PATIENT PREPARATION

FOR IMAGING AND

RADIOLOGICAL
PROCEDURES
1.
2.
3.
4.
5.
6.
7.

Mohamad Afif bin Mohd Radzi

Mahirah bt. Ab. Rahim
Sofia Syahira bt. Badrol Hisham
Nurdiana Syaheera bt. Mustapha
Fatin Aqilah bt. Hasnan
Noor Atikah bt. Abd Rashid
Alyaa Diyanah bt. Fadzlan

BARIUM SWALLOW,
BARIUM MEAL,
BARIUM ENEMA
MOHAMAD AFIF B. MOHD RADZI
012011100145

CONTRAST MEDIA
Barium suspension is made up from pure Barium
Sulphate
Advantages of Barium :
excellent coating which allow demonstration of
mucosal pattern
low cost
Disadvantages of Barium :
High morbidity if leaks into peritoneal cavity
Difficult to do CT scan and Ultrasound due to presence of Barium
on musoca ( therefore, CT and US should be done prior to Ba
study)

Barium must be mix with Pharmacological Agents

PHARMACOLOGICAL AGENT :
1. BUSCOPAN ( Hyoscine N Butyl Bromide )
An antimuscarinic agent that inhibits
intestinal motility and gastric secretion
Advantage : immediate onset , short action
duration, cost
DISADVANTAGE
:
Blurring of
vision
Dry mouth
Thacycardia
Urinary
retention
Acute gastric
dilatation

CONTRAINDICATION
S:
Closed angle
glaucoma
Myasthenia
gravis
Paralytic ileus
Pyloric stenosis
Prostatic
enlargement

2. GLUCAGON
A hormone that has hyperglycaemic effect &
causes smooth muscle relaxant
Advantages : more potent than Buscopan

DISADVANTAGES :
Hypersensitivity
reaction
Long onset of
action (1minute)

CONTRAINDICATION
:
Phaechromocyto
ma (glucagon can
cause the tumor to
release
cathecolamine)
Insulinoma
Glucagonoma

BARIUM SWALLOW
AIM : To detect abnormalities of the esophagus
INDICATIONS
1. Dysphagia
2. Anaemia
3. Abdominal pain
4. Assessment of tracheo-esophageal fistulae
5. Assessment of the site of perforation
CONTRAST VOLUME : 100 ml of 250% Barium

CONTRAINDICATION :
* Water soluble contrast agents should be used
instead of Barium in these cases :
Suspected perforation
Risk of aspiration
Suspected tracheo-esophageal OR bronchoesophageal fistula
Post operative assesment for leak
COMPLICATIONS :
1. Leakage of Barium from an unsuspected
perforation
2. Aspiration

Patient preparation for Barium Swallow :

1. Overnight fasting
2. Avoiding smoking / chewing gum to decrease
secretions in oral cavity and pharynx.

Picture on the left

shows the smooth
outline and indentation
made by the aortic
arch (arrow)
Picture on the right
shows the parallel
mucosal folds, after the
main volume of barium
has passed

BARIUM MEAL
AIM : To detect abnormality of the stomach and
duodenum
METHODS :
1. Double contrast : demonstrate mucosal pattern
2. Single contrast : demonstrate gross pathology
CONTRAST VOLUME :
1. 135 ml of 250% Barium
2. Carbex granules (double contrast)

INDICATIONS :
1. Dyspepsia
2. Weight loss
3. Upper abdominal mass
4. GI hemorrhage / iron deficiency anaemia
5. Partial obstruction
6. Assessment of site of perforation
7. Failed endoscopy
CONTRAINDICATION : Complete large bowel obstruction
PATIENT PREPARATION :
8. Fasting 6 hours before
9. Stop cigarette smoking on the day of procedure

AFTERCARE :
1. Warn patient about white bowel motion
2. Drink adequate water with/without laxatives
3. Wait untill blurring of vision resolves (Buscopan)
COMPLICATIONS :
4. Leakage of barium from unsespected perforation
5. Aspiration of stomach contents
6. Impaction of barium
7. Barium appendicitis

BARIUM ENEMA
INDICATIONS :
Change in bowel habit
Abdominal pain
Abdominal mass
Melena / anaemia
Intestinal obstruction
CONTRAST VOLUME :
1. 500 ml of 115% Barium
2. Air

METHODS :
1. Double contrast : to demonstrate mucosal
pattern
2. Single contrast : to demonstrates gross
pathology in children & reduction of an
intussusception
CONTRAINDICATONS :
.Toxic megacolon
.Pseudomembranous collitis
.Recent rectal biopsy
.Incomplete bowel preparation
.Recent barium meal

PATIENT PREPARATION :
3 days prior to examination :
low residue diet
1 day prior to examination :
Fluids only
Picolax ( a laxative for bowel clearance )
On the day of examination :
antibiotic prophylaxis
( amoxicillin / vancomycin + gentamycin )

AFTERCARE :
White bowel motion
Wait untill blurring of vision resolved (Buscopan)
COMPLICATIONS :
o Bowel perforation :
Infants & elderly
Obstructing neoplasm
Ulceration of bowel wall
Inflation of Foley catheter balloon in colonostomy
Steroid therapy patient
Hypothyroidism

o
o
o
o

Transient bacteraemia
Cardiac arrythmia
Intramural barium
Barium pulmonary embolus

HEPATOBILIARY
SYSTEM
PROCEDURES

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

(ERCP)
PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY (PTC)

MAHIRAH BT. AB. RAHIM

012011100070

ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY (ERCP)

Endoscopic retrograde
cholangiopancreatography(ERCP) is a
diagnostic and
interventionalproceduretechnique using
bothendoscopy and fluoroscopy for
examination and intervention of
thebiliary treeandpancreatic ducts.

INDICATIONS OF ERCP

DIAGNOSTIC

Evaluation of Biliary tract Obstruction suspected or

known

Evaluation of Pancreatic duct Obstruction suspected or

known

Evaluation of signs/symptoms suggesting pancreatic

THERAPEUTICS
malignancy
Stent
placement
Investigation
of diffuse biliary disease, e.g. sclerosing
Balloon
dilatation of ductal strictures
cholangitis
Tissue biopsy from biliary or pancreatic ducts
Sphincterotomy

CONTRAINDICATIONS OF
ERCP
Oesophageal obstruction; varices; pyloric
stenosis

Previous gastric surgery

Evaluation of abdominal pain of obscure origin

in the absence of objective findings which
suggest biliary or pancreatic disease

Evaluation of suspected gallbladder disease

without evidence of bile duct disease

When glucagon or Buscopan are

contraindicated

PATIENT PREPARATION FOR

ERCP
Patient will be asked not to eat or drink anything for 6 - 8
hours before the procedure ( no bowel prep needed )
Patients current medications, and any allergies to
medications
Before the procedure begins, you may be given local
anesthetic (a numbing spray applied onto the throat or
gargled).
IV sedation patient not usually intubated
Antibiotic cover

COMPLICATIONS OF ERCP
Due to the contrast medium
1. 'Allergic reactions' - rare
2. Acute pancreatitis - more likely with large volumes, high
pressure injections.
Due to the technique
Local
-Damage by the endoscope, e.g. rupture of the oesophagus,
duodenal perforation, damage to the ampulla, proximal
pancreatic duct and distal common duct.
Distant
Bacteraemia,
septicaemia,
aspiration
pneumonitis,
hyperamylasaemia (approx. 70%), acute pancreatitis, postERCP pancreatitis - normally mild

PERCUTANEOUS TRANSHEPATIC
CHOLANGIOGRAPHY (PTC)
Percutaneous transhepatic
cholangiography (PTC) is a radiologic
technique used to visualize the
anatomy of the biliary tract.
A contrast medium is injected into a
bile duct through the liver, after
which X-rays are taken.

INDICATIONS OF PTC
Failed ERCP in treating distal CBD obstruction
ERCP not feasible (e.g. patients with gastrojejunostomy)
Assessment of high biliary obstruction especially at
Hilar region (Porta hepatic)
To identify obstructive cause of jaundice; and
differentiate from medically treatable cause
Introducing stents across the obstruction

CONTRAINDICATIONS OF
PTC
Bleeding tendency: - platelets less
than 100 000 - prothrombin time 2 s
greater than control
Biliary tract sepsis
Non-availability of prompt surgical
facilities, or a patient who is unfit for
surgery
Hydatid disease.

PATIENT PREPARATION FOR

PTC
Haemoglobin, prothrombin time and platelets

are checked and corrected if necessary.

Prophylactic antibiotics T. Ampicillin 500 mg

q.d.s. to commence 24 h before and continue

for 3 days after the examination.
Nil by mouth for 5 hours prior to the procedure.
Premedication.

COMPLICATIONS OF
PTC
Due to the contrast medium
Allergic/idiosyncratic reactions - very uncommon.
Due to the technique
Local
1. Puncture of extrahepatic structures
2. Intrathoracic injection
3. Cholangitis
4. Bile leakage - may lead to biliary peritonitis (incidence
0.5%).
5. Subphrenic abscess
6. Haemorrhage
7. Shock - owing to injection into the region of the coeliac
plexus.
. Generalized
Bacteraemia, septicaemia and endotoxic shock. The
likelihood of sepsis is greatest in the presence of

REFERENCES
Chapman S, Nakielny R, A Guide to
Radiological Procedures, 6th edition,
Saunders Ltd. USA, 2013
http://
patient.info/doctor/endoscopic-retro
grade-cholangiopancreatography
http://
radiopaedia.org/articles/percutaneou
s-transhepatic-cholangiography

THANK YOU

INDICATIONS AND PREPARATIONS

OF ULTRASOUND

SOFIA SYAHIRA BT BADROL

HISHAM

ULTRASOUND?
medical test that uses high-frequency sound waves
to capture live images from the inside of your body.
non-invasive test (safe and painless) and nonionizing
usage of a small transducer (probe) and ultrasound
gel placed directly on the skin.
High-frequency sound waves are transmitted from
the probe through the gel into the body.
The transducer collects the sounds that bounce
back and a computer then uses those sound waves
to create an image.
also known as sonography

 Used to :
- help physicians evaluate symptoms (pain,
swelling, infection)
- examining body's internal organs
- guide procedures such as needle biopsies

Doppler USG, see and evaluate :

blockages to blood flow (such as clots).
narrowing of vessels.
tumors and congenital vascular malformations.

ULTRASOUND FOR
HEPATOBILIARY SYSTEM

Indications:
visualize and assess liver and gallbladder
structure and function
assist in obtaining a biopsy,
diagnose disorders such as gallstones, cancer,
tumors, cysts, and bleeding.
evaluate the effectiveness of therapeutic interventions.
Eg : suspected gallstone
: right upper quadrant pain
: jaundice
: acute pancreatitis
: fever with unknown origin
: guided percutaneous procedures

Contrast
Done without contrast

Patient preparations
Fasting for at least 6 h, preferably overnight.
Water might be allowed.
You may be asked to eat fat-meal in the evening before
the test and then to avoid eating 8 to 12 hours before
the test.

Contraindication
No contraindication

ULTRASOUND FOR RENAL

SYSTEM

Indications:

visualize and assess the kidneys

perform biopsies
diagnosing disorders such as tumor, cancer, stones, and
congenital anomalies.
evaluate therapeutic interventions such as transplants.
Eg : suspected renal mass lesion
: suspected renal parenchymal disease
: possible renal obstruction
: haematuria
: renal cystic disease
: facilitate accurate needle placement in interventional
procedures

Contrast
Done without contrast
Patient preparations
bowel gas must be displaced
filling the urinary bladder to capacity.
The patient should be instructed to drink 1-2
pints of water during the hour prior to scanning
and not to empty their bladder.
Contraindication
No contraindication

Referrences
A GUIDE TO RADIOLOGICAL PROCEDURE by
chapman & nakielny
http://www.radiologyinfo.org/en/info.cfm?pg=
genus
http://www.labdxtest.com/labdxtest/view/Dav
is-Lab-and-Diagnostic-Tests/425161/all/Ultr
asound_Kidney?q=ultrasound%2C%20renal%20sys
tem&ti=0
http://www.labdxtest.com/labdxtest/view/Davi
s-Lab-and-Diagnostic-Tests/425315/all/Ultras

RENAL AND
REPRODUCTIVE SYSTEM

INTRAVENOUS UROGRAPHY (IVU)

A radiographic study of the renal
parenchyma, pelvicalyceal system,
ureters and urinary bladder.

Indications
Check for anatomical
variants or congenital
anomalies
Check the course of
the ureters
Detect and localise a
ureteric obstruction
Assess for
synchronous upper
tract disease in those
with bladder
transitional cell
carcinoma

Contraindication
A previous severe
adverse reaction to
contrast medium
Asthma or severe allergy
Hypersensitivity to
iodine
Infancy, thyrotoxicosis
Using B-blocker, heart
disease
Hepatic failure and renal
impairment
Poor hydration
Sickle-cell anaemia

Normal examination

Bladder calculi

Left Staghorn
kidney

Patient Preparation
No food 5 hours prior to the
examination.
Patient should be ambulant 2 hour
prior to the examination to reduce
bowel gas

Complications
Due to contrast medium

Pain at the injection

site
A feeling warmth or
flushing
Nausea and vomiting
Hives
Anaphylactic shock
Acute renal failure in
DM patient,
hypertension patient
and heart disease.

Due to technique

Incorrectly applied
abdominal
compression may
produce intolerable
discomfort or
hypotension

Contrast Medium
(HOCM OR LOCM 370)
LOCM
Infants and small
children
Elderly
Poor hydrated patient
Patient with diabetes,
myelomatosis, sickle-cell
anaemia
Patient who had a
previous severe contrast
medium reaction with
LOCM or allergic history

Dosage

Adult - 50 ml
Paediatric - 1ml per
kg

MICTURATING
CYSTOURETHROGRAPH
Y
(MCU)

A specialised X-ray pictures to assess

the structure and function of lower
urinary tract such as bladder and
urethra.

Indications
Vesicouretric reflux
Study of the urethra during
mictuirition
Abnormalities of the bladder
Stress incontinence
UTI, dysuria, hydronephrosis
Hematuria
Trauma
Congenital anomalies of
GUT

Contraindications

Acute urinary tract

infection

Partial ureteral
duplication

Normal MCU
Vesicoureteric

Equipments

Contrast medium of
HOCM or LOCM 150
Fluoroscopy unit with
spot film device and
tilting table
Video recorder
Jaques or foley`s
catheter

Patient
preparation

The patient
mictuirates prior to
the examination

Film

Aftercare

Should include sacrum

and symphysis pubis
Lateral bladder
Lateral bladder,
straining
Lateral bladder during
mictuiriation

Warned about dysuria,

urinary retention
Give antibiotics to
treat recent UTI.

Complications
Due to contrast medium

Due to technique

Adverse reaction may

result from absorption
of contrast medium by
bladder mucosa
Contrast mediuminduced cystitis

Acute UTI
Catheter trauma
Perforation from over
distension
Catheterization of
vagina or an ectopic
ureteral orifice
Retention of Foley`s
catheter

HYSTEROSALPINGOGRAPHY (HSG)
This is a special x-ray using dye to
look at the uterus and fallopian tube.

Indications
Infertility
Recurrent miscarriage
Following tubal
surgery
Assessment of the
integrity of a
caesarean uterine scar

Contraindications
Pregnancy
A purulent discharge
of the vulva or cervix
or diagnosed as PID
patient
Recent dilatation
&curettage or
abortion, immediately
post menstruation
Contrast sensitivity

Normal finding on
HSG

Blockage of fallopian
tube

Equipments
Fluoroscopy unit with
spot film device
Vaginal speculum
Vulsellum forceps
Uterine cannula,
Leech-Wilkinson
canula, olive or 8-F
paediatric Foley
catheter

Contrast medium

HOCM or LOCM 300

Volume 10-20ml

Complications
Due to contrast
medium

Allergic phenomena

Due to technique
Pain.
Bleeding
Transient nausea,
vomitting and
headache
Intravasation of
contrast medium into
the venous system
Infection
abortion

Preparation
This procedure is best
performed one week
after menstruation but
before ovulation
On the night before the
procedure, patient
given laxative or an
enema to empty bowel
Make sure patient is
not pregnant, allergy
Patient may be given
sedative to minimize
the discomfort

Film
Preliminary film by
coned PA view of the
pelvic cavity
Using undercouch tube
1. As the tubes begin
to fill
2. When peritoneal
spill has
occurred and with
all the
instrument
removed

After care
It must be ensured that the patient is
in no serious discomfort nor has
significant bleeding before she
leaves
The patient must be advised that she
may have bleeding per vagina for 1-2
days and pain may persist up to 2
weeks.

Image Guided Biopsy

and Percutaneous
Nephrostomy
Fatin Aqilah Bt Hasnan
012011100291

Image Guided Biopsy

Biopsy: removal of a small tissue
from a part of body/organ for the
purpose of examination
Imaging are used to determine
exactly where to place the needle
and perform the biopsy
Ultrasound
CT scan
X ray
MRI

 Preparation
Consent
Stop blood thinners
Investigations (coagulation factors, FBC)

Aftercare
Apply pressure to the site of puncture to
prevent or minimize bleeding
May experience soreness at the site
No heavy lifting or strenuous activity in
24 hour

 Complication
Bruising and bleeding
A hematoma or collection of blood
may form at the biopsy site
Infection or abscess
Chest Biopsy: pneumothorax, local
pulmonary hemorrhage and
haemoptysis

Percutaneous Nephrostomy
Drainage
catheter is place
into the kidney
done under
radiological
guidance (x ray
or ultrasound)

 Indication:
Obstructive uropathy
Access for percutaneous procedure
( e.g: prior to percutaneous
nephrolitotomy)
Ureteric fistulae
Urinary diversion
Contraindications:
Uncontrolled bleeding diathesis

 Preparation
Consent
Investigations
Fasting for at least 4 hour
Premedication (Analgesia, sedation)
Prophylactic antibiotic
Patient should empty the bladder prior
to the procedure

 Aftercare
Bed rest for 12 hour
Monitor blood pressure and temperature
half hourly for 6 hour
Monitor input and output chart
Urine cultures and sensitivity

Complication
Unsuccessful drainage
Hemorrhage
Perforation of collecting system
Septicemia

References
Chapman S, Nakielny R, A Guide
to Radiological Procedures, 6th
edition, Saunders Ltd. USA, 2013
http://www.radiologyinfo.org/en/inf
o.cfm?pg=biopgen
http://www.riainvision.com/exams/im
age_guided_biopsy.aspx
http://radiopaedia.org/articles/perc
utaneous-nephrostomy

ANGIOGRAPHY

NOOR ATIKAH ABD RASHID

012011100294

 Angiography is the x-ray imaging of blood vessels

using contrast agents injected into the
bloodstream through a catheter that is placed
directly in the blood vessel.
The images taken are called angiograms.
Angiography provides information about blood
vessel abnormalities such as narrowing, blockage,
aneurysm and bleeding.
Contrast agents are injected into an artery or vein
to make the blood vessels visible on X-rays.

 Angiography is used to examine blood

vessels - brain
- heart
- lungs
- abdomen (such as the kidneys and liver)
- pelvis
- legs
- arms
Angiograms can also be obtained by CT or
by MRI.

INDICATION
Determining the severity and the location of
the narrowing/blockage of blood vessel
causing the symptoms.
Locating a bleeding site and often combined
with embolization.
Locating the aneurysm site and putting the
stent.
Locating and removing a blood clot in a
blocked blood vessel and restoring blood flow.
Treating certain type of tumours by blocking

CONTRAINDICATION
Relative contraindications
Blood disorders
Pregnancy
Allergy to contrast medium
Renal impairment

PATIENT PREPARATION
The patient may need admission to hospital as
careful preparation before and observation after
the procedure will be required.
Explain to patient regarding the procedure.
Take consent from patient.
Ask some relevant history from patient; medical
history, medication, allergy and pregnancy.
Examine the patient together with vital sign.
Check for urea and creatinine level.

 Fasting before is not required in all cases, only in

certain circumstances.
Patient should be well-hydrated to minimize the
risk of contrast medium-induced nephrotoxicity.
Remove contact lenses, eyeglasses, hair clips and
jewelry before the procedureand change into a
hospital gown.
Insert a cannula into the vein in patients hand for
medication/hydration.
Give sedation or general anaesthesia.

TECHNIQUE
The area around the artery to be assessed is
covered with antiseptic.
Give local anaesthetic to numb the area where a
catheter will be inserted into the blood vessel.
(femoral, brachial and axillary artery)
Seldinger Technique step by step.
Inject the contrast dye.
The procedurewill usually take less than an hour to
carryout. If it is combined with another procedure,
such as angioplasty or embolization, the time will
be longer.

Seldinger Technique

Make a tiny puncture with a needle.

Insert a guide-wire through the needle.
Removal of needle, guide wire in position.
Threads a catheter over the wire to guide it to the
location of interest by using fluoroscopy.
Withdraw the guide-wire, catheter remains in
place.

AFTERCARE
Remove the catheter.
Press the insertion site for 10
minutes to help stop the bleeding.
Stay in a recovery room for up to
4hours after the procedure.
Allow patient to eat and drink after
the procedure.

COMPLICATION
- Allergic reaction
- Bleeding and bruising at the
puncture site
- Infection at the puncture site
- Damage to blood vessel
- Thrombosis or embolus formation
- Septicemia

COMPUTERIZED
TOMOGRAPHY
(CT) SCAN

ALYAA DIYANAH BINTI FADZLAN

012011100293

 A computerized tomography (CT) scan combines a

series of X-ray images taken from different angles and
uses computer processing to create cross-sectional
images, or slices, of the bones, blood vessels and soft
tissues inside your body.
INDICATIONS
Diagnose muscle and bone disorders, such as bone
tumors and fractures.
Pinpoint the location of a tumor, infection or blood clot.
Guide procedures such as surgery, biopsy and radiation
therapy.
Detect and monitor diseases and conditions such as
cancer, heart disease, lung nodules and liver masses.
Monitor the effectiveness of certain treatments, such
as cancer treatment.
Detect internal injuries and internal bleeding.

PATIENT PREPARATION
Explain on the procedure:
How it is done briefly, the purpose, its duration, the
contrast medium, the necessity for immobility, the
necessity for breath-holding whilst scanning chest
and abdomen, the risks and side effects, the
release of results, etc.

Waiting times should be kept to a minimum.

The patient should be as pain-free as is
practical.
Children <4 years will usually need sedation.

 Patient should removed any articles of clothing or

jewellery that might degrade the CT images, such
as belts, earrings, bras, glasses, dentures,
hairpins, etc. change into attire provided.
For IV contrast, insertion of cannula is needed.
In some patients who have compromised renal
function, iodinated contrast can produce a
nephrotoxic effect resulting in acute tubular
necrosis.
So, the urea and creatinine level must be
investigated to make sure it is in normal range.

 Assess relevant history related to contrast.

Asthmatics and those with a history of severe
allergies or prior reactions to IV contrast have a
higher likelihood of contrast reactions.
If present
steroid prophylaxis T. Prednisolone 40mg 12
hours and 2 hours before
use low osmolar contrast material

INTRAVENOUS CONTRAST MEDIUM

The dose will depend on the area examined.

ORAL CONTRAST MEDIUM

CT of the abdomen may required the patient to

drink a different kind of iodinated contrast
solution to outline the GIT.
This will require fasting for 4 hours prior to scan.
Oral contrast (15mls of gastrograffin in 1 litre of)
is given. This drink is given in a different way
depending where the patient is having the CT
done.
Rarely it may be necessary to opacify the rectum
using direct instillation of contrast medium or air

SIDE EFFECTS
DUE TO CONTRAST:
A feeling of warmth,
Nausea and vomiting,
Local irritation at the site
of injection,
Itchiness, allergic reaction,
Nephrotoxic effect in renal
compromised patient,
Unpleasant metallic taste
DUE TO RADIATION

CONTRAINDICATIONS

Patient weight>150kg
Pregnancy
Allergic reaction to
contrast medium
Renal impairment or
dehydration

MAGNETIC RESONANCE
IMAGING (MRI)

 Magnetic resonance imaging (MRI) is a

technique that uses a magnetic field and
radio waves to create detailed images of
the organs and tissues within the body.
The magnetic field temporarily realigns hydrogen
atoms in the body.
Radio waves cause these aligned atoms to
produce very faint signals, which are used to
create cross-sectional MRI images.

INDICATIONS

PATIENT PREPARATION
Explain on the procedure:
How it is done briefly, the purpose, its duration, the
contrast medium, the , the necessity for immobility,
the risks and side effects, the release of results,
etc.

Assess the safety issues in MRI.

Assess relevant history related to contrast.
Sedation is required in young patient and
adults that have claustrophobic.
For IV contrast (gadolinium), insertion of
cannula is needed.

SAFETY IN MRI
Potential hazards associated with
magnetic resonance imaging which may
affect patients and staff are due to:

Magnetic fields
Auditory effects of noise
Inert gas quench
Claustrophobia
Intravenous contrast agents

CONTRAINDICATIONS
Ferromagnetic objects
These objects include medically inserted items
such as cerebral aneurysm repair clips, vascular
clips, and surgical staples.
It can be moved by the magnetic field and could
damage adjacent tissues.
Potential to be heated and cause burns to
surrounding tissues.
Some foreign bodies, such as bullets,
shrapnel, and metal in the eyes (as can be
seen in metal workers) can also be ferromagnetic.

 Cannot be performed in patients who have

pacemakers, pain stimulator implants,
insulin pumps, other implantable drug
infusion pumps, and cochlear implants.
The device may be deactivated by the magnetic
field, and there may also be heating induced in
the leads that could injure the endocardium.
Pregnancy
Although no conclusive evidence of teratogenesis
exists in humans, scanning should be avoided,
particularly during the first trimester, unless
alternative diagnostic procedures would involve
the exposure of the fetus to ionizing radiation.

Preexisting renal dysfunction

Gadolinium-based contrast agents have been
associated with a rare, painful, debilitating, and
sometimes fatal disease called nephrogenic
systemic fibrosis (NSF).
NSF produces fibrosis of skin, eyes, joints, and
internal organs resembling scleroderma.
Caution is exercised when administering
gadolinium to patients who have moderate
renal disease.
Gadolinium is typically avoided in patients with

THANK YOU!