MRISC Organizational Chart

2. MRISC Organizational Chart Research and Graduate Studies Dr. James Tracy College of Medicine Fred de Beer, M.D. Director Dr. Charlie Smith Faculty Support MRISC Users Administrative Staff (Primary in Academic Depts) Officer Nancy Bailey Anders Andersen, Ph.D. Anatomy & Neurobiology Peter Hardy, Ph.D. Radiology MRI Technologist Beverly Meacham David Powell, Ph.D. Biomedical Engineering

3. MRI Terminology 1. Ferrous- Objects made of metal that are highly attracted to the MRI machine examples: Cast Iron, Steel, Wrought Iron 2. Nonferrous- Objects made of metal that are not attracted to the MRI machine examples: Titanium, Copper, Aluminum

4. MRI Terminology Tesla or Gauss- Magnetic field strength is measured in one of these two units 1Tesla = 10KG=10,000 Gauss Teslais used to measure higher magnetic field strengths Gaussis used to measure lower magnetic field strengths example: Earth’s magnetic field is 0.6Gauss

5. MRI Terminology 5 Gauss Line- inside the MRI room ****Electronic devices and ferromagnetic objects inside the 5 Gauss line are strictly prohibited****

6. MRI Terminology Missile Effect- Ferromagnetic metal objects such as an oxygen tank can become airborne as a projectile in the presence of a strong magnetic field.

7. MRI Terminology Fringe Field- stray magnetic field outside of the bore of themagnet

8. MRI Terminology Static Magnetic Field- is the non-fluctuating main magnetic field

9. Bioeffects: Static Magnetic Field There is a great deal of information about the possible bioeffects of static magnetic fields. Many effects cannot be reproduced consistently in a controlled environment. Most studies conclude that static magnetic fields below 2 Tesla produce no substantial harmful bioeffects.

10. Bioeffects: Static Magnetic Fields • Fields above 2 Tesla can cause the following side effects: • Nausea • Vomiting • Dizziness • Magnetophospenes

11. Bioeffects: Static Magnetic Field • Magnetophosphenes • Defined as flashes of light • Caused by the induction of the electricity within the optic nerves

12. Bioeffects: Static Magnetic Field Other biological effects at fields above 2T include: Fatigue Headaches Hypotension Irritability

13. Bioeffects: Static Magnetic Field • The FDA limits clinical magnets to 8.0 Tesla. • Most common clinical field strengths between .3 Tesla and 1.5 Tesla.

14. MRI Safety

15. Magnet Safety

16. THE INVISIBLE FORCE

19. Safety: Missile Effect

20. Safety: Projectiles • Small objects such as a paperclip can travel up to 60 mph when pulled into a 3Tesla Magnet. • The amount of force on a projectile depends on the following: • The strength of the magnetic field • The mass of the object • The distance from the magnet • The orientation to the magnetic field

25. Magnet Safety Equipment safe for MRI room: MRI Wheelchairs MRI Stretchers MRI Monitoring equipment **Equipment will be identified as MR safe** (The equipment is made of nonferrous material) ***Absolutely NO outside stretchers/wheelchairs allowed in the MR Room

27. Video- #1 Chair gets stuck in an MRI machine 27 secs

28. Video #2 MRI oxygen bottle 9sec

29. Video #3 Oxygen cylinder in MR scan room 2:01 min

30. Video #4 Gurney let loose in MR scan room 1:28 min

32. Screening

33. Safety: Pregnancy Screening Possible Pregnancy • There are no known biological effects of MRI on fetuses. • Many of the mechanisms could potentially cause adverse affects in developing fetuses • FDA requires labeling of MR systems to indicate the safety when imaging a fetus or infant. • Benefit should out weight the risk and caution should be used within the first trimester.

34. Safety: Pregnant Employees Pregnant Employees • No known effects • Should avoid RF and gradient magnetic fields. • Make your own decision

35. Subject Screening • The MRI subject questionnaire should include the following: • Subject history related to problem • Previous surgeries • Metallic foreign bodies • Possible Pregnancy • Biomedical Implants • Pacemaker • Aneurysm Clips

36. Subject Screening All subjects will have a screening form completed Forms are filed in the Study Binder kept in the MRI console area.

37. Safety: Subject Screening • Evaluating Implants • Determine type and location • Use published implant list • Call surgeon • Call manufacturer

38. Safety: Subject Screening • Evaluating Metallic Foreign Bodies: • Determine type, location, and size • Use X-ray to evaluate • Use CT to evaluate orbital objects

39. Safety: Subject Screening • Protecting From Missile Effect (Projectiles) • Remove any and all metal (lockers available) • Dress subject in gown or scrubs if required • Check all metallic items with bar magnet • Wheelchair, Patient Beds, Oxygen tanks

40. Safety: Subject Screening MRI complications with Tattoos: Rarely, tattoos or permanent makeup might cause swelling or burning in the affected areas during MRI exams. In some cases, tattoo pigments can interfere with the quality of the image — such as when a person who has permanent eyeliner has an MRI of the eye.

41. Safety: Auditory Effects MRI is a noisy procedure. Various noises come from gradients, cryogen pumps, and monitors. Gradient noise is the most potentially harmful. Caused by vibrations of the gradient coils within their fiberglass casing.

42. Safety Auditory Effects • Effects can include the following: • Annoyance • Decreased ability to communicate • Increased anxiety • Potential temporary hearing loss • Potential permanent hearing loss

43. Safety: Auditory Effects • Techniques used to reduce the risk of hearing loss during the MRI procedure include the following: • Ear plugs /Ear muffs • Active noise cancellation

44. Safety: Subject Monitoring • Who should be monitored? • Sedated subjects • Subjects with communication difficulties • Subjects with weak voices or impaired hearing • All Subjects should be monitored visually and verbally. • Give Subjects emergency squeeze ball

45. Safety: Subject Monitoring • Problems with subject monitoring include the following: • Monitors attracted to the magnet (8ft) • RF distorts monitor readings (Shielding) • Monitor causes artifacts on MRI images • Monitor wires may cause subject burns (fiber optic)

46. Safety: Subject Monitoring • Techniques used to reduce the potential for subject burns from monitors include the following: • Straighten looped cords • Eliminate direct subject contact where possible • Use only tested MRI safe devices

47. Safety: Subject Monitoring • Commonly used MRI subject monitoring techniques include the following: • EKG • Capnography • Blood Pressure • Pulse Oximetry • Ventiltor

48. Safety: Subject Monitoring • EKG monitor monitors the heart rate.

49. Safety: Subject Monitoring • Pulse Oximeter measures the oxygen level of the blood.

50. Safety: Subject Monitoring • Ventilator breaths for heavily sedated subjects that cannot breath on their own. • The monitors used in MRI are MRI safe and only used in the MRI suite.