PRINCIPLES OF PHARMACOLOGY

Effective claustrophobia medications have not yet evolved. Only the clinical use of MR imaging has increased even more in treating claustrophobic patients. MR imaging procedure involves intranasally administered midazolam spray in the prevention of claustrophobic responses.However, the MR imaging process is quite a lengthy one involving long duration of scanning, accompanied by additional sequences, sedation or general anesthesia.The prescribed drugs as proper claustrophobia medications include Benzodiazepines, Xanax and even Valium in certain cases.However, some precautionary measures before going for a sedation treatment include: If sedation is necessary for you for the MRI, your physician should be informed just at the time of the appointment. Arrive to the radiologist at least one our before the time of the appointment. You must have a driver to drive you home or else the radiologist will not be ready to give you your prescribed sedation. Consumption of solid food is prohibited at least for three hours before arriving the hospital. Intake of clear liquid is permissible before two hours of your arrival. Asthma medicines and smoking is strictly prohibited prior the treatment.However, with the right sort of claustrophobia medications and treatments it is extremely easy for an individual to show an exemplary improvement in his behavior by way of getting rid of unnecessary panic or phobia. http://www.phobia-fear-release.com/claustrophobia-medications.htmlThe Best Drug or Medication for ClaustrophobiaWe strongly believe that no medication isthe best prescription for claustrophobia. If you are currently taking meds, of course, you should consult with your doctor before changing anything, but we believe the goal should always be todeal with the source of the problem, so you will not need pharmaceuticals.That said, three types of medication are commonly used in the treatment of claustrophobia (claustrophobia):Beta blockersBeta blockers are used for relieving performance anxiety. They work by blocking the flow of adrenaline that occurs when youre anxious. While beta blockers dont affect the emotional symptoms of anxiety, they can control physical symptoms such as shaking hands or voice, sweating, and rapid heartbeat.AntidepressantsAntidepressants can be helpful when the feelings of fear are severe and debilitating. Three specific antidepressants Paxil, Effexor, and Zoloft have been approved by the U.S. Food and Drug Administration for phobias.BenzodiazepinesBenzodiazepines are fast-acting anti-anxiety medications. However, they are sedating and addictive, so they are typically prescribed only when other medications have not worked. http://www.changethatsrightnow.com/claustrophobia/medication-and-drugs/What causes claustrophobia?Claustrophobia is generally the result of an experience in the person's past (usually in their childhood) that has led them to associate small spaces with the feeling of panic or being in imminent danger. Examples of these kinds of past experiences are: falling into a deep pool and not being able to swim being in a crowded area and getting separated from parents/group crawling into a hole and getting lost/stuck.As the experience will have dealt some kind of trauma to the person, it will affect their ability to cope with a similar situation rationally. The mind links the small space/confined area to the feeling of being in danger and the body then reacts accordingly (or how it thinks it should).This type of cause is known asclassic conditioningand can also be a behavior inherited from parents or peers. If for example, a claustrophobic person has a child, the child may observe their parent's behavior and develop the same fears.There are other theories behind the causes of claustrophobia, these are:

The amygdalae (red areas) were found to be smaller in people with panic disorders. Smaller Amygdalae- theamygdala (plural: amygdalae)is a tiny part of the brain that is used to control how the body processes fear.

In a study published inPsychiatry and Clinical Neurosciences7, Fumi Hayano and colleagues discovered that people who suffered panic disorders had smaller amygdalae than average.

This smaller size could interfere with how the body processes panic and anxiety.

Prepared Phobia- there is also a theory that phobias develop on the genetic level rather than psychologically. The research behind this theory suggests that claustrophobia and some other phobias are dormant evolutionary survival mechanisms. A survival instinct buried within our genetic code that was once crucial to human survival but is no longer needed.

A team from Germany and the United Kingdom wrote in the journalTranslational Psychiatry2that a single gene defect probably contributes to the development of claustrophobia.How is it diagnosed?Claustrophobia is diagnosed by a psychologist or psychiatrist. The patient may be seeing the psychologist because he or she is experiencing the symptoms of claustrophobia, or the consultations could be originally about another anxiety problem or phobia.The psychologist will ask for a description of the symptoms and what triggers them. This helps determine the type and severity of the patient's phobia.The psychologist needs to rule out other anxiety disorders or phobias, such as cleithrophobia (fear of being trapped).There are methods put in place to help decide if the patient is suffering claustrophobia and to what extent. These methods are: Claustrophobia questionnaire- Originally developed in 1993 and modified in 2001, this has been a helpful way of identifying the symptoms of claustrophobia. It is especially useful in determining whether the patient's anxiety is driven by a fear of suffocation or restriction. Claustrophobia Scale- Developed in 1979, this method is made up of 20 questions that when answered can help establish the levels of anxiety when diagnosing claustrophobia. An article published inBehavior Research and Therapy3reported "The CS (Claustrophobia Scale) is useful both as a state, and as an outcome self-report measure of claustrophobia."Treatment optionsAfter diagnosis has been made, the psychologist may recommend one or some of the following methods to help the patient deal with his or her fear: CBT (Cognitive Behavioral Therapy)- This is a well recognized treatment method for most anxiety disorders. The goal of CBT is to retrain the patient's mind to no longer feel threatened by the places they fear. This may involve slowly exposing the patient to small spaces and helping them deal with their fear and anxiety (in vivo exposure).

Watching others as a cure for claustrophobia- researchers at the Karolinska Institute, Sweden, reported in the journalPsychological Sciencethat phobias may be cured by watching others interact with the source of the fear.

Drug Therapy- This type of therapy can help manage the anxiety symptoms, however, it does not deal with the problem itself. Health care professionals may use drug therapy if other interventions have not provided satisfactory results.

Relaxation Exercises- Taking deep breaths, meditating and doing muscle-relaxing exercises are effective at dealing with negative thoughts and anxiety.

Alternative/Natural medicine- There are some natural products and homeopathic medicines that some patients say help them manage panic and anxiety.http://www.medicalnewstoday.com/articles/37062.phpTreatment of specific phobia in adults Yujuan Choy,, Abby J. Fyer, Josh D. LipsitzChoy, MD, Yujuan; Fyer, Abby J.; Lipsitz, Josh D. (2007). "Treatment of specific phobia in adults".Clinical Psychology Review27(3): 266286.doi:10.1016/j.cpr.2006.10.002.http://www.sciencedirect.com/science/article/pii/S027273580Treatments and medications[edit]The following are two therapies normally used in treating specific phobia:Cognitive behavioral therapy(CBT)- a psychotherapeutic approach that addresses dysfunctional emotions, maladaptive behaviors and cognitive processes and contents through a number of goal-oriented, explicit systematic proceduresOne-session treatment (OST)- a variant of cognitive-behavioral therapy, combines graduated in vivo exposure, participant modeling, reinforcement, psychoeducation, cognitive challenges, and skills training in an intensive treatment model. Treatment is maximized to one three-hour session. The success of the treatment could be affected by the therapeutic relationship, motivation, and expectations towards the treatment and their possible relations with the outcome.A type of CBT,exposure therapy, is usually utilized. The specific exposure treatments used for specific phobia include:systematic desensitization,imaginal exposure,in vivo,virtual reality, andinteroceptive exposure.While many kinds of therapies can be used, different subgroups respond better to certain treatments. Overall,in vivotherapy displays the greatest effectiveness despite its high dropout rates; there are some exceptions however. According to theClinical Psychology Review, cognitive therapy looks like a successful solution to claustrophobia and virtual reality demonstrates equal effectiveness for fear of heights and flying. Blood-injury, in addition, responds well to applied tension. Medications have not been as encouraging with the exception of adjunctive D-clycoserine.[7]Medication- For situational phobias/ specific that produce intense, temporary anxiety (for example, a fear of flying), short-acting sedative-hypnotics (benzodiazepines)[8]Treatment[edit]Cognitive therapy[edit]Cognitive therapyis a widely accepted form of treatment for mostanxiety disorders.[16]It is also thought to be particularly effective in combating disorders where the patient doesn't actually fear a situation but, rather, fears what could result from being in such a situation.[16]The ultimate goal of cognitive therapy is to modify distorted thoughts or misconceptions associated with whatever is being feared; the theory is that modifying these thoughts will decreaseanxietyand avoidance of certain situations.[16]For example, cognitive therapy would attempt to convince a claustrophobic patient that elevators are not dangerous but are, in fact, very useful in getting you where you would like to go faster. A study conducted by S.J. Rachman shows that cognitive therapy decreased fear and negative thoughts/connotations by an average of around 30% in claustrophobic patients tested, proving it to be a reasonably effective method.[3]In vivoexposure[edit]This method forces patients to face their fears by complete exposure to whatever fear they are experiencing.[16]This is usually done in a progressive manner starting with lesser exposures and moving upward towards severe exposures.[16]For example, a claustrophobic patient would start by going into an elevator and work up to anMRI. Several studies have proven this to be an effective method in combating variousphobias, claustrophobia included.[16]S.J. Rachman has also tested the effectiveness of this method in treating claustrophobia and found it to decreasefearand negative thoughts/connotations by an average of nearly 75% in his patients.[3]Of the methods he tested in this particular study, this was by far the most significant reduction.[3]Interoceptive exposure[edit]This method attempts to recreate internal physical sensations within a patient in a controlled environment and is a less intense version ofin vivoexposure.[16]This was the final method of treatment tested by S.J. Rachman in his 1992 study.[3]It lowered fear and negative thoughts/connotations by about 25%.[3]These numbers did not quite match those of in vivo exposure or cognitive therapy, but still resulted in significant reductions.[3]Other forms of treatment that have also been shown to be reasonably effective are psychoeducation, counter-conditioning, regressive hypnotherapy and breathing re-training. Medications often prescribed to help treat claustrophobia include anti-depressants and beta-blockers, which help to relieve the heart-pounding symptoms often associated with anxiety attacks.Studies[edit]MRI procedure[edit]Because they can produce afearof bothsuffocationand restriction,MRIscans often prove difficult for claustrophobic patients.[17]In fact, estimates say that anywhere from 420% of patients refuse to go through with the scan for precisely this reason.[18]One study estimates that this percentage could be as high as 37% of all MRI recipients.[17]The averageMRItakes around 50 minutes; this is more than enough time to evoke extremefearandanxietyin a severely claustrophobic patient.This study was conducted with three goals: 1. To discover the extent ofanxietyduring anMRI. 2. To find predictors foranxietyduring anMRI. 3. To observe psychological factors of undergoing anMRI. Eighty patients were randomly chosen for this study and subjected to several diagnostic tests to rate their level of claustrophobicfear; none of these patients had previously been diagnosed with claustrophobia. They were also subjected to several of the same tests after theirMRIto see if theiranxietylevels had elevated. This experiment concludes that the primary component ofanxietyexperienced by patients was most closely connected to claustrophobia.This assertion stems from the high Claustrophobic Questionnaire results of those who reportedanxietyduring the scan. Almost 25% of the patients reported at least moderate feelings ofanxietyduring the scan and 3 were unable to complete the scan at all. When asked a month after their scan, 30% of patients (these numbers are taken of the 48 that responded a month later) reported that their claustrophobic feelings had elevated since the scan. The majority of these patients claimed to have never had claustrophobic sensations up to that point. This study concludes that the Claustrophobic Questionnaire (or an equivalent method ofdiagnosis) should be used before allowing someone to have anMRI.[17]Use of virtual reality distraction to reduce claustrophobia[edit]The present case series with two patients explored whethervirtual reality(VR) distraction could reduce claustrophobia symptoms during a mockmagnetic resonance imaging(MRI) brain scan. Two patients who metDSM-IVcriteria forspecific phobia, situational type(i.e., claustrophobia) reported high levels of anxiety during a mock 10-min MRI procedure with no VR, and asked to terminate the scan early. The patients were randomly assigned to receive either VR or music distraction for their second scan attempt. When immersed in an illusory three-dimensional (3D) virtual world named SnowWorld, patient 1 was able to complete a 10-min mock scan with low anxiety and reported an increase in self-efficacy afterwards. Patient 2 received "music only" distraction during her second scan but was still not able to complete a 10-min scan and asked to terminate her second scan early. These results suggest that immersive VR may prove effective at temporarily reducing claustrophobia symptoms during MRI scans and music may prove less effective.[19]Separating the fear of restriction and fear of suffocation[edit]Many experts who have studied claustrophobia claim that it consists of two separable components: fear ofsuffocationand fear of restriction. In an effort to fully prove this assertion, a study was conducted by three experts in order to clearly prove a difference. The study was conducted by issuing a questionnaire to 78 patients who receivedMRIs.The data was compiled into a "fear scale" of sorts with separate subscales for suffocation and confinement. Theoretically, these subscales would be different if the contributing factors are indeed separate. The study was successful in proving that the symptoms are separate. Therefore, according to this study, in order to effectively combat claustrophobia, it is necessary to attack both of these underlying causes.However, because this study only applied to people who were able to finish their MRI, those who were unable to complete the MRI were not included in the study. It is likely that many of these people dropped out because of a severe case of claustrophobia. Therefore, the absence of those who suffer the most from claustrophobia could have skewed these statistics.[18]A group of students attending theUniversity of Texas at Austinwere first given an initial diagnostic and then given a score between 1 and 5 based on their potential to have claustrophobia. Those who scored a 3 or higher were used in the study. The students were then asked how well they felt they could cope if forced to stay in a small chamber for an extended period of time. Concerns expressed in the questions asked were separated into suffocation concerns and entrapment concerns in order to distinguish between the two perceived causes of claustrophobia. The results of this study showed that the majority of students feared entrapment far more than suffocation. Because of this difference in type of fear, it can yet again be asserted that there is a clear difference in these two symptoms.[20]http://en.wikipedia.org/wiki/Claustrophobia#cite_note-Treatment-16

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1819.2009.01960.x/abstracthttp://info.blockimaging.com/when-is-short-bore-mri-too-shorthttp://www.researchgate.net/publication/263782209_How_to_Overcome_Claustrophobia_in_Closed_MRI_Systems Researchgatehttp://www.uw-anxietylab.com/uploads/7/6/0/4/7604142/judicious_sb_paper_jbtep.pdf Does the judicious use of safety behaviors improve the efficacy and acceptability of exposure therapy for claustrophobic fear?http://www.reddit.com/r/AskReddit/comments/qu41r/can_i_buy_my_own_mri_machine_and_severely/http://omicsonline.org/open-access/lowdose-lowconcentration-spinal-anesthesia-for-inguinal-herniorraphy-in-a-patient-with-claustrophobia-2155-6148.1000473.pdfhttp://www.sciencedirect.com/science/article/pii/S0010027711000692 Near space and its relation to claustrophobic fear

Magnetic Resonance Imaging (MRI)Mr Richard McIntyreProf Stacy GoergenDate last modified: May 14, 2013

1. What is Magnetic Resonance Imaging (MRI)Magnetic resonance imaging (MRI) is a scanning procedure that uses strong magnets and radio frequency pulses to generate signals from the body. These signals are detected by a radio antenna and processed by a computer to create images (or pictures) of the inside of your body.The MRI scanner is generally shaped like a large, covered box with a tunnel passing through it. A table, on which you lie, slides into the tunnel. Both ends of the scanner are open and will not close. The tunnel has lights in it and sometimes a mirror. Some of the MRI scanners have wider tunnels or are partially open (more like a 'C', rather than an 'O').

2. Why would my doctor refer me to have an MRI?There are many imaging procedures that help doctors look for and assess medical conditions. Different procedures provide different specialised information. Sometimes more than one type of imaging might be used to show information about a problem.MRI might be the best way of showing certain problems, such as for a knee injury, the brain or spine. MRI is also often used to provide additional information to other tests, such as X-ray or ultrasound.There are many different techniques or types of MRI scans that can be carried out. Each one offers theradiologist(specialist doctor) specific information, to best show what the problem might be. The information gained using MRI should help to diagnose the medical condition you might have.

top 3. How do I prepare for Magnetic Resonance Imaging (MRI)Safety in the MRI scanner is vital. The strong magnetic fields can attract and interfere with metal objects that you might have in or on you (including electronic and magnetic devices). Some of these interactions can cause harm or death (see thesection on Risks of MRIbelow).To ensure it is safe for you to have an MRI, you will be required to complete a safety questionnaire. Sometimes a questionnaire is mailed to you that you will need to complete and take with you to the appointment. If a friend or relative will be in the scanning room with you, they will also need to complete a safety questionnaire.If you have apacemakeror other implants, it is important to tell the radiology practice before having the scan. An alternative test might need to be arranged.Objects in your body that can cause particular harm or be damaged include: pacemakers, aneurysm clips, heart valve replacements, neurostimulators, cochlear implants, metal fragments in the eye, metal foreign bodies, magnetic dental implants and drug infusion pumps. Some of these implants, particularly more recent devices, might be safe to go into the MRI scanner, but have to be accurately identified for the scan to proceed.You should take any documents about your implants to the appointment. These can help to correctly identify the type of implant to assess if it is safe for you to have the MRI.It is important that you do not wear any makeup or hairspray, as many of these products have tiny metal particles that could interfere with the scan and reduce the quality of the images. They might cause the area to heat up and, on the rare occasion, burn your skin.You will not be able to take anything with you into the scan room, and there are usually lockers available. It is easier if you leave objects such as watches, jewellery, mobile phones, belts, safety pins, hairpins and credit cards at home.If you are pregnant, please discuss this with your doctor and tell the radiology practice before having the scan.If you are claustrophobic (a fear of small or enclosed spaces) and think you might not be able to proceed with the scan, advise your doctor or the MRI facility when making your appointment. Sedative (calming) medication can be given. If this happens, you will not be able to leave the facility until you are fully awake and someone else will need to drive you home.Some MRI facilities have stereos or CD and DVD players attached to the MRI scanner. You can take CDs or DVDs to listen to or watch while you are having the scan.Fasting (going without food) for a MRI procedure might be required in some cases. When you make your MRI appointment, you will be advised of any fasting requirements.Continue to take all your normal medications, unless you are otherwise advised when you make the booking for your MRI scan.Please bring any previous X-ray, computed tomography or ultrasound films. The radiologist might like to review the older studies or see if your condition has changed since your last scan.

top 4. What happens during Magnetic Resonance Imaging (MRI)?The MRI procedure will be thoroughly explained to you, and your safety questionnaire reviewed and discussed before you enter the scan room. If you have any questions, please ask theradiographer(medical imaging technologist), who will be operating the MRI scanner, as it is important that you are comfortable and know what will be happening. The radiographer will be able to see you from the control room throughout the scan.You will usually be asked to change into a gown. This increases safety, with items in your pockets not being accidentally taken into the scan room.You will be asked to lie on the scan table and given a buzzer to hold. When you squeeze it, an alarm sounds in the control room and you will be able to talk to the radiographer.The MRI scanner is very noisy during the scans. It is at a noise level that can damage your hearing. You will be given earplugs or headphones to reduce the noise to safe levels.Depending on the type of MRI you are having and your particular situation, at this point you might have: leads placed on your chest to monitor your heartbeat if having a heart scan; a small plastic tube (pulsoximeter) taped on your finger to check your breathing and heart rate if having sedative (calming) medication; and/or a needle inserted into a vein in your arm if any medication is required during the scan.If you are claustrophobic and find you are unable to proceed with the scan, a sedative can be injected. The radiology facility has special procedures for people with claustrophobia and will advise you of what to do if this applies to you.The most common medication injected is a special dye calledGadolinium contrast medium. This highlights the part of the body being scanned, which can give more information to the radiologist who is assessing your problem.Other medication might be injected; for example, to slow down your intestinal movement if having an MRI of the rectum.The part of your body to be scanned will be carefully positioned and gently secured, so you are comfortable and more likely to remain still. This part will then have special antennae (coils) positioned around it to pick up signals from your body for the computer to create images. The coils are usually encased in a plastic pad or frame. Depending on the part of the body being scanned, they might be wrapped around your shoulder or lie on top of your stomach. A frame containing the coils can be used; for example, around your knee or wrist, and also for your head and upper neck. Some coils are in the mattress of the scan bed, used when your back is being scanned.The scan table will then move into the centre of the machine. Your head might be inside or outside the scanner, depending on the part of the body being scanned.When the scan begins, you will hear a knocking noise that continues during each scan. Scanning is not continuous, and each scan varies in length from about 1 to several minutes, with a break in between. You will be able to talk to the radiographer between each scan and can press the buzzer if you are not comfortable or want to come out of the machine at any time.The scanning process is painless. You might feel warm during scanning. If you do feel anything at all, it is important you tell the radiographer carrying out the scan.You need to lie still and hold your position during the scan. In general, you can breathe normally. Occasionally, during some types of MRI, you will need to hold your breath. Breathing and movement can make the images blurry and assessment of your problem more difficult.

top 5. Are there any after effects of Magnetic Resonance Imaging (MRI)?There are no after effects of the MRI itself. You will be able to carry on your day as planned once the test has been completed.If you require sedation for the scan, the MRI facility will give clear instructions on what to do before and after the scan. You will not be able to leave until you are fully awake and you will need someone to drive you home.If you are given any medication during the scan, you might experience after effects. These are detailed in individual items on this website (such asMRI of the Rectum). The staff looking after you will discuss any after affects with you, and will help you if they do occur.

top 6. How long does Magnetic Resonance Imaging (MRI) take?The scan can take between 10minutes to over an hour to complete. This depends on the part of the body being imaged and what type of MRI is required to show the information. Before the scan begins, the radiographer will tell you how long the scan takes, so you know what to expect. Occasionally, you might need to return for delayed scans, usually after 1 or 2hours, mostly with scanning of the liver.If you received sedative medication, this will increase the time you will need to stay at the MRI facility.

top 7. What are the risks of Magnetic Resonance Imaging (MRI)?There are no known side-effects of an MRI, providing you do not have any implants or objects that must not go in the scanner.The danger from the MRI is due to interactions of objects with magnetic fields. Metal objects can move, as well as get hot, and electrical currents can be produced and lead to malfunction of a device. A strong magnet can alter or wipe information from other magnetic devices. Some of these interactions can cause harm or death.Some implants, such as pacemakers, defibrillators, hearing devices and drug pumps, make it unsafe for a person to have a scan. It is important you complete the safety questionnaire fully and contact the facility where you are having the MRI if you have any questions about the implants you have. The radiographers have literature about most implants. They might ask you or your doctor for more information on any implants you have, and will find out whether it is safe for you to go in the scanner.Metal objects that are attracted to magnets (called ferromagnetic objects), such as buckets, chairs or objects in your pocket, can be pulled rapidly, like a missile, into the MRI machine. These can damage the machine, as well as injure anyone in the way. People have died due to injuries cause by this.Other metal in your body might move if not well fixed. These would include metal fragments in your eyes, which can interfere with vision if they move in the MRI. Most implants (hip replacements for example) are well fixed, and are usually made of non-magnetic or only weakly magnetic materials and are not a problem. Clips in the brain, used on an aneurysm (dilated blood vessel or out-pouching of a vessel), must be non-magnetic or they cannot be scanned.Heating of metal can cause burns, such as from necklaces, and these will be removed before the scan. Some catheters (fine tubes usually in your blood vessels) can melt if they contain a wire.Electronic devices can be damaged and not work by moving in the body, heating and also having abnormal electrical currents. A pacemaker is a common device that can exclude you from having an MRI scan.Magnetic dental implants will no longer remain attached if placed in the strong magnetic fields of the MRI scanner. Magnetic strips, such as on credit cards, can also be damaged.If you are pregnant, please discuss the scan with your doctor and tell the MRI facility before your procedure. This will not necessarily stop you from having the scan. There are no reported effects of an MRI on the unborn child, but caution is always used in pregnancy.If you are required to have an injection ofGadolinium contrast medium, there is a very small risk of an allergic reaction. Gadolinium contrast medium is generally very safe, but as with all medications, allergic reactions can occur. Minor reactions (such as hives or itchy eyes) can occur in approximately 1 in 1000 people. More significant reactions (difficulty in breathing or collapse) might occur in 1 in 10,000 people. The hospital radiology department or radiology practice where you are having the scan will treat you if you have an allergic reaction. There is a small risk of an allergic reaction to any of the medications that might be given during an MRI scan.If you have a history of kidney disease, you should have a blood test before the scan to ensure that the contrast medium can be given safely. Nephrogenic systemic fibrosis is a rare, but serious complication following a gadolinium chelate injection (seeGadolinium Contrast Medium (MRI Contrast agents)) in people with very poor kidney function.The chance of an allergic reaction to the contrast medium is very small, but please ask the MRI radiographer about the injection to obtain more information.

top 8. What are the benefits of Magnetic Resonance Imaging (MRI)?MRI has no known long-term harmful effects, provided the safety precautions are followed. MRI does not use radiation. Avoiding the need for exposure to radiation (X-rays) is of significant benefit to younger people and children, and MRI can also be used safely in pregnancy, if required.MRI is capable of providing your doctor with a wide range of information about your body and particular diseases or conditions you might have. It can show certain conditions that other tests cant show. The benefits of MRI depend on the part of the body being imaged, and specific benefits are covered in individual items on this website (seeBreast MRIorMRI of the Rectum, for example).MRI can image most parts of the body in any direction to obtain maximum information and provides this information in high-quality images. These images give accurate details about certain processes or structures within the body and can also provide information as data or graphs.

top 9. Who does Magnetic Resonance Imaging (MRI)?Aradiographer(medical imaging technologist), who is specially trained in MRI, is responsible for looking after you in the hospital department or private radiology practice, and for taking the scans. The scans are then passed to aradiologist(a specialist doctor), who interprets these and provides a written report to the doctor who referred you for the scan.

top 10. Where is Magnetic Resonance Imaging (MRI) done?Most private and public hospitals, and private radiology practices have MRI scanners. You can contact your local hospital, radiology practice or your referring doctor for a list of places that have an MRI scanner.

top 11. When can I expect the results of my Magnetic Resonance Imaging (MRI)?The time that it takes your doctor to receive a written report on the test or procedure you have had will vary, depending on: the urgency with which the result is needed; the complexity of the examination; whether more information is needed from your doctor before the examination can be interpreted by the radiologist; whether you have had previous X-rays or other medical imaging that needs to be compared with this new test or procedure (this is commonly the case if you have a disease or condition that is being followed to assess your progress); how the report is conveyed from the practice or hospital to your doctor (i.e. phone, email, fax or mail).Please feel free to ask the private practice, clinic or hospital where you are having your test or procedure when your doctor is likely to have the written report.It is important that you discuss the results with the doctor who referred you, either in person or on the telephone, so that they can explain what the results mean for you.

MRI (magnetic resonance imaging) and MR angiography

A+|Reset|A-OverviewMRI (magnetic resonance imaging) is a noninvasive diagnostic test that takes detailed images of the soft tissues of the body. Unlike X-rays or CT, images are created by using a magnetic field, radio waves, and a computer. It allows your doctor to view your spine or brain in slices, as if it were sliced layer-by-layer and a picture taken of each slice. This test can help diagnose tumors, strokes, and disc herniations.How does an MRI work?An MRI scan works by using a powerful magnet, radio waves, and a computer to create detailed images. Your body is made up of millions of hydrogen atoms (the human body is 80% water), which are magnetic. When your body is placed in the magnetic field, these atoms align with the field, much like a compass points to the North Pole. A radio wave knocks down the atoms and disrupts their polarity. The sensor detects the time it takes for the atoms to return to their original alignment. In essence, MRI measures the water content (or fluid characteristics) of different tissues, which is processed by the computer to create a black and white image. The image is highly detailed and can show even the smallest abnormality.Similar to CT, MRI allows your doctor to see your body in narrow slices, each about one quarter of an inch thick. For example, imagine that you are slicing a loaf of bread and taking a picture of each slice. It can view slices from the bottom (axial), front (coronal), or sides (sagittal), depending on what your doctor needs to see.A dye (contrast agent) may be injected into your bloodstream to enhance certain tissues. The dye contains gadolinium, which has magnetic properties. It circulates through the blood stream and is absorbed in certain tissues, which then stand out on the scan.MR angiogram (MRA).MRI can be used to view arteries and veins. Standard MRI cant see fluid that is moving, such as blood in an artery, and this creates flow voids that appear as black holes on the image. Contrast dye (gadolinium) injected into the bloodstream helps the computer see the arteries and veins. Contrast is also used to view tumors and arteriovenous malformations (AVMs).What does an MRI show?Nearly every part of the body may be studied with MRI. MRI gives very detailed pictures of soft tissues like the brain. Air and hard bone do not give an MRI signal so these areas appear black. Bone marrow, spinal fluid, blood and soft tissues vary in intensity from black to white, depending on the amount of fat and water present in each tissue and the machine settings used for the scan. The radiologist compares the size and distributions of these bright and dark areas to determine whether a tissue is healthy. Head and neck(Fig. 1). MRI can be used to detect brain tumors, traumatic brain injury, developmental anomalies, multiple sclerosis, stroke, dementia, infection, and the causes of headache.

Figure 1. MRI of the brain. Arteries and veins(Fig. 2). MRA can detect aneurysms, blockages of the blood vessels, carotid artery disease, and arteriovenous malformations.

Figure 2. MRA of the brain arteries. Spine(Fig. 3). MRI is sensitive to changes in cartilage and bone structure resulting from injury, disease, or aging. It can detect herniated discs, pinched nerves, spinal tumors, spinal cord compression, and fractures.

Figure 3. MRI of the lumbar spine.Types of MRI scanners Standard MRI:this machine looks like a long cylinder with a narrow tube in the center. You lay on a moveable bed and your whole body slides inside the tube. Even though this machine can be confining to some people, it produces the best-looking images. Short-bore MRI:this machine is similar to the standard, but its about half the length. If you are having pictures taken of your head, then your feet will stick out one end of the tube; if your back is being imaged, then your head will stick out. You may find this option more tolerable if tight spaces make you anxious (Fig. 4).

Figure 4. Viewed from the side, a short bore MRI is half the length of a standard MRI, which means your whole body does not have to be inside the scanner, just the area being imaged. Open MRI:this machine is designed more like a bagel sliced in half rather than a donut hole. It is a good choice for large or claustrophobic patients because there is much more room inside the machine. The only disadvantage is that the images it produces are not as detailed as those made by the standard or short-bore MRI scanners (Fig. 5).

Figure 5. Viewed from the front, an open MRI resembles a bagel more than a donut, allowing the person being scanned more room.Who performs the test?A radiology technologist will perform the test in the MRI suite of the Radiology department of the hospital or outpatient imaging center.How should I prepare for the test? Avoid caffeinated beverages. Wear comfortable clothes since you will be lying still for about 30 minutes. Avoid wearing jewelry and metal, and remove credit cards. Bring any relevant X-rays, CT scans, or previous MRI exams. Bring your insurance identification card if you have one.What happens during the test?You will lie on a moveable bed with your head cradled on a headrest and your arms at your sides. An antenna device, called a coil, will be placed over or around the area of the body to be imaged. It is specialized to produce the clearest picture of the area it is placed over.If the MRI scan will be used for surgical planning, the technologist may place small markers called fiducials on your forehead, face, or behind your ear. Fiducials look like lifesavers and assist the surgeon during image-guided surgery. Do not remove or get the fiducials wet.When you are comfortably positioned, the table will slowly move into the magnetic field. The technologist will stay in constant contact with you. You can listen to music on a stereo system during your testing. As the exam proceeds, you will hear a muffled thumping sound for several minutes at a time. This is the sound of the pictures being taken. There will be no pain or discomfort associated with the sound or exam.The exam usually takes 20 to 50 minutes. It is important that you relax and lie as still as possible. Any movement during this time will blur the picture. You may be given an injection of contrast dye (gadolinium) into your arm or through an IV to enhance the images. After the test is complete, the IV will be removed and you are free to go. You may be told to drink lots of fluids to help your kidneys remove the contrast dye from your body.What are the risks?MRI is very safe. There are no known health risks associated with the magnetic field or the radio waves used by the machine. Some people are sensitive to the contrast agent and may develop an allergic reaction. All contrast agents are FDA-approved and safe.Be sure to tell your doctor if you have diabetes or kidney problems. In some cases a kidney function test may be needed prior to the MRI to make sure your kidneys are able to clear the contrast agent from your body.Some special circumstances limit the use of a magnetic field, so its important for you to tell your doctor if any of the following apply to you: cardiac pacemaker or artificial heart valve metal plate, pin, or other metallic implant piercings (particularly body piercing) intrauterine device, such as Copper-7 IUD insulin or other drug pump aneurysm clips previous gunshot wound cochlear implant or other hearing device employment history as a metalworker (had metal in eye) permanent (tattoo) eye-linerAny metallic substance on your body can affect the quality of the images. It can also cause discomfort or injury to you when placed in the magnetic field, and may exclude you from the exam.Also, be sure to tell your doctor if youre pregnant. The American College of Radiology recommends that MRI scanning not be done in the first trimester of pregnancy. After the first trimester, there is no definitive research indicating that MRI is contraindicated in pregnancy. However, you will need to obtain a written order from your gynecologist for the test to be performed.How do I get the test results?The radiologist will promptly review your images and communicate directly with your referring doctor, who in turn will discuss the results with you.Sources & linksIf you have further questions about this diagnostic test, contact the doctor that ordered the test or visitwww.radiologyinfo.org.Glossarycontrast agent:a liquid (usually iodine or gadolinium) that is injected into your body to make certain tissues show up clearly during diagnostic imaging.gadolinium:a type of contrast agent used during MRI.radiofrequency:radiation used in MRI whose waves are in the frequency range of 300 MHz to 3 kHz.radiologist:a doctor who specializes in reading X-rays and other diagnostic scans.X-ray:electromagnetic radiation used in diagnostic imaging to view shadows of tissue density in the body, also called roentgenogram.Open MRI vs. Traditional MRI - Should I be open to the idea?POSTED BY: Ivy GuardiolaSeptember 26, 2012

Open MRI vs. Traditional MRI - Should I be open to the idea?Have you ever had to stop during a magnetic resonance imaging (MRI) because of anxiety over the enclosed space? Research shows around 15 percent of all people suffer from claustrophobia, and not everyone knows they suffer from it until they have their MRI appointment scheduled. Its important to know your options for next time. Basic Types of MRI ScannersTraditional closed MRI scannerThe traditional MRI unit is a large cylinder-shaped tube surrounded by a circular magnet, closed at the end of the cylinder. Even though this machine can be confining to some people, it produces the best-looking images.If you arent scared of tight or dark spaces or high noises, can tune out external influences and can hold still for 30-45 minutes, this is a good option for you.Short-bore/open ended MRI scannerThis machine is similar to the standard, but its about half the length. If you are having pictures taken of your head, then your feet will stick out one end of the tube and vice-versa.This MRI is used on similar candidates to the traditional MRI. However, you might find it more tolerable if you think tight spaces may make you anxious.Wide-bore MRI scannerThis MRI has a bigger opening offering nearly a half foot more space in diameter. It provides room for lying on your side or raising your knees.This scanner is great for people with large or broad frames, including athletes, as well as those with claustrophobia.Open MRI scannerThis type of machine is designed more like a bagel sliced in half rather than a donut hole. Its open around it so you get a view around yourself.This machine might be a good choice for large or claustrophobic patients because there is much more room inside the machine.In addition to understanding your options for MRI machines, its important to evaluate any type of exam restrictions that any of these machines might have. Your physician and radiologists will be able to guide you on what and what not can be done at any of these machines. Also, audiovisual amenities are very useful to ease the anxiety and entertain you while your MRI exam can take around 30-45 minutes.Visit us atwww.FloridaHospitalFRi.comfor more information on this or any other imaging modality.https://www.floridahospital.com/blog/open-mri-vs-traditional-mri-should-i-be-open-idea#sthash.66tVmJkQ.dpuf

Top 5 ways to relieve MRI claustrophobia.The number five means of relieving MRI claustrophobia is a common 'solution' so we included it purely for informational value. However, it is also the 'solution' with the most risk. Think accordingly.DRUG THERAPYWhoa... Drugs? Well it is a common manner in relieving anxiety.

If clausrophobia is something you suffer from or think might prevent you from completing an important MRI proceedure, let your doctor know. He or she may prescribe drugs to control the panic and physical symptoms of claustrophobia, specifically related to getting an MRI proceedure. But there's the catch - and an important one - they must be perscribed by your doctor and approved by the facility doing the MRI. Why?....

While 'Taking the edge off' with drugs may help many people get through their anxiety during the scan itself, it should be strongly pointed out that the drugs they might take help temporarily may help, they are simply a mask.

Don't kid yourself. The drugs won't actually cure the actual claustrophobia, they simply suppress the symptoms for just a long enough time to get through the test. And for some, that may just do the trick.

No drug has ever been developed specifically for claustrophobia.

So maybe if the MRI is a one-time thing and maybe if you con't see any other option and maybe if your doctor and your radiologist prescribed it for you and approve it's use during the test then maybe, just maybe, it might be right for you.

It should be strongly noted that if a patient takes any sort of drug for the test that they inform the radiologist doing the proceedure and they find someone to help them home until the effects of the drug wears off.