Maximum intensity pixel (MIP)
Shaded surface display (SSD)
This content introduces the basic principles of MR safety and covers the basic concepts of patient management. Educating patients and ancillary staff on magnet safety also is presented. Patient and magnet-related emergencies represent a unique situation to an MR technologist; recommended procedures and responsibilities of the technologist will be discussed for these situations. This content also covers MR contrast agents.
This introduction provides basic knowledge of MR safety, patient preparation and monitoring of patients in the MR suite. This information enables the student to better communicate with the health care team to ensure the patients’ safety.
Methods of patient care – equipment, psychology, communication and rationale of patient care techniques.
Upon completing the education, the student will be able to:
Discuss the elements of safety management that ensure an MR facility operates safely.
Demonstrate proper screening and preparation of patients for MR.
Monitor patients during procedures.
Describe when and how to quench the magnet and handle other emergencies in the MR environment.
Demonstrate an understanding of MR contrast agents.
Content Introduction Magnetic fields in MR
Main static field aligns spins
Radio frequency field flips spins
Gradient field is used for spatial encoding of the image
MR safety concerns
Force and torque on magnetic materials from the static magnetic field
Heating caused by the RF magnetic field used to flip spins
Nerve stimulation caused by gradient magnetic fields used for spatial encoding
Implanted medical devices affected by the static magnetic field, RF magnetic field and gradient magnetic fields
MR safety organizations
International Electrotechnical Commission (IEC)
U.S. Food and Drug Administration (FDA)
National Electrical Manufacturers Association (NEMA)
American Society for Testing and Materials (ASTM)
American College of Radiology (ACR)
International Society for Magnetic Resonance in Medicine (ISMRM) Safety Group
Institute for Magnetic Resonance Safety Education and Research (IMRSER)
Static Magnetic Field Force and torque on magnetic materials caused by the static magnetic field can cause projectile hazards
Potential dangers in a hospital setting with examples of projectiles
Force vs. distance from magnet: The force increases very rapidly as distance to magnet decreases
Magnetic shielding: active and passive
Designing MR guidelines for safety
Provide written safety policies and procedures
Enforce vigilance in controlling access to the MR suite to trained MR personnel
ACR guidelines regarding MR suite safety zones I through IV
Lock MR suite door when trained MR personnel are absent
Provide safety education to all staff that could potentially work near the magnet, including the local fire department
Post warning signs citing examples of potentially dangerous projectiles
Field strength relevance to safety
Status of high-field MR safety studies
Radio Frequency (RF) Magnetic Field Theory of RF heating in MR
Factors that affect the amount of heat produced
Most heat is deposited on perimeter of body where it can be more easily dissipated
Regions with high resistance can cause focal heating
RF heating in clinical MR
Use SAR to estimate temperature increase
SAR = absorbed power/mass (e.g., watts/kg)
Concerns are for core (whole body) and localized heating
Responsibilities of technologist concerning patient safety in avoiding RF heating
Position patients properly
Position monitoring equipment properly
Screen patients for electronically conducting jewelry, tattoos, cosmetics, medication patches, etc.
Monitor patients with physiological conditions that are unable to dissipate heat
Monitor patients who are unable to respond due to sedation or mental status
Limit pregnant individuals from being present in the RF field
Determines energy needed to get a 90° flip and 180° flip
Adds energy of all RF pulses in a sequence and divides by pulse repetition time (TR) to calculate power
Divides by patient weight to calculate whole body SAR
IEC/FDA limits for whole-body heating
Normal mode limit (suitable for all patients)
First level controlled mode (medical supervision)
Gradient Magnetic Fields Gradient coils and current waveforms
Linear magnetic fields for spatial encoding
Echo planar imaging pulse train
Effects on patients
Orientation of field gradient with respect to the body
Location in the body
Duration of the gradient pulse
Hearing damage caused by dangerously loud sound pressure levels
Hyperbolic relationship between pulse duration and stimulation threshold
Variations in patient response to nerve stimulation
Patient and Personnel Safety Screening in MR (Technologist Responsibilities) Obtain documentation and consent in the form of an MR safety screening questionnaire completed by the patient or guardian
Obtain any necessary special consent documentation for non-FDA approved MR scanning for the following instances:
Injection of contrast to a pregnant patient
Cardiac stress agent
Patient and personnel safety — contraindications for entering the MR suite
Implanted electronic devices
Implanted metallic objects at risk of deflection
Indications for plain film radiography for safety screening include intra-ocular foreign bodies, shrapnel and bullets in the body
The physician in charge should be consulted in each instance and approve of the patient entering the MR environment
Equipment Safety Screening in MR Environment (Technologist Responsibilities) Screen all equipment before allowing entrance to the MR suite
Properly label MR-safe equipment
Keep all MR conditional and MR unsafe equipment clear of the MR suite and anteroom
Recognize table stop and emergency shut-down switches that control electricity to the scanner, and quench or magnet run-down switch
Monitor, record and report cryogen levels
Monitor the cryogen exhaust vent line for blockages
Monitor the cryogen fill line for ice blockages
Maintain awareness and marking of gauss lines in MR area
Display warning signs prominently
Strong magnetic field
This magnet is always on
Radio frequency field
Hearing protection necessary
Hazardous material including phantom liquids and helium dewars
Laser light in use
Display signage that prohibits items and implants
Implants susceptible to electromagnetic fields
Monitoring of Ancillary Equipment Perform quality measurement of the RF coils
Perform quality measurement of software
Perform and report cryogen levels
Perform checks on pulse receptor, ECG cables and disposable electrodes
Remove patient from MR suite if treatment is required
Assess patient for breathing difficulty
Notify the physician in charge to examine the patient before he/she is released
Appropriate health care provider to administer medications if necessary
Give patient written instructions to follow after discharge
Document/report the contrast reaction
Keep epinephrine and asthma-related drugs in MR suite for emergencies
Have the respiratory therapy immediate response number available
Have code blue button available in the MR area
Gadolinium-based MR contrast and NSF
ACR guidelines regarding renal function and dialysis.
Pharmacology and Drug Administration
Content__Drug_Nomenclature'>Content provides basic concepts of pharmacology. This section covers the theory and practice of basic techniques of venipuncture and administering diagnostic contrast agents and/or intravenous medications. The appropriate delivery of patient care during these procedures is emphasized.
Prior to introducing this educational content, students should have successfully completed patient care objectives (including CPR/BLS certification), as well as objectives related to anatomy and physiology of the circulatory and excretory systems.
Although regulations regarding administration of contrast media and intravenous medications vary in different states and institutions, the skill should be included in the didactic and clinical curriculum with demonstrated competencies of all appropriate disciplines regardless of the state or institution where the curriculum is taught.
In states or institutions where students are permitted to perform intravenous injections, the program has specific ethical and legal responsibilities to the patient and the student. The student shall be assured that:
Legal statutes allow student MR technologists to perform this procedure.
Professional liability coverage is adequate.
Adequate supervision is provided.
Appropriate, structured, laboratory objectives are identified.
Competency is demonstrated and evaluated before the student performs this task unsupervised.
Content Drug Nomenclature Chemical name
Methods of Drug Classification Chemical group
Mechanism/site of action
General Pharmacologic Principles Pharmacokinetics
Five Rights of Drug Safety The right medication
The right dose
The right patient
The right time
The right location
Drug Categories of Relevance to MRI (Side Effects, Uses and Impacts on Medical Imaging) Analgesics
Vasodilators and vasoconstrictors
Anticoagulant and coagulant drugs
Antiallergic and antihistamine drugs
Antiseptic and disinfectant agents
Sedative and hypotonic drugs
Cathartic and antidiarrheal drugs
Diagnostic contrast agents
Classification of Contrast Agents Types of compound
Ionic contrast agents
Nonionic contrast agents
Pharmacologic profile of contrast agents
Initiation of intravenous therapy
Intravenous infusion/venipuncture equipment
Patient identification, assessment and instructions
Dosage, dose calculations and dose-response
Application of standard precautions
Procedure for intravenous infusion/direct puncture
Emergency medical treatment procedure
Emergency cart (crash cart)
Emergency medical treatment follow-up tasks
Discontinuation of intravenous therapy
Equipment/supplies for withdrawal
Application of standard precautions
Documenting a complication/reaction
Current Practice Status Professional standards
Scope of Practice
Professional liability and negligence
Physical Principles of Magnetic Resonance Imaging
This unit provides the student with a comprehensive overview of MR imaging principles. The subjects are formatted in individual outlines and can be sequenced according to the level of knowledge desired. Topics include the history of MR, nuclear MR signal production, tissue characteristics, pulse sequencing, imaging parameters/options and image formation.
This course is required in order to understand the basic principles of MR image acquisition. The course provides information on the fundamentals of MR image acquisition. This information is useful to enable the student to maximize MR image quality by understanding the fundamentals of MR imaging.
Prerequisites Medical Terminology – a course in terminology used in the medical profession.
Patient Care – methods, equipment, psychology, communication and rationale behind patient care techniques.
Overview of imaging parameters and terminology, safety and patient care procedures.
A course in the fundamentals of digital imaging systems.
Upon completing this course, the student will be able to:
Know the researchers who provided the means for MR imaging.
Describe various nuclei in a magnetic field.
Explain how an image is acquired in MR (nuclei in a magnetic field, excitation, relaxation).
Explain how an MR signal is produced and detected.
Explain MR tissue characteristics, such as spin density and T1 and T2 relaxation.
Understand the behavior of various nuclei in the magnetic field and/or during the application of the radiofrequency pulse.
Understand the concept of resonance and excitation in MR.
Understand the concept of relaxation in MR.
Apply the principle of pulse sequences and image formation to appropriate clinical applications.
Describe and apply the imaging parameters and options available to the user for optimal MR imaging.
Content History of MR Scientific discovery of the principles of nuclear magnetic resonance (NMR)
Felix Bloch (Bloch equations)
Sir Peter Mansfield
Scientists associated with MR
Jean Baptiste Fourier (Fourier transformation)
Richard R. Ernst (Ernst angle)
Joseph Larmor (Larmor equation)
Michael Faraday (Faraday’s Law of Induction)
Charles Dumoulin (MRA)
Early MR images
Matter Periodic table of elements
MR active nuclei
This is a study of human anatomy as seen in multiple orthogonal planes. Bone, muscle, vascular structures, organs and soft tissues of the following anatomical regions are studied: central nervous system (brain and spine), other structures in the head, soft tissue neck, musculoskeletal, cardiovascular, thorax, abdomen and pelvis.
The student should be able to recognize normal anatomy to ensure that the region of interest is adequately imaged. A study of normal anatomy and normal variations, as well as its appearance in multiple planes, enables the student to better recognize abnormal conditions and make the associated imaging changes required to adequately demonstrate the patient's anatomy and pathology.
Human Anatomy and Physiology I and II – anatomy of all body regions.
Upon completing the course, the student will be able to:
Identify anatomical structures as seen in multiple orthogonal planes on MR images.
Describe gross anatomic relationships in the body.
Describe anterior-posterior, proximal-distal and lateral-medial relationships of anatomy.
Distinguish normal anatomy from abnormal anatomy.
Content The Head Bones of the skull and cranium
The Upper Extremity Shoulder joint
Upper arm (brachium)
Muscular components (anterior and posterior)
Contents (identify nerves, arteries, veins and tendons that emphasize a medial to lateral [ulnar to radial] relationship)
Muscular components (anterior and posterior)
Lower Extremity Hip joint
Muscular components (anterior, posterior and medial groups)
Muscular components (anterior, medial and posterior compartments)
Musculotendinous components (medial, lateral, anterior and posterior groups)
This list of magnetic resonance resources can assist educators in sampling the pool of references and study materials that pertain to medical imaging. The resources list should be viewed as a snapshot of available materials. Omission of any title is not intentional. Because the creation of literature and media related to the field is dynamic, educators are encouraged to search additional sources for recent updates, revisions and additions to this title collection.