If Unable to Complete MRI Screening
Patients are normally screened for contraindications to MRI using a hospital-approved screening form prior to entering the scanner suite. This form is completed by the patient or by his or her healthcare provider, and reviewed by the scanning technologist prior to the patient’s MRI examination. Occasionally, urgent or emergent MRI studies are indicated in patients who are unable to complete the screening form due to neurologic issues. This policy is written to outline the procedure for obtaining MRI in patients who are unable to undergo the normal screening process.
A knowledgeable family member or caretaker for a patient can complete the screening form on behalf of the patient. In the case of family members, this should be a member familiar with the patient’s exposures and medical history, such as a spouse, partner, or child. Healthcare providers familiar with the patient’s medical history may also complete the screening form in consultation with the medical record. However, in the absence of sufficient history the following steps should be performed to document the safety of MRI:
- Attending radiologist approval for the MRI, along with medical necessity for MRI documented in the medical record by the attending physician requesting the study.
- Separate chest and abdominal (KUB) radiographs should be obtained and reviewed prior to scanning to ensure the absence of contraindicated devices (pacemakers, spinal stimulators, et al) or other metallic material (shrapnel in close proximity to a major vessel or organ) that may be a contraindication to MRI. It is the responsibility of the requesting provider to order these radiographs.
- Screening orbits CT should be obtained and reviewed for metallic foreign bodies. The scout image for this CT can be used to screen for aneurysm clips. When the request is for a brain MRI, a full head CT should be obtained instead of orbits CT. The requesting provider is responsible for ordering these screening CT examinations.
Note that this policy does not apply to patients who cannot complete screening due to language difficulties. In this case, a translator should be retained to complete screening together with the patient in their native language.