Current guidelines for MRI safety in patients with cardiovascular implantable electronic devices.

Historically, MRI was contraindicated in patients with cardiovascular implantable electronic devices because the devices' metallic components made this imaging study unsafe. Advances over the last decade have now made MRI safe for many of these patients. This article examines the risks of MRI technology for this patient population and reviews recent guidelines from the Heart Rhythm Society.

The pilot study of radiology nursing intervention in abdominal 3-T Magnetic Resonance examination / Estudio piloto de intervención de enfermería radiológica en examen de resonancia magnética 3-t / Estudo piloto sobre a intervenção de enfermagem na radiologia em exame de ressonância magnética abdominal 3 tesla

Abstract OBJECTIVE The aim of this study was to investigate the effect of radiology nursing intervention in abdominal examination at 3-T MRI. METHOD 60 patients with abdominal diseases were divided into two groups randomly: MR nursing intervention group and control group. All the patients underwent abdominal MR examination at 3-T. The MR nursing interventions were performed in nursing intervention group. The outcomes, including one-time success rate, the ratio of diagnosable MR images and the points of image quality, were compared between these two groups. RESULTS The one-time success rates in control group and MR nursing intervention group were 66.67% and 96.67% with significant difference ( χ2 =9.017, P<0.05). The ratios of diagnosable images in the two groups were 76.67% and 96.67% with significant difference (χ2 =5.192, P<0.05). The points of MR image quality in the two groups were 1.87±0.86 and 2.33±0.55, respectively. There was significant difference between these two groups (t=-2.508, P<0.05). CONCLUSION The effective nursing intervention can make the patients cooperation better in abdominal MR examination and improve the image quality significantly.

Resumen OBJETIVO Se objetivó investigar el efecto de la intervención de enfermería radiológica en examen abdominal de IRM 3-T. MÉTODO Sesenta pacientes con enfermedades abdominales fueron divididos aleatoriamente en dos grupos: grupo intervención de enfermería RM y grupo control. Todos fueron sometidos a examen abdominal de RM 3-T. Las intervenciones de enfermería RM se efectuaron en el grupo establecido. Los resultados, incluyendo tasa de éxito en única vez, relación de imágenes de RM diagnosticables y puntos de calidad de imagen, fueron comparadas entre ambos grupos. RESULTADOS La tasa de éxito en única vez en grupo control y grupo intervención de enfermería RM fueron de 66,67% y 96,67%, expresando diferencias significativas (χ2 =9.017, P<0.05). Los puntos de calidad de imagen de RM en ambos grupos fueron 1,87±0,86 y 2,33±0,55, respectivamente. Existió diferencia significativa entre los grupos (t=-2.508, P<0.05). CONCLUSIÓN La intervención de enfermería efectiva puede mejorar la cooperación de los pacientes en examen abdominal de RM y mejorar significativamente la calidad de imagen.

Resumo OBJETIVO O objetivo deste estudo foi investigar o resultado da intervenção de enfermagem na radiologia em exame de ressonância magnética (RM) abdominal 3 Tesla. MÉTODO 60 pacientes com patologias abdominais foram aleatoriamente divididos em dois grupos: grupo de intervenção de enfermagem em RM e grupo controle. Todos os pacientes foram submetidos ao exame de RM abdominal 3 Tesla. As intervenções de enfermagem em RM foram realizadas no grupo de intervenção de enfermagem. Os resultados foram comparados entre os dois grupos, incluindo a taxa de sucesso único, o coeficiente das imagens de RM diagnosticáveis e os pontos da qualidade de imagem. RESULTADOS As taxas de sucesso único no grupo controle e no grupo de intervenção de enfermagem em RM foram 66,67% e 96,67%, com diferença significativa de (χ2 =9,017, P<0,05). Os coeficientes das imagens diagnosticáveis nos dois grupos foram 76,67% e 96,67%, com diferença significativa de (χ2 =5,192, P<0,05). Os pontos da qualidade de imagem da RM nos dois grupos foram respectivamente 1,87±0,86 e 2,33±0,55. Houve uma diferença significativa entre estes dois grupos (t=-2,508, P<0,05). CONCLUSÃO A intervenção de enfermagem eficaz pode melhorar a cooperação dos pacientes no exame de RM abdominal e melhorar consideravelmente a qualidade da imagem.

The pilot study of radiology nursing intervention in abdominal 3-T Magnetic Resonance examination.

OBJECTIVE: The aim of this study was to investigate the effect of radiology nursing intervention in abdominal examination at 3-T MRI. METHOD: 60 patients with abdominal diseases were divided into two groups randomly: MR nursing intervention group and control group. All the patients underwent abdominal MR examination at 3-T. The MR nursing interventions were performed in nursing intervention group. The outcomes, including one-time success rate, the ratio of diagnosable MR images and the points of image quality, were compared between these two groups. RESULTS: The one-time success rates in control group and MR nursing intervention group were 66.67% and 96.67% with significant difference ( χ2 =9.017, P<0.05). The ratios of diagnosable images in the two groups were 76.67% and 96.67% with significant difference (χ2 =5.192, P<0.05). The points of MR image quality in the two groups were 1.87±0.86 and 2.33±0.55, respectively. There was significant difference between these two groups (t=-2.508, P<0.05). CONCLUSION: The effective nursing intervention can make the patients cooperation better in abdominal MR examination and improve the image quality significantly.

Satisfacción de los pacientes diagnosticados de enfermedad de Crohn con respecto a la colonoscopia y entero-resonancia magnética / Crohn's disease patient's satisfaction with colonoscopy versus entero magnetic resonance imaging (MRI)

Objetivos. Evaluar la satisfacción y las preferencias sobre la colonoscopia (CL) y la entero-resonancia (ERM) de los pacientes que padecen enfermedad de Crohn a los que se les ha realizado ambas pruebas. Valorar también la eficacia del sistema de información para la recogida de estos datos. Método. Estudio piloto transversal, mediante una encuesta telefónica de satisfacción realizada a pacientes diagnosticados de enfermedad de Crohn (EC). Los pacientes del estudio se seleccionaron en la consulta del Servicio de Aparato Digestivo del Hospital Universitario Príncipe de Asturias. Se les realizaron las dos pruebas objeto del estudio durante el periodo comprendido entre el 1 de enero de 2011 y el 30 de junio de 2012. Las encuestas se efectuaron durante los meses de julio y agosto de 2012. Resultados. Han participado un total de 48 pacientes con enfermedad de Crohn. De ellos, 24 eran mujeres y 24 hombres. Con una media de edad de 43 años (DE: 13.8). La peor valoración se obtuvo en la preparación previa de ambas. Si los pacientes pudieran elegir, 23 preferían CL, 16 ERM y a 9 les era indiferente. Conclusiones. La preferencia de los pacientes hacia la CL pudo deberse a la administración previa de sedación. Una prueba como la CL, que a priori puede resultar desagradable para el paciente, resulta mucho mejor tolerada gracias a la sedación. En ambas pruebas las preparaciones previas se perciben como molestas. Nos plantearemos cómo poder mejorar la tolerancia a dicha preparación, quizá dando más información, puesto que muchas veces no se realiza correctamente y eso puede acentuar dicha percepción desagradable (AU)

Objectives. To evaluate satisfaction and preferences in Crohn's disease patients who have undergone a colonoscopy (CL) and a MRI colonography (MRI). As well as evaluate the effectiveness of the information system to collect the data. Method. A sectional pilot study conducted through a satisfaction survey questionnaire for patients diagnosed with Crohn’s disease (CD). Study patients were selected from the Gastroenterology Department in the Principe de Asturias University Hospital, where both the colonoscopy and the entero magnetic resonance imaging tests were done from the 1st of January to the 30th of June 2012. Surveys were conducted during July and August 2012. Results. A total of 48 patients with Crohn’s disease participated. Out of these, 24 were women and 24 were men. The mean age was 43 years (SD: 13.8). The worst score was obtained at the time of preparation for both procedures. If patients could choose they would prefer CL 23, 16 MRI and 9 were indifferent. Conclusions. The patients’ preference for CL could be due to the administration of sedatives prior to the procedure. A procedure such as the CL which initially may result unpleasant for the patient is tolerated much better as a result of the sedation. In both tests, the preparations prior to the procedures are perceived as unpleasant. We will think about how to improve patients’ tolerance to these preparations, maybe by giving more information as patients, because we don’t know often how to do it properly, which could magnify this unpleasant perception (AU)

Multiple sclerosis: managing patients in primary care.

In this era of the Patient Centered Medical Home model of care, chronic diseases such as multiple sclerosis (MS) are managed in partnership with specialty care practices. For the patient and family living with MS, assuring that patients get proper care when and where they need it requires that nurse practitioners understand their role in assessing and managing complex chronic diseases.

Developing a nurse-led child sedation service.

This article explores nurse-led sedation of children in preparation for investigations such as magnetic resonance imaging or minor surgical procedures. The importance of the multidisciplinary team in setting up, implementing and evaluating this new nurse-led initiative is described. Effective planning, involvement, agreement and training are key to a successful change in practice, with responsibility being delegated to competent nursing staff. Evaluation has shown all-round benefits. Trained nurse-led sedation is safe, effective and efficient and nurses are motivated to undertake this extended role.

Estadificación prequirúrgica del cáncer de recto mediante RM y correlación radiopatológica / Preoperative staging MRI for rectal cancer and pathologic correlation

Fundamento. El objetivo de este trabajo es revisar lautilidad de la RM pélvica para la estadificación del cáncerde recto y establecer una correlación radiopatológica.Material y métodos. Se realizó un análisis retrospectivode 120 pacientes con una edad comprendida entre 43 y87 años a los que se realizó una RM pélvica para el estadiajede cáncer rectal en nuestro hospital entre los años2005 y 2010. Se catalogaron los pacientes de acuerdo ala clasificación TNM.Resultados. De los 120 pacientes, 80 fueron tratadoscon RT y/o QT neoadyuvante debido a que presentabanenfermedad localmente avanzada (T3-T4), afectaciónganglionar (N1-N2) o metástasis resecables. Con los40 pacientes que no fueron sometidos a tratamientoneoadyuvante se realizó una correlación entre los hallazgosde la RM y de la anatomía patológica con unaprecisión diagnóstica para predecir el estadio T del72%, el estadio N del 60% y la distancia a la FMR del87,5%.Conclusión. La RM pélvica es una técnica útil para laestadificación locorregional del cáncer de recto, obteniendouna buena correlación radiopatológica aunquela identificación de la afectación ganglionar es todavíaun problema diagnóstico(AU)

Background. Our aim is to asses the accuracy of MRIfor preoperative rectal cancer staging and to establisha histopathologic correlation.Material and methods. A retrospective analysis wasperformed on 120 patients aged between 43 and 87 withhistologically proven rectal cancer who underwent MRIfor preoperative staging in our hospital between 2005and 2010. Patients were categorized according to theTNM classification.Results. Eighty of 120 patients underwent adjuvantchemoradiotheraphy because they had advanceddisease (T3-T4), lymph node involvement (N1-N2) orresectable metastases. With 40 patients who didn’tundergo neoadjuvant therapy we performed a correlationbetween MRI and histopathological findings witha diagnostic accuracy in predicting T stage of 72%, Nstage of 60% and distance to the mesorectal fascia of87,5%.Conclusion. Pelvic MRI is a useful technique for locoregionalstaging of rectal cancer with a good radiopathologiccorrelation although the identification of nodaldisease is still a diagnostic problem(AU)

Magnetic resonance imaging studies without sedation in the neonatal intensive care unit: safe and efficient.

Use of magnetic resonance imaging (MRI) in the neonatal intensive care unit has been increasing over the past several years because of improved MRI technology and increased clinical awareness of the prognostic and diagnostic information available. Historically, the use of sedation has been the standard for achieving quality imaging without motion artifact, but it exposed the patient to risks associated with sedation medications. In an effort to obtain MRI studies with elimination of risks associated with sedation, a quality improvement project was initiated. Implementing a standardized approach utilizing a vacuum immobilizer has led to successful neonatal MRI completion without the need for sedation in 94% of study attempts. Acceptable or excellent image quality was achieved in more than 97% of attempts. Time away from the neonatal intensive care unit significantly decreased with this approach, with the mean duration of time away decreasing from 60 to 48 minutes (P < .0001). Obtaining MRI studies without sedation can be successfully implemented in a neonatal intensive care unit, nearly eliminating patient risks associated with sedation while improving utilization of hospital resources and maintaining adequate quality imaging.

Nurse led sedation for paediatric MRI: progress and issues.

AIM: This article describes the current magnetic resonance imaging (MRI) sedation service, the role of the nurse sedationist, results of clinical audits, and future issues within MRI. METHOD: Data from 2004 until 2006 were analysed to describe the percentage of children who were successfully sedated, and any complications. The recovery profile was investigated by a questionnaire of 100 consecutive cases. FINDINGS: Sedation was attempted in 455 cases with chloral hydrate, and 325 with temazepam and droperidol. The success rate was 97.4 and 92.6 per cent respectively. Top-up sedation was used in 10 and 29 per cent respectively. There were seven minor incidents but none required admission. Approximately 20 per cent of children were drowsy the following day. CONCLUSION: We believe that the success of the service depends upon three main factors: the deselection of children in whom sedation is unsafe or likely to be unsuccessful, the use of appropriate drugs in limited doses, and the training of experienced nurses.

Radiology nursing.

Radiology nursing is a relatively new field in which nurses can use multiple skills in caring for adult and pediatric patients. The authors present an overview of the role nurses play in interventional radiology, nuclear medicine, ultrasound, magnetic resonance imaging, computed tomography, and mammography. In addition, information about the professional affiliations and certification in the American Radiological Nurses Association is provided.

[Nursing participation in magnetic resonance applied to diagnosis of coronary syndromes]. / La resonancia magnética como método diagnóstico en los síndromes coronarios agudos e intervenciones de enfermería.

The cardiovascular magnetic resonance is a method diagnose noninvasive that does not use radiation obtaining itself a space resolution and temporary that allows to analyze the anatomy and cardiovascular function. The material of used paramagnetic resistance is the gadolinium which causes increase of signal in vascularized weaves and better characterization of the visualized weave, acute east allows to the analysis of the perfusion of the myocardium Subsequent to the coronary syndrome study allows to determine with exactitude the extension of the zone of necrosis, to stratify the risk and of identifying the viable weave as well as of determining the affected territory. This revision must like intention describe the provided interventions of infirmary to the patient with acute coronary syndrome that is put under this type of study since without a doubt our recent incorporation to the Department of Magnetic Resonance has been translated in an integral attention.

It's like being in another world--patients' lived experience of magnetic resonance imaging.

AIM: The aim of this study was to illuminate patients' lived experience during magnetic resonance imaging. BACKGROUND: Magnetic resonance imaging has increased in importance since the early 1980s and is today a common useful diagnostic tool. Although magnetic resonance imaging are non-invasive and considered painless, many patients experience anxiety, sometimes so strong that the scan has to be terminated. DESIGN AND METHODS: The study had an inductive design and a hermeneutic phenomenological methodology was used. RESULTS: The essential theme of going through magnetic resonance imaging was a feeling of being in another world. The strange environment and isolation inside the scanner made the participants' experiences unusual, with varying degrees of difficulty dealing with it. Being in the other world caused a threat to the participants' self-control. There was a relation between threat to self-control, effort and need for support in the sense that the magnitude of threat to self-control had an impact on the effort it took to handle the situation and on the need for support, and conversely that the support received could affect the effort and threat to self-control. CONCLUSIONS: The study shows that the information received and the interaction between patients and staff have a significant influence on patients' lived experiences. The individual experience of threat to self-control requires the need for support to be individualized and care need to be adjusted for each patient.