Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) is a non-invasive medical examination that helps physicians to diagnose and treat medical conditions. MR imaging uses a powerful magnetic field, radio frequency pulses and a computer monitor to produce detailed pictures of organs, soft tissues, bones and other internal structures. These can then be examined on a computer monitor, printed or copied to CD. MRI does not use X-rays.
In most cases, an MRI exam is safe for patients with metal implants. Patients with the following implants cannot be scanned and should not enter the scanning area unless explicitly instructed by a radiologist or technologist:
Internal defibrillator or pacemaker, cochlear implant and some types of clips used on brain aneurysms. Please tell the radiologist about artificial heart valves or other implanted electronic devices, metal pins, screws, plates or surgical staples. Tattoos may contain iron and heat up during MRI, but this is rarely a problem. MRI examinations take about 20 to 30 minutes. You will lie on a moveable table that slides into the centre of the scanner which is open at both ends. If you have claustrophobia or anxiety you may want to ask the physician for a mild sedative. In this case you should not drive or operate a machine for 12 hours. Women should inform the physician if they are pregnant, although there have been no reports of any ill effects due to scanning. In some cases a contrast agent may be injected during the MRI examination. A technologist will insert an intravenous (IV) line into a vein in your hand or arm. There is a very slight risk of allergic reaction to a contrast agent but this is usually mild and easily controlled by medication. There is a very small chance of the needle causing a swelling at the site of injection. Patients with kidney malfunction can only be examined with a contrast agent under special conditions.
Do you have a special electronic device (e.g. pacemaker)? Yes No
Do you have any metal objects in your body? Yes No
Do you wear dentures with magnetic fixation? Yes No
Have you had a head or heart Operation? Yes No
Do you have any allergies? Yes No
Are you pregnant? Yes No
Do you have any kidney malfunctions? Yes No
Are you suffering from an infectious disease? Yes No
Weight:
I have no further questions, everything has been sufficiently explained, I have had enough time to think it over and I agree to the examination.
I agree to the injection of a contrast agent yes no
I certify that I have no metal devices in my body except the above mentioned. I will not take any metal objects or electronic devices into the examination room.
Date Signature