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The Most Common Problems in MRI

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by

Ekhlas Barnawi

on 7 December 2013

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Transcript of The Most Common Problems in MRI

Solutions for kids who are Terrified of Getting MRI:

• General anesthetic is often used when young children and babies have an MRI scan.
• The parent can stay with their child in the scan room if they are not contraindicated .


• Use MR Cinemavision to provide a visual distraction .







Verbal contact between the parent and the child during MR procedure .


Claustrophobia
It is an abnormal irrational fear of having no escape and being closed-in small , narrow spaces or rooms.
Metal
Tattoos, Permanent Cosmetics, and Eye Makeup

What Do You See?
A 32 years old man came to the MRI department with lower back pain
note that
the patient suffers from Claustrophobia .

General Problems in MRI
pregnancy
The Problem
How
Yes
Sign the consent form .
Prepare the patient like any MRI scan .
Start the scan .
problem 1 & 2
Gadolinium-based contrast usually avoided in pregnancy .
A 25 pregnant female came to MRI department with suspected fracture in her pelvis .



As a
Technologist
,
You will do it for her or not ? Why ?
A pregnant woman in her first trimester come to MRI department to check her fetus development.


As a
Technologist
,
You will do it for her or not ? Why ?
No
That's
THE WRONG
answer !

Because of :

That's
THE RIGHT
answer !
Because of :
Case Study 1
Case Study 2
Case Study 1
Case Study 2
The concerns in pregnancy are the same as for MRI in
general, but the fetus may be more sensitive to the effects.

That's THE
CORRECT
answer
!

Case Study 1
MRI is safer for the unborn child (fetus) than imaging with X-rays or CT scans.
Save the mother life .
Pre-surgical scan (if needed) .
Because of :
Case Study 2
Its not urgent case .
Used to check on the baby’s development only after the first trimester.

That's
THE WRONG
answer !
Because of :
There are some instances where an MRI scan may not be recommended because of the strong magnets used during the scan can affect any metal implants or fragments in patients' body.
Before having an MRI scan, patients should tell medical staff if they think they have any metal in thier body, such as:

For example, the patient may be able to have an MRIwith a pacemaker or defibrillator if a cardiologist (heart specialist) or another trained healthcare professional is able to make the device MRI-safe. They will also need to carefully monitor the heart rhythm of the patient during the procedure.

If  a patient is unsure whether or not they have metal fragments in his body, he will need an X-ray to confirm whether this is the case.


MRI scans often prove difficult for claustrophobic patients. Because they can produce a fear of both suffocation and restriction .
Case Study 3
Children
Case Study 4
A child presents with inner ear problems .
• open-sided MRI scanner can be used in people who suffer from claustrophobia or anxiety .



• Bring the patient out of the magnet in between each sequence , especially in long film .
• Place patient feet first instead of head first into the MR system .
• Use MR Cinemavision to provide a visual distraction .




• Maintain physical and verbal contact with the patient during MR procedure .

Traditional (i.e., decorative) and cosmetic tattoo procedures have been performed for thousands of years.
Before undergoing an MR procedure, the patient should be asked if he or she has ever had a permanent coloring technique (i.e., tattooing) applied to the body
.
A first degree tattoo burn caused by an MRI machine.
Interestingly,

decorative tattoos tend to cause worse problems (including first- and second-degree burns) for patients undergoing MR imaging compared to those that have been reported for cosmetic tattoos.
A hospital reported that heavy metal particles used in the pigment base of mascara and eyeliner tattoos, have a paramagnetic effect that causes alteration of the local magnetic field in adjacent tissues. Changes in the MR signal pattern may result in distortion of the globes. In some cases, the artifact and distortion may mimic actual ocular disease, such as a ciliary body melanoma or cyst.
Example
-The screening form used for patients should include a question to identify the presence of permanent cosmetics or decorative tattoos.

-Before undergoing an MR procedure, the patient should be asked if he or she had a permanent coloring technique (i.e., tattooing) applied to any part of the body. This includes cosmetic applications such as eyeliner, lip-liner, lip coloring, as well as decorative designs.

-The patient should be informed of the risks associated with the site of the tattoo.

-The patient should be advised to immediately inform the MRI technologist regarding any unusual sensation felt at the site of the tattoo in association with the MR procedure.

-The patient should be closely monitored using visual and auditory means throughout the operation of the MR system to ensure safety.

-As a precautionary measure, a cold compress (e.g., ice bag) may be applied to the tattoo site during the MR procedure.
GUIDELINES AND RECOMMENDATIONS
References
http://www.nhs.uk/Conditions/MRI-scan/Pages/Who-can-use-it.aspx
http://www.who.int/peh-emf/meetings/archive/en/paper04ng.pdf
http://www.mrisafety.com/safety_article.asp?subject=145
http://www.livescience.com/32801-do-mri-machines-affect-tattoos.html
http://www.webmd.com/skin-problems-and-treatments/tattoos-what-you-need-knowhttp://www.youtube.com/watch?v=LaAjrPbahBA
Done By :
Abrar Al Hulaily
Asmaa Ghazuain
Ekhlas Barnawi
Manal Al Suhaimi
Shikhah Al Salem
Health Effects
The potential benefits of MRI are numerous. However, there are hazards intrinsic to the MR environment which must be understood, acknowledged and respected. In general, during MR diagnostic imaging and spectroscopy, patient being scanned and those individuals in the immediate vicinity of the equipment can be exposed to three types of magnetic fields simultaneously.

The static (main) magnetic fields

· Time-varying magnetic field gradients
· Radiofrequency (RF) magnetic fields

The hazards caused by these fields can affect patients, staff and other persons within the magnetic field environmen

Several incidents involving MR have been reported in ECRI Health Device Alerts (HDA), U.S. Food and Drug Administration (FDA) Medical Device Reporting (MDR). Below are some examples from the database:

In 2001
A 6-year-old boy died after undergoing an MRI exam at a New York-area hospital when the machine's powerful magnetic field jerked a metal oxygen tank across the room, crushing the child's head.
In 1989
A patient with an implanted cardiac pacemaker died during or shortly after an MR exam. The coroner determined that the death was due to the interruption of the pacemaker by the MR system .
In 1992
A patient with an implanted intracranial aneurysm clip died as a result of an attempt to scan her. The clip reportedly shifted when exposed to the magnetic field. The staff apparently had obtained information indicating that the material in this clip could be scanned safety .
In 1993
A patient complained of double vision after an MR exam. The MR exam as well as an x-ray revealed the presence of metal near the patient's eye. The patient was sedated at the time of the exam and was not able to inform anyone of this condition .

In 1995
A patient received blistered burns on the finger where a pulse oximeter was attached during MR scanning. A skin graft was required to treat the affected area.
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