The MR Environment: Knowing the Risks

The opportunity for injury in the MR room remains an issue for all MR users. This is a result of clinical and technological factors, including growth in the number of implanted and external medical devices present during MR scans, increases in MR patient acuities, the greater emphasis on maximizing workflow efficiency, and the increasing use of MR systems with stronger magnetic fields, steeper spatial field gradients, and more powerful gradient and radio-frequency (RF) transmissions. The clinical literature and problem reporting databases include numerous reports of injuries—and a few deaths—from incidents in MR centers. Costly damage can also result.

Many of these incidents occurred because ferromagnetic materials (that is, materials that can become strongly magnetized) were mistakenly brought into the MR environment. The most spectacular outcome of such an error is the projectile effect, in which an object becomes airborne and literally flies through the air, crashing into the magnet or patient. Other incidents can be attributed to the use of devices within the MR environment in a manner not in accordance with their restrictions or limitations. For example, electrically conductive objects, such as sensor leads, may be subject to inductive heating when inside the bore of the magnet. In some cases, the heating can cause patient burns.

Although these issues are widely recognized, individual staff members may not always be aware of them. What's more, existing licensure, regulatory, and accreditation bodies may acknowledge MR-specific risks, but they largely do not (as of the time of publication) require compliance with the existing best practices for addressing them.

Given the increasing MR risk factors, the absence of enforcement for best practices and, as we'll discuss below, the growth in MR accident rates, it's more important than ever that healthcare facilities pay careful attention to MR safety protocols. The MR environment should always be a controlled-access environment; as a result, only successfully cleared patients (and anyone accompanying them, including providers) should be allowed into this environment. Keeping staff conscious of MR risks, along with the existing established best practices to mitigate them, is a vital and ongoing priority. What's more, the range of individuals who need to be educated about MR hazards and the precautions that must...