Performing MRI studies

Performing MRI Studies

Magnetic Resonance Imaging (MRI) uses strong magnetic fields and radio waves to create detailed images of soft tissue, organs, and the brain. Unlike CT and X-ray, MRI does not use ionizing radiation, making it particularly valuable for repeated imaging and pediatric patients. However, MRI has strict safety protocols due to the strong magnetic field. After acquiring MRI images, results must be documented and archived for radiologist interpretation.

Before you start

• The patient must have an active MRI order in the system.
• You must be a certified MRI technologist or trained MRI operator.
• Ensure the MRI scanner is functioning properly and has been recently quality-assured.
• Confirm the anatomical region, sequences, and protocol (e.g., "brain with and without contrast").
• Screen for contraindications:
  • Ferromagnetic implants (pacemakers, metallic prostheses, non-MRI-safe aneurysm clips).
  • Metal fragments in eyes or body.
  • Severe claustrophobia.
  • Pregnancy (especially in first trimester; consult radiologist if contraindication unclear).

Steps

1. Navigate to the Diagnostics & Laboratory section and locate the pending MRI order. Open in Usystems

2. Verify patient identity using two identifiers before the scan.

3. Conduct a comprehensive safety screening:

   • Use a standard MRI safety questionnaire.
   • Ask about all implants, devices, metallic objects, and prior surgeries.
   • If the patient has an implant or device, verify MRI safety with the device manufacturer or medical records.
   • Remove or document all metallic objects (jewelry, watches, hairpins, dentures, etc.).
   • Have the patient remove outer clothing and change into an MRI gown if needed.

4. Brief the patient on the procedure:

   • Explain the loud banging noise during scanning.
   • Mention the examination duration and need to remain still.
   • Assure the patient that an alarm call button is available if needed.
   • Explain any breath-hold instructions (if applicable to the protocol).

5. Position the patient on the MRI table with appropriate coils and padding for comfort and signal reception.

6. Administer contrast if ordered:

   • Use an MRI-compatible IV injector for gadolinium contrast.
   • Ensure IV access is secure and contrast dose is verified.
   • Follow the facility's timing protocol for optimal imaging.

7. Perform MRI acquisition:

   • Set imaging parameters (sequences, field of view, repetition time) according to the protocol.
   • Ensure the patient can communicate (intercom system).
   • Acquire T1, T2, FLAIR, or other sequences as prescribed.
   • Monitor the patient for discomfort or anxiety; provide reassurance.
   • Acquire additional sequences or localizers as needed based on initial images.

8. Assess image quality in real time. If images are degraded by patient motion or artifact, repeat acquisitions as needed.

9. Document the study in the system:

   • Mark the study as Complete or Performed.
   • Record the date, time, and MRI scanner model used.
   • Note the sequences acquired (e.g., "T1, T2, FLAIR, DWI").
   • Specify if contrast was used (type and amount).
   • Document the magnetic field strength (1.5T, 3T, etc.).
   • Add notes about patient cooperation, motion artifacts, or technical issues.
   • Record any adverse reactions or patient concerns.

10. Save the study. Images are transferred to PACS and made available for radiologist interpretation.

What happens next

• MRI images are archived in the imaging system.
• A radiologist reviews the images and writes an interpretation report.
• The report is added to the patient's medical record.
• The ordering physician is notified that results are available.

Tips & common mistakes

• Safety first: MRI safety screening is non-negotiable; metal in the bore can cause serious injury or death. When in doubt, do not scan.
• Know your protocols: different anatomical regions require different sequences; verify you are using the correct protocol for the order.
• Patient comfort matters: anxious patients may move more; calm reassurance reduces retakes and improves image quality.
• Document artifacts: if patient motion or other artifacts degrade image quality, document this so the radiologist can interpret with full context.