[Tolerance of magnetic resonance imaging in children and adolescents performed in a 1.5 Tesla MR scanner with an open design]

Good scent in MRI: can scent management optimize patient tolerance?

BACKGROUND

Psychological distress for patients undergoing magnetic resonance imaging (MRI) may range from mild anxiety to serious panic attacks. Scents associated with a sense of wellbeing have been used to diminish psychological stress in various clinical conditions.

PURPOSE

To evaluate the influence of inhalation aromatherapy in the reduction of artifacts in patients undergoing MRI.

MATERIAL AND METHODS

Based on the assumption aromatherapy will lead to significant reduction of patient-related motion artifacts (PRMA) in MRI, a randomized controlled trial with two groups of 54 patients was enrolled. The primary endpoint was the number of sequences with PRMAs. Secondary outcomes were improvements of mood measured with the ASTS questionnaire as well as patient's recommendation to fellow patients tested by a visual analogue scale. Incidence and intensity of adverse events were documented.

RESULTS

Ninety-five patients were included in the statistical analysis. We were not able to detect a significant reduction of PRMAs. There were also no significant differences in mood or in relation to the feeling before and after examination. The only differences that neared significance were "positive mood" and "recommendation". No adverse reaction was observed.

CONCLUSION

Although aromatherapy has been effective in enhancing patient's mood or wellbeing in a variety of stressful clinical settings, we were not able to find a similar effect. Neither the primary nor the secondary endpoints reached a clinical meaningful magnitude.

Reduction of claustrophobia with short-bore versus open magnetic resonance imaging: a randomized controlled trial

BACKGROUND

Claustrophobia is a common problem precluding MR imaging. The purpose of the present study was to assess whether a short-bore or an open magnetic resonance (MR) scanner is superior in alleviating claustrophobia.

METHODS

Institutional review board approval and patient informed consent were obtained to compare short-bore versus open MR. From June 2008 to August 2009, 174 patients (139 women; mean age = 53.1 [SD 12.8]) with an overall mean score of 2.4 (SD 0.7, range 0 to 4) on the Claustrophobia Questionnaire (CLQ) and a clinical indication for imaging, were randomly assigned to receive evaluation by open or by short-bore MR. The primary outcomes were incomplete MR examinations due to a claustrophobic event. Follow-up was conducted 7 months after MR imaging. The primary analysis was performed according to the intention-to-treat strategy.

RESULTS

With 33 claustrophobic events in the short-bore group (39% [95% confidence interval [CI] 28% to 50%) versus 23 in the open scanner group (26% [95% CI 18% to 37%]; P = 0.08) the difference was not significant. Patients with an event were in the examination room for 3.8 min (SD 4.4) in the short-bore and for 8.5 min (SD 7) in the open group (P = 0.004). This was due to an earlier occurrence of events in the short-bore group. The CLQ suffocation subscale was significantly associated with the occurrence of claustrophobic events (P = 0.003). New findings that explained symptoms were found in 69% of MR examinations and led to changes in medical treatment in 47% and surgery in 10% of patients. After 7 months, perceived claustrophobia increased in 32% of patients with events versus in only 11% of patients without events (P = 0.004).

CONCLUSIONS

Even recent MR cannot prevent claustrophobia suggesting that further developments to create a more patient-centered MR scanner environment are needed.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00715806.