MRI scanning of the claustrophobic patients

Transcription

1 MRI scanning of the claustrophobic patients Poster No.: C-0549 Congress: ECR 2014 Type: Educational Exhibit Authors: M. minov, A. Doreski, M. Popovska, G. Markoski, S Jovanoska, I. miladinovski ; Stip/MK, Skopje/MK, MK Keywords: Education and training, Safety, MR, MR physics DOI: /ecr2014/C-0549 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 16

2 Learning objectives Role of MR radiographers in dealing with claustrophobia in everyday MR scanning procedures is very important. MR Radiographers and other imaging professionals should be knowledgible with solutions to deal with claustrophobia, especially how to prepare the patient for examination and optimize the scanning protocol. Images for this section: Fig. 1: Radiographers communication with patient is crucial in scanning of the claustrophobic patients Page 2 of 16

3 Background Claustrophobia is defined as "a fear of being in a confined or enclosed place". It is typically classified as an anxiety disorder and often results in panic attack and can be the result of many situations or stimuli, including elevators crowded to capacity, windowless rooms, and even tight-necked clothing. According to many authors claustrophobia (just as a pacemakers and metal implants) is one of the inabilities to perform MRI exam, but here is radiographers to solve the problem. Radiographers could choose or combine couple of solutions described in "Findings and procedure details" section. Images for this section: Fig. 2: Claustrophobia often results in panic attack Page 3 of 16

4 Findings and procedure details Solutions to deal with claustrophobia: 1. Optimizing the MRI exam - Reducing the exam time by choosing the most important and shorter sequences - Using parallel acquisition techniques (IPAT) - Using BLADE Motion Compensation sequences. BLADE uses special algorithms and advanced pulse sequences to decrase or eliminate motion artefact and also reduce MRI examination time. - Optimal reducing of the FoV in phase encoding directions (this will decrease acquisition time but not affect to much image quality). 2. Open MRI systems They are usually up to 0.5T and have benefits and limitations. - Benefits: greatly reduces the feeling of claustrophobia - Limitations: limited use in advanced clinical studies 3. Preparing the patient for the exam - Explaining all the procedure details telling that have the control by giving him the panic button - Having constant verbal interaction through the whole exam - Medications - level of sedation appropriate for the patient - Offer him company by family member in MRI room - Small towel placed over the eyes 4. Environment Page 4 of 16

5 - Windows within the MRI suite that provides natural light and enhances the sense of openness, - Creating sky with stars and dim ambient light that increases the sense of comfort - Using system of mirrors above the patient head, and enabling them a wider field of view MRI audio and video systems, 3D options like cinema-vision 5. Unconventional techniques - Hypnosis - a possibility in dealing with claustrophobia? - Meditation - reducing the stress and anxiety should improve the exam? 6. Future solutions - New MRI systems - with its large bore and high magnetic field (even 3T available) - New design of coils (with direct digital signal coding accelerate the acquisition time) - Specialized extremity MRI systems - smaller compact systems for scanning arms, hands, wrists, knees, ankles, etc. - New open "upright" systems that claim effective field up to 1.2T Images for this section: Page 5 of 16

6 Fig. 3: Open MRI systems up to 3T and environment with windows and sky pictures giving patients sense of openness Page 6 of 16

7 Fig. 4: Alarm pump and device for communication with patient Page 7 of 16

8 Fig. 5: Medications in control dose could be helpful during examination. Page 8 of 16

9 Fig. 6: Video systems as cinema-vision are very helpful especially in younger patients and kids Page 9 of 16

10 Fig. 7: In some cases company from member of the family help patient to fill relax Page 10 of 16

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12 Fig. 8: Hypnosis is one of the unconventional methods in dealing with claustrophobia Fig. 9: MRI up to 0.2T suitable for examination of the joints Page 12 of 16

13 Fig. 10: Open up-right MRI systems up to 1.2T Page 13 of 16

14 Conclusion MR Radiographers have very important role in finding a way in minimizing symptoms from claustrophobia and making as better examination as thay can. New technical advances (machine or environment) could reduce the number of canceled MRI examinations. Personal information Mijalche Minov Radiographer Policlinic Neuromedica Skopje, Republic of Macedonia [email protected] Images for this section: Page 14 of 16

15 Fig. 11: Me, my colleagues and Prof. Chepreganov-Head of Diagnostic department in Policlinic Neuromedica Page 15 of 16

16 References 1. Emotional Claustrophobia - Aphrodite Matsakis PhD (New Harbinger Publications) 2. Secrets to Beat MRI Claustrophobia - Jessie E. Lopez 3. Claustrophobic and Anxiety related reactions during MR and CT procedures - Derick Sule 4.MRI in Clinical Practice - Liney Gary 5. MRI in Practice - Catherine Westbrook; Caroline Kaut Roth; John Talbot Page 16 of 16