If Unable to Complete MRI Screening
Patients are normally screened for contraindications to MRI using the medical center-approved electronic screening form prior to entering the scanner suite. Patients require a new screening form for every MRI order because new implants or devices may have been placed since the last MRI. This form is completed by the patient or by his or her healthcare proxy and reviewed interactively by the primary MRI technologist prior to the patient’s MRI examination. Assessment of the patient's ability to follow instruction, understand the questions being asked and to reliably provide accurate answers is critical. Occasionally, urgent or emergent MRI studies are indicated in patients who are unable to complete the screening form due to neurologic issues and/or status as an unreliable historian. 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, caretaker, or healthcare proxy for a patient can complete the screening form on behalf of the patient. These persons should have extensive knowledge of the patient’s exposures and medical history; healthcare providers familiar with the patient’s medical history may also complete the screening form in consultation with the medical record. However, never assume MR safety information related to an implant or device if it is not clearly documented. Do not “copy answers” from prior MRI screening forms as a substitute for direct interaction with the patient. Prior MRI screening forms may only be used as a resource or “starting point” to begin a thorough screening.
In the absence of sufficient history and/or patient is an unreliable historian, then the following steps should be performed to document the safety of MRI:
- Attending radiologist evaluation for appropriateness of the MRI. The medical necessity for MRI documented in the medical record by the attending physician requesting the study is required.
- An MR Level II Radiologist will perform a review and determine if there is an imaging alternative that can answer the diagnostic question.
- Plain film radiographs, inclusive of head/neck, chest, abdomen/pelvic, upper arms, and thighs, should be obtained and reviewed and cleared by an MRI Attending Radiologist or Fellow prior to MRI scanning to ensure the absence of implant devices or other metallic material (such as shrapnel near a major vessel or organ) that may be a contraindication to MRI.
- Distal extremities should be visibly examined by the patient care team for any obvious post-traumatic changes. If changes are present, those regions should also undergo plain film radiography prior to MR exposure. Examples of post-traumatic changes to distal extremities: healed sutures and scars.
- It is the requesting provider's responsibility to order these radiographs and/or CT exams.
- When the request is for a brain MRI, a full head CT should be obtained instead of orbits CT.
- Please keep in mind that the MRI procedures cannot be scheduled until the screening form is documented as completed.
- MRI magnet bores are confined spaces, and imaging may take up to one hour or longer. Therefore, patients will need to tolerate the confined space of the MRI magnet bore and lie flat and still for at least 1 hour – preparations and coordination with E1 team may be necessary.
Note that this policy does not apply to patients who cannot complete screening due to language difficulties.
If the patient has a preferred language other than English, then a direct interview utilizing Interpreter Services is required. A healthcare proxy is NOT applicable as a translator. Refer to Interpreting, Translation, and Language Access Services policy.
Last updated 10/7/25