Procedure and contraindications for MRI

Procedure for an MRI exam

What do I need to consider?

Before the examination

Please remember your referral slip, and bring any previous diagnoses and images and blood test results with you, if possible.

Before starting the examination, you must remove all metal objects. This includes watches, hearing aids, and check or credit cards. Metal components in the body, such as permanent tooth replacements, prosthetic joints, or metal plates following a bone fracture operation, typically do not present a problem. Please take note of the contraindications listed below.

During the exam

During the exam, you will be lying on a pallet that starts to move slowly into the opening of the machine, that is, toward the magnet. You will then be completely or partially—for instance, for a knee joint scan—inside the machine.

Magnetic fields switching on and off produce a relatively loud knocking noise that many patients find disturbing. For this reason, you will be given earplugs or closed ear protection; you are often able to listen to (your own) music during the exam as well. The exam takes from a few minutes to half an hour, depending on the region of the body being examined and the specific case. In some cases, a sedative—not a sleeping aid—can be administered. This means that MRI exams can be performed for all patients without a problem. Please consider that an accompanying person may be needed in such cases, as you will not be able to drive a car immediately after the exam.

Injections of a contrast agent

During the MRT exam it may be necessary to inject a special contrast agent. The injection is done in a body vein. Access is put in place prior to the exam. The administration of the contrast agent is typically not dangerous. We use only high-quality, annular contrast agents where side effects have been reported only in a few individual cases. Because the contrast agent is eliminated substantially through the kidneys, we need at least your creatinine levels if you have any kidney diseases. We would like to emphasize that the annular MRI contrast agents that we use have never been reported to have any clinical side effects to date due to buildup in the brain or the like, despite having been used millions of times. Buildup of gadolinium in the brain has been described in the literature, but this significance of this is not yet clear. For patients with limited kidney function, skin problems have been described, particularly NSF (nephrogenic systemic fibrosis). These problems have not been described for patients with normal kidney function. The contrast agents that we use are the latest generation of contrast agents—side effects due to contrast agents are very rare.

When would the exam be problematic or impossible?

Contraindications

Contraindications for an MRI exam include:

Pacemaker
Cardio-defibrillator (ICD)
Permanently implanted neurostimulators, insulin pumps, etc.
Metal splinters in the eye
Metal splinters in the body near organs, vessels, or nerves
Dental prosthetics with magnetic mounts (most are not magnetic and therefore not problematic)
Bypass vessels with magnetic mounts (most are not magnetic and therefore not problematic)

Please clarify with your doctor whether you have any contraindications to the administration of MRI contrast agents. For a heart exam (cardio MRI, cardio CT) no coffee should be drunk on the day of the exam. Do not take any erectile dysfunction medications (such as Viagra) for at least 24 hours before a cardio MRI or cardio CT exam.

It may be necessary to consult with the operator for:

Cochlear implants
Aneurysm clips in the head

The exam can be problematic in case:

Large tattoos in which the inks used contain metal particles that could heat up during the MRI
Pregnancy in the first trimester. Damaging effects of MRI on the fetus have not been proven, but an exam should nevertheless be performed only in exceptional cases and for an important reason. Administration of a contrast agent should always be avoided during pregnancy except when absolutely necessary in life-threatening situations.
Patients who suffer from claustrophobia. As a rule, however, these can be medicated in order to make the exam possible. Driving a motor vehicle or active participation in road transportation not possible afterward, however. Therefore, you should bring a companion to the exam.
When an intrauterine device (IUD, “spiral”) with metal components is used, displacements have been described in the literature. In case of doubt, the gynecologist should be consulted prior to an MRI exam to check for correct positioning after the exam.

The following do not present a problem:

Prosthetic joints
Blood vessel stents
Artificial heart valves
Wire cerclages (e.g., following heart surgery)

If MRI is contraindicated, computed tomography, another type of X-ray exam, or sonography may be used instead.

Procedure and contraindications for MRI

What do I need to consider?

Contraindications

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