Although MRI does not emit the ionizing radiation that is found in x-ray and CT imaging, it does employ a strong magnetic field. The magnetic field extends beyond the machine and exerts very powerful forces on objects of iron, some steels, and other magnetizable objects; it is strong enough to fling a wheelchair across the room. Patients should notify their physicians of any form of medical or implant prior to an MR scan.
When having an MRI scan, the following should be taken into consideration:
- People with implants, particularly those containing iron, — pacemakers, vagus nerve stimulators, implantable cardioverter- defibrillators, loop recorders, insulin pumps, cochlear implants, deep brain stimulators, and capsules from capsule endoscopy should not enter an MRI machine.
- Noise—loud noise commonly referred to as clicking and beeping, as well as sound intensity up to 120 decibels in certain MR scanners, may require special ear protection.
- Nerve Stimulation—a twitching sensation sometimes results from the rapidly switched fields in the MRI.
- Contrast agents—patients with severe renal failure who require dialysis may risk a rare but serious illness called nephrogenic systemic fibrosis that may be linked to the use of certain gadolinium-containing agents, such as gadodiamide and others. Although a causal link has not been established, current guidelines in the United States recommend that dialysis patients should only receive gadolinium agents when essential, and that dialysis should be performed as soon as possible after the scan to remove the agent from the body promptly.
- Pregnancy—while no effects have been demonstrated on the fetus, it is recommended that MRI scans be avoided as a precaution especially in the first trimester of pregnancy when the fetus’ organs are being formed and contrast agents, if used, could enter the fetal bloodstream.
- Claustrophobia—people with even mild claustrophobia may find it difficult to tolerate long scan times inside the machine. Familiarization with the machine and process, as well as visualization techniques, sedation, and anesthesia provide patients with mechanisms to overcome their discomfort. Additional coping mechanisms include listening to music or watching a video or movie, closing or covering the eyes, and holding a panic button. The open MRI is a machine that is open on the sides rather than a tube closed at one end, so it does not fully surround the patient. It was developed to accommodate the needs of patients who are uncomfortable with the narrow tunnel and noises of the traditional MRI and for patients whose size or weight make the traditional MRI impractical. Newer open MRI technology provides high quality images for many but not all types of examinations.