MRI safety of devices and implants

This is a survey of the safety of medical devices and implants in magnetic resonance imaging (MRI). Information adapted from Wikipedia, 2009 FDA guidelines, and TrueLearn. ADDITIONAL TAGS: 2009 FDA labeling system: MRI safe: poses no hazard in all MRI environments MRI conditional: safe under defined MRI environments; if the model number or name is known, conditions can be found at or on the manufacturer’s website MRI unsafe: not safe in any MRI environments. Device/Implant Safety Comments Arterial stents, coils, clips After six to eight weeks, they become embedded in the arteries and are MRI safe Bare metal coronary stents are considered MRI safe immediately after placement Breast implants/tissue expanders Most are rated MRI safe Some do have metallic components or magnetic injection site guides, and safety should be verified prior to imaging Bullets/Shrapnel/Metallic Fragments MRI is contraindicated if an object is near vital structures (eye, heart, arteries) Prior radiographic imaging should be reviewed to assess the location; if radiographic imaging is unavailable, consider using radiography or computed tomography to assess the location Cardiac valves Rated as MRI safe or conditional Cardiovascular implantable electronic device (pacemakers and/or implantable cardioverter-defibrillators) A cardiologist should be involved before, during, and after the MRI If an object is a legacy device, it is considered MRI unsafe Most modern CIEDs are MRI conditional Cerebrospinal fluid shunt Typically rated as MRI safe or conditional Cochlear implants The battery should be removed, and implant wrapping scheduling should occur before MRI is performed Contraceptive devices Most are rated as MRI safe or conditional Copper or steel (commonly used in China but can cause artifact) intrauterine devices have had no adverse effects Subdermal implants are MRI safe Dental implants Detachable implants should be removed Permanent implants tend to be ferromagnetic but do not pose harm due to being securely fixed to the bone or surrounding teeth Drug infusion pumps/patches Should be removed because of the risk of malfunction and thermal injury IVC filters If MRI is required, it should ideally be performed at least 8 weeks after placement to allow for embedding in the IVC Intracranial aneurysm clip Identification of the clip is required to prevent injury or death Jewelry All metallic jewelry should be removed Neurostimulators Rated as MRI conditional or unsafe Orthopedic implants Most are MRI conditional and consist of titanium which is not ferromagnetic Screws and anchors may be ferromagnetic but are secured in the bone and do not pose a hazard but will cause imaging artifact Penile prostheses Rated as MRI safe or conditional except for duraphase and omniphase, which are MRI-unsafe bc risk of displacement or torque injury Permanent makeup and tattoos Typically do not cause issues with MRI. Ferromagnetic ink can cause imaging artifacts. Dark or curved patterns can cause minor burning → treat with cold compress Surgical skin staples After six to eight weeks, granulomas form, and MRI can be performed Urinary catheters MRI safe because they are composed of plastic Vascular ports and intravenous catheters Rated as MRI safe or conditional