MI-Assignment-Iv

By McNeill A. DSilva
Roll no. 05
Safety Considerations in MRI
Magnetic resonance imaging has dramatically improved diagnostic capabilities since its
introduction nearly 0 years ago! leading to increased con"idence in diagnoses and enhanced
patient management. No#! manu"acturers are introducing MR units that have higher static and
gradient magnetic "ield strengths and are capable o" producing a better image in less time. $hese
more po#er"ul machines! ho#ever! are raising ne# sa"ety concerns. Magnetic resonance imaging
has been #idely accepted as a sa"e! noninvasive procedure. Most sa"ety studies! ho#ever! #ere
per"ormed on systems #ith "ield strengths up to %.5 $esla &$'. $oday(s MR systems can have
"ield strengths up to ).0 $! and some e*perts are concerned that these high "ields may adversely
a""ect patients.Although no study has "ound that MR+ directly causes biological damage! it is
important to identi"y potential ris,s associated #ith higher "ield strength scanners.$here are
sa"ety and po#er considerations associated #ith the application o" high speed gradients.Rapid
gradient s#itching can cause stimulation o" peripheral nerve. Such s#itching results in mild
cutaneous sensations! muscle contraction and stimulation o" retinal phosphenes. -or this very
reason!many ultra."ast gradient systems operate /ust belo# the stimulation threshold. $he -DA
limits gradient strength to 0 $1s "or all gradients but permits 0 $1s "or a*ial gradients. Since the
techni2ue o" MR+ is used to image humans! it is important to ,eep the sa"ety o" the sub/ects as a
high priority. Since MR+ does not use any "orm o" ionising radiation! it is considerably sa"er than
*.ray or radio.isotope techni2ues. 3o#ever it is important! especially in a research setting! that
the potential ha4ards o" any ne# developments are care"ully considered. $he ma/or sa"ety
aspects are outlined belo#.
Potential Dangers in MRI
As the name implies! MR+ uses a strong magnet to create a static magnetic "ield. +n a
conventional %.5 $ machine! the scanner has an operational "ield strength appro*imately
50!000 times as strong as the earth(s magnetic "ield.
+n the ne# machines! "ield strength can be increased by a "actor o" 5 or ).
$his situation ampli"ies the ,no#n ha4ards o" operating a po#er"ul magnet. $he most
obvious o" these dangers is "erromagnetic attraction.
6b/ects in the scan room must be screened "or possible "erromagnetic attraction to the
MR scanner.
A misplaced #rench! o*ygen tan,! mop buc,et or other ob/ect constructed o"
"erromagnetic material! including some types o" stainless steel! can become an e*tremely
dangerous pro/ectile i" maneuvered into the in"luence o" the magnetic "ield.

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$o alleviate this problem! many scanners "eature additional shielding to minimi4e the
magnetic "ield outside the scanning area.
$he net e""ect is a magnetic "ield that is more constrained in space! but that increases in
intensity very rapidly near the scanner itsel".
$his gives the MR technologist less time to react i" a potential pro/ectile enters the scan
room.
Any "erromagnetic ob/ect can be /er,ed very 2uic,ly into the bore o" the scanner. +t is
important! there"ore! to locate the lines o" magnetic "orce around the scanner.
$he strength o" the magnetic "ield around an MR scanner varies #ith the distance "rom
the magnet.
-ield strength is greatest #ithin the bore o" the scanner. +t #ea,ens! at a rate dependent on
the amount o" shielding and the "ield strength o" the magnet! as the distance increases.
By measuring this "orce at various points! a plot map can be created that demonstrates
di""erent points o" e2ual magnetic "ield strength.
7oints o" e2ual "ield strength #ill "orm a line called a 8auss &8' line.
$he location o" 8auss lines must be ta,en into account due to potential interaction the
magnetic "ield can have #ith nearby "erromagnetic materials. $he MR technologist
should ,no# the location o" all 8auss lines.
+n addition to creating pro/ectile ha4ards! magnetic "ields also can a""ect biomedical
implants. MR scanning is contraindicated "or any patient #ith a pacema,er! especially i"
even temporary mal"unction o" the device #ould endanger the patient(s health. Magnetic
"ields can cause pacema,ers to mal"unction at "ields as lo# as %9 8! and some
pacema,ers may be a""ected by "ields as lo# as 5 8. +t is recommended! there"ore! that
anyone e2uipped #ith a pacema,er stay outside the 5 8 line. +n high "ield MR units! the 5
8 line #ill e*tend "arther "rom the scanner than it does #ith conventional units.
Also! people #ith magnetically activated implants and devices such as cochlear implants
and ocular prostheses should be considered at ris, #hen they are near an MR scanner.
$he magnetic "ield may trigger the mechanism inappropriately( or cause the implant to
become dislodged! causing damage to tissue.
Many metallic biomedical implants have been deemed sa"e "or the MR environment
because they do not display signi"icant "erromagnetic 2ualities in tests per"ormed e* vivo
#ith %.5 $ systems.

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3o#ever! additional tests should be per"ormed #ith ).0 $ systems be"ore these
biomedical implants are permitted near a high "ield MR scanner. Many implants are made
"rom alloys o" "erromagnetic metals such as iron! cobalt or nic,el! and the degree to
#hich these combinations display "erromagnetic 2ualities is uni2ue to each alloy.
Risks Associated with Higher Fields
Scan times o" several minutes o"ten are re2uired to produce a diagnostic image #ith MR+.
6ne #ay to reduce scan times is to increase "ield strength! thereby boosting the signal
available to produce the image.
Another method is to increase the rate o" variations o" the magnetic "ield gradients! as
#ith the echoplanar imaging method.
According to -araday(s la#! ho#ever! rapid changing &pulsing' o" the gradient magnetic
"ield may induce voltages in any electrical conductor #ithin the "ield.7ossible conductors
include the human body and biomedical implants! as #ell as devices used to monitor the
patient during scanning. Burns have resulted #hen a loop is "ormed bet#een the patient
and the conductive leads to monitoring e2uipment #ithin the gradient magnetic "ield.
$here"ore! it is important to chec, all e2uipment to ensure that no loops are "ormed #ith
the patient.
Biological e""ects o" electrical currents induced by gradient "ields are mani"ested
thermally or nonthermally. $hermal e""ects are assumed to be negligible.Nonthermal
reactions to induced currents include muscle and nerve stimulation! ranging "rom tingling
in the s,in to involuntary muscle contractions and cardiac arrhythmias
.7eripheral muscle stimulation in humans has been noted in rapidly changing magnetic
"ield gradients at a threshold o" 00 $1second.
:isual "lic,ers o" light! called magnetophosphenes! have been reported in association
#ith rapidly changing magnetic "ield gradients and #ith rapid eye movements #ithin a
static magnetic "ield.Magnetophosphenes have not been reported in association #ith lo#
"ield strength systems! but have been reported by people #or,ing #ith ).0 $ scanners.
Another area o" concern is the loud ,noc,ing or tapping noise produced by the rapidly
s#itching magnetic "ield gradients #ithin a po#er"ul static magnetic "ield.
$emporary hearing loss has been reported in association #ith this sound!#hich is even
louder in scanners e2uipped #ith higher static and gradient magnetic "ields.
7atients undergoing an MR e*amination should be o""ered earplugs and! i" possible! the
scanner should be e2uipped #ith noise cancellation technology that produces sound
similar in amplitude but opposite in phase to the scanner noise. $his technology ;cancels
out; scanner noise! thereby reducing potential ris, "rom this ha4ard.

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Although high "ield scanners tend to produce a higher amplitude o" noise! the patient is
sub/ected to the noise "or a shorter period o" time because the e*am can be per"ormed
more 2uic,ly.
Static Magnetic Fields
By "ar the more serious e""ect o" the static magnetic "ield is the response o" "erromagnetic
ob/ects to such "ields.
+t is essential that no "ree "erromagnetic ob/ect is allo#ed near the magnet since the "ield
#ill turn it into a pro/ectile.
+n a laboratory setting this means that most tools! connectors! and other e2uipment to be
used in the vicinity o" the "ield must not be "erromagnetic.
Sub/ects must be screened "or ob/ects li,e ,eys! pens! belts and other metal on clothing!
as #ell as the possibility o" surgical implants.
Be"ore scanning a sub/ect it is also necessary to chec, that there #ould be no ill e""ects
"rom e*posure to the magnetic "ield.
+t is common to e*clude people #ho are in the early stages o" pregnancy! people #ho
may have any ,ind o" metal "ragments in them! and those su""ering "rom certain
conditions such as epilepsy.
Time Varying Magnetic Fields
As #ell as the high static magnetic "ield used in MR+! it is possible that the t#o time
varying "ields! namely the gradients and the R- radiation! could a""ect the sub/ect in the
scanner.
$he rapid s#itching o" the "ield gradients produce t#o sa"ety concerns. -irstly there is
the possibility o" inducing voltages in tissue by -araday(s la#. $he current induced in a
loop o" tissue is dependent on the rate o" change o" the "ield &dB1dT'! the conductivity o"
the tissue! and the cross section o" the loop.
<alculations by Mans"ield and Morris sho# that "or dB1dT = %.0 $1s! the currents
induced are o" the order % A1cm

.
<ohen reports o" sub/ects e*periencing mild neural stimulation at gradient "ield
variations o" 0% $s
.%
! #hich is higher than the rates in normal use.
+t is #ise ho#ever! i" high s#itching rates are used! that sub/ects are #arned o" the
possible e""ects! and monitored during the imaging.
A second sa"ety concern #ith the gradients is that o" acoustic noise levels.
Since large currents are "lo#ing through #ires in a large magnetic "ield! a "orce is
e*erted on the #ires. >hen the currents oscillate at audio "re2uencies! the resulting noise
can be in e*cess o" %00 dB.
Sub/ects there"ore must #ear suitable ear protection during scanning! to reduce the noise
to an acceptable level.
$he heat that can be dissipated by R- "ields is a "urther source o" concern.
$he currents induced in tissues by such "ields are dissipated as heat. Although most
tissue has ade2uate blood "lo# to carry the heat a#ay! some anatomical regions such as
the eye do not.

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+t is sensible to ,eep the heating due to R- radiation to a minimum.
$his is achieved by limiting the mean absorption rate in the #hole body to 0.) >,g
.%
and
in any mass o" tissue to ) >,g
.%
.
+t is also essential that there are no conductive items touching the sub/ect(s s,in! since the
heating o" such ob/ects by the R- radiation can cause serious burns.
ther Safety Considerations
<laustrophobia! and other psychological problems! can prevent a sub/ect "rom being able to
enter the scanner! and should be screened "or be"ore attempting to scan. +t is necessary to chec,
the sub/ect is "ully in"ormed as to the nature o" the e*periment and happy to proceed. Depending
on the medical condition o" the sub/ect! it may be necessary to monitor them closely during the
scanning! and communication is important so that the sub/ect does not "eel isolated.
Concl!sion
Although no deleterious biological e""ect has been directly associated #ith the magnetic "ields
used in MR scanning! the ne# high "ield scanners must be evaluated #ith a thorough analysis o"
potential ris,s and actual bene"its. +n this manner! #e can apply our ,no#ledge in a sa"e and
e""ective manner that #ill ma*imi4e the bene"its to our patients as #ell as our pro"ession.
References
%.Di*on A?! Southern @7! $eale A! et al. Magnetic resonance imaging o" the head and spineA
e""ective "or the clinician or the patientB BM@. %CC%D50A9E.E.

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