What are
the specific problems encountered with physiologic monitors and equipment in
the MRI suite?
The use of a conventional electrocardiogram
(ECG) monitor in the MRI suite can cause distortion of the image as a result of
the wire leads acting as antennas. In addition, the ECG monitor may not be able
to distinguish the ECG from the background static magnetic field and RF pulses.
Voltage induced in the wire leads can cause electrical shock hazards and burns
to the patient.
The magnetic fields produced by the MRI scanner
can cause interference and possible inactivation of the conven-tional operating
room pulse oximeter. Either a nonferrous or fiberoptically cabled pulse
oximeter should be used. The pulse oximeter probe should be placed on a distal
extrem-ity as far from the site to be scanned as possible, to prevent
interference and possible scan artifact.
The oscillometric method is optimal for
noninvasive blood pressure monitoring in the MRI suite because it is not
affected by magnetic fields. Fiberoptic systems in conjunction with invasive
blood pressure monitoring have been used successfully. In addition, central
venous pressure can be monitored if necessary. There are several transduc-ers
that lack ferrous components and can be used in the MRI suite.
The use of side-stream capnography with a long
sampling line allows for monitoring of patient ventilation, anesthetic gas
concentrations, and circuit disconnection during the MRI scan. However, the
long sampling line may create a greater lag time between the actual event and
the time of its detection.
There are several MRI-compatible anesthesia
machines available commercially. Only
oxygen, air, and nitrous oxide cylinders
made of aluminum can be used in the MRI suite. Ferromagnetic compressed gas cylinders are pulled by the
attractive force of the magnet, and have resulted in either injury or death to
patients or personnel.
Infusion pumps should be checked for MRI
compatibility as well.
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