoid exposure while the laser is ON.

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Contrast Agents and Kidney Function

Some MRI contrast agents, like Gadolinium, can be harmful to people with kidney problems. They should be closely monitored and may need alternative imaging tests.

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Positive Relaxation Agent

MR contrast media that affect T1 relaxation, causing tissues to show brighter on T1-weighted images (T1WI).

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Negative Relaxation Agent

MR contrast media that affect T2 relaxation, causing tissues to show darker on T2-weighted images.

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Gadolinium (Gd)

A paramagnetic agent used as a T1 contrast enhancer in MRI. It decreases T1 relaxation time, making tissues appear brighter on T1WI.

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Gadolinium Side Effects

Can cause temporary increases in bilirubin and blood iron, mild headaches, nausea, vomiting, hypotension, gastrointestinal upset, and rash.

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Gadolinium Contraindications

Avoid using Gadolinium in patients with hematological disorders, sickle cell anemia, and pregnancy.

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Gadolinium Dosage

The effective dosage is typically 0.1 millimole (mmol) per kilogram (kg) of body weight, or about 0.2ml/kg.

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Study Notes

MRI Safety, Preparation, and Contrast Agents

  • MRI Safety:

    • Patient identity is checked before scans
    • Patients may be anxious; technicians should use a calm manner
    • Children and uncooperative patients may need sedation
    • Patients must remove all metal objects (jewelry, watches, keys, etc.)
    • Wheelchairs/trolleys must remain outside the MRI room
    • Patients lie down on a table that moves through the scanner tunnel
    • The region of interest is positioned in the center of the magnet
    • Patients can hear radiologist/technologist instructions and respond
    • The entire process takes 30-40 minutes
    • Patients are expected to remain relaxed and still
    • Patients can resume normal activities after the scan

  • Patient preparation and Safety:

    • Patients should be informed about the process.
    • Avoid makeup containing metallic particles
    • Ensure patient comfort to ensure stillness
    • Guide patients on breathing and swallowing
    • Patients with certain implants and conditions might be unsuitable for MRI
      • Aneurysm clips
      • Cardiac pacemakers
      • Otologic/ocular implants
      • Cochlear implants
      • Metallic foreign bodies (especially in the eye)

Precautions

  • Metallic Objects:

    • Screen patients and their accompanying persons for metal objects.
    • Strong magnetic attraction poses severe risks

  • Electrical Wires:

    • Wires/coils must be well-insulated to prevent burns
    • Body parts should not touch the magnet bore
    • Avoid forming wire loops
    • Avoid body part loop formations (e.g., crossed arms/legs)

  • Emergency Preparedness:

    • MR facilities have procedures for accidents and emergencies
    • Scan room doors should have stickers/labels of prohibited items

  • Radiofrequency (RF) Power Effects:

    • The RF pulses used in MRI can cause tissues to absorb RF power and potentially heat them.
    • Heating is based on patient size, pulse timing etc.
    • Computer estimates heating levels vs preset limits
    • System adjusts parameters if necessary
    • Accurate patient weight is crucial

  • Claustrophobia and Sedation:

    • Patient anxiety and claustrophobia can hinder MRI completion
    • Scan abort rates in these cases vary, from 1% to 20%.
    • Methods to minimize stress: lighting, ventilation, and mirrors

  • Pregnancy and MRI:

    • MRI is usually safe during pregnancy
    • First-trimester MRIs are generally avoided unless medically needed

  • Acoustic Noise:

    • MRI scanner noise is due to rapidly varying current

Quenching

  • Magnet quenches can last several days; avoid pressing buttons unless in an emergency
  • Only qualified service personnel should test the “Quench” button
  • Immediate medical attention is needed, then press the emergency stop button
  • Remove patient immediately

Laser Alignment Lights

  • MRI systems have alignment lights; avoid direct eye exposure
  • Instruct patients to close eyes when landmarking
  • Do not leave the laser beam on after positioning patients

Contrast Agents

  • Contrast and Kidney Function:
    • Gadolinium-based agents enhance tissue visibility
    • Risk to individuals with impaired kidney function; careful monitoring
  • Contrast Media Types:
    • Positive relaxation agents (T1 agents): affect T1 relaxation, increase signal on T1-weighted images. (e.g., Gadolinium)
    • Negative relaxation agents (T2 agents): affect T2 relaxation, reduce signal on T2-weighted images. (e.g., iron oxide)

Gadolinium

  • Gadolinium Properties:
    • Paramagnetic agent with large magnetic moment
    • Shortens T1 relaxation times, increasing signal intensity on T1-weighted images
    • Cannot be excreted by the body; long-term side effects
  • Gadolinium Side Effects:
    • Slight transient increase in bilirubin and blood iron
    • Mild transitory headaches
    • Nausea
    • Vomiting
    • Hypotension
    • Gastrointestinal upset
    • Skin rash
  • Gadolinium Contraindications:
    • Hematological disorders
    • Sickle cell anemia
    • Pregnancy
  • Gadolinium Administration:
    • Effective dose is 0.1 mmol/kg body weight (approximately 0.2ml/kg)

Clinical Applications of Gadolinium

  • Tumor pre- and post-surgery
  • Pre- and post-radiotherapy
  • Infection
  • Infarction
  • Inflammation
  • Post-traumatic lesions
  • Post-operative lumbar disc
  • Breast disease
  • Prostatic disease

Iron Oxide

  • Shortens relaxation times of nearby hydrogen atoms
  • Reduces signal intensity in normal tissues
  • Used as a T2 enhancement agent
  • Potential for signal loss on proton density and heavily T2WI images

Iron Oxide Side Effects

  • Back, leg, and groin pain (mild to severe)
  • Head and neck pain
  • Digestive side effects (nausea, vomiting, diarrhea)
  • Anaphylactic reactions and hypotension (less common)

Iron Oxide Contraindications

  • Allergy/hypersensitivity to iron
  • Discoloration of skin due to extravasation

Iron Oxide Administration

  • Recommended dose: 0.56 mg per kg body weight
  • Administered as an IV infusion over 30 minutes (e.g. 0.56 mg of iron per kg of body weight, using Feridex dilute in 100 ml of 50% dextrose)

Clinical Applications of Iron Oxide

  • Primarily used in liver imaging where normal liver is dark on T2WI and lesions appear bright.

Other Contrast Agents

  • Gastrointestinal Contrast Agents:
    • Used to enhance bowel visibility
    • Include barium, ferromagnetic agents and fatty substances
    • Movement artifacts common
    • Anti-spasmodic agents might decrease artifacts
    • Could be used for lung perfusion (inhaled helium)

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MRI Safety, Preparation, and Contrast Agent PDF

Description

Test your knowledge on MRI safety protocols and patient preparation steps. This quiz covers essential procedures, including checking patient identity, the removal of metal objects, and tips on managing patient anxiety. Understand the importance of preparing patients for a smooth MRI experience.

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