Why It’s Important To Find Metal Before MRI

A few weeks ago I posted my layperson’s summary of why there’s even an issue with metal and MRI (click here to read that post on MRI and Metal). In this posting, I hope to explain why it’s so critical to find metals, particularly ferromagnetic metals, being carried by people or inside objects.

First, let’s get the issue of non-ferromagnetic metals taken care of.

Metals that aren’t attracted to magnets are non-ferromagnetic. However, even if they aren’t attracted to the magnet, non-ferromagnetic metals do still interact with the magnetic field. They can cause local distortions which can mess up MRI scans (making it very difficult to image anatomy close to any metallic implant or object). Orthodontic braces may make certain facial / brain scans difficult. Orthopedic implants may disrupt the MR imaging of areas right around the pin / plate / screw / rod. Different materials will have different disruptive properties, so never assume that you can’t be imaged simply because you have an orthopedic implant. Check with a radiologist.

Also, MR imaging makes use of radio frequency (RF) energy. Like magnetism, RF is non-ionizing (doesn’t break down DNA and give rise to cancers as X-ray energies have been shown capable of), and like magnetism RF interacts with electrically conductive materials. If an electrically conductive element is the right shape and/or size, the material may inadvertently serve as an antenna for the RF signal and the energy may disproportionately collect in the conductor. As you may remember from high school physics, energy doesn’t just ‘go away,’ it converts. in the case of RF energy, it converts to heat. If you have the ‘ideal’ antenna length and/or configuration for a particular radio frequency, it can cause remarkable heating and that heat can cause damage.

But just as with the issue of image disruption, don’t assume that the presence of an electrical conductor inside your body is an automatic contraindication for an MRI exam. Consult your radiologist.

For these reasons, it is important to identify all electrically conductive materials on or in the patient. But even with these real risks associated with non-ferromagnetic materials, the greatest threat, both in terms of numbers of incidents and fatalities, is ferromagnetic materials.

Now, let’s move on to ferromagnetic materials. Some of this may seem familiar to you if you’ve read my prior post on MRI and Metal, but work with me here and you’ll find that we delve a little deeper into what happens that makes ferromagnetic materials such a concern.

When a ferromagnetic material enters a magnetic field, it becomes a magnet itself. A ferromagnetic material accepts an induced magnetic field. Many ferromagnetic materials give up the field almost as easily as they accept it, so they aren’t significantly magnetized. Think of them in the same way as I’m a baseball fan… when surrounded by baseball fans, I can pretend to be interested. Away from other baseball fans, I have almost zero interest in the game.

So, if a ferromagnetic material becomes a magnet when exposed to another magnet, we now have two magnets, and we all know what happens when we bring two magnets together… [SNAP]

Actually, when we bring two magnets together, two distinct things happen. The first is that the two magnets work to align themselves to one another. We know that two like magnetic fields (positive-to-positive) will repel each other, but opposite polarity fields will attract. The natural action is that the magnets will work to rotate themselves in order to align their fields positive-to-negative. Compass needles are the living illustration of this as we count on them to rotate to align with the North Pole.

In the case of a ferromagnetic object brought near an MRI, let’s compare our two magnets. One weighs perhaps 12 tons and is bolted to the floor, the other is a pair of scissors that weigh a few ounces. Which of these two things is going to rotate to align itself? Right, the scissors.

So the smaller ferromagnetic objects that we wear, carry, or have placed within our bodies, are going to be subject to intense forces that will be working to align the magnetic polarity of the object to the massive (in weight and strength) magnetic polarity of the MRI magnet. This results in torque forces that can twist, turn and even tear whatever may be trying to hold them in place.

The other mechanical force that develops between two magnets is the one we’re all very familiar with… attractive force. As we bring two magnets that have aligned themselves to one another (or, as it the case of sticking a magnet to your fridge door, the non-magnetized large ferromagnetic material develops a localized magnetic domain in order to receive the fridge-door magnet you’re sticking to it), they snap together, often with startling speed and strength.

We describe this phenomenon in MRI as the ‘missile effect’ because ferromagnetic objects, propelled by enormous amounts of magnetic energy, can launch across the room with tremendous force towards an MRI. While magnetic projectiles may look as though they’ve been launched from a cannon, unlike ‘launched’ projectiles, these magnetic missiles don’t lose their inertia just because they hit something. Their singular mission in life is to reach the strongest part of that magnetic field and, if interrupted in their flight, they will incessantly continue applying pressure to try and push their way towards the peak of the magnetic field (typically the center of the MRI).

The torque from rotating ferromagnetic materials and the force of flying ferromagnetic materials have each killed people in the MRI, and caused many injuries, and done horrific damage to MRI machines and their components. This presents two major problems…

First, metal is everywhere. It’s in our shoes. It’s in the shiny filaments in our clothes. Our belt-buckles. It’s in the stuff in our pockets. It’s often in thing that are labeled ‘sand bags’. It’s in stuffed animals and even often in hospital pillows. Metal is an unavoidable part of modern life.

Second, as I described in my prior post on metal and MRI, it’s impossible to visually distinguish between magnetic and non-magnetic metals. Even if we know something is made out of wood, for example, doesn’t mean that we can be confident that it isn’t held together with steel screws or reinforced with a steel rod. So, not only is metal ubiquitous, but ferromagnetic metals are perhaps the most widespread types of metal used in contemporary life.

Because of the torque and attraction risks of ferromagnetic materials, many tools and devices made for use in the MRI environment that require the strength and durability of metal use of aluminum, titanium, brass and other non-magnetic materials.

It is the intersection of these concerns – that all types of metal are everywhere and that we usually want to admit non-ferromagnetic metals into the MRI room – that generates the need for a detection system that distinguishes only ferromagnetic material.

The name of this blog is the MRI Metal Detector for precisely this reason… while I frequently digress and discuss many things relevant to MRI safety, at the heart this forum is about the specific risks associated with ferromagnetic metals and, equally importantly, the contemporary tools that can be effectively deployed to help reduce those risks.

To help protect patients, staff, and millions of dollars of MRI equipment, I recommend (as do the VA, the ACR and others) that every MRI provider avail themselves of ferromagnetic detection to help more effectively screen people and equipment intended to enter the MRI suite.

Tobias Gilk, President & MRI Safety Director
Mednovus, Inc.
Tobias.Gilk@Mednovus.com
www.MEDNOVUS.com

13 thoughts on “Why It’s Important To Find Metal Before MRI

  1. Pingback: ferromagnetic metals

  2. Kevin Smith

    About 3 months ago i was chushed by a Mac truck ,right after the surgery i remember waking up to nurses talking they were strapping me to an MRI table, I went back to sleep. I then again woke to a noise, but it was not a nurse. They had powered up the MIR and I could see the indicator light in the ring to show its spinning. after a moment went by I began to fall back to sleep, but stoped by a strange feeling in my hips where I have steel implants. Red warning lights started flashing , nurses were screaming and grabing me pulling. In all the dismay i started to panic not knowing what the problem was, I realised that i was no longer laying on the table i was floating in mid air! I became hotter and hotter to the point it was to much. Finally a doctor powered down the MRI causeing me to drop violently onto the table. After that I passed out from shock and delauded.

  3. Tobias Gilk Post author

    Kevin,

    I’m sorry about your injury and I hope that your recovery progresses smoothly. With regards to your story, I suspect you have elements of your treatment jumbled… not unusual following a traumatic injury.

    If there was something spinning around you inside the scanner, that suggests that what you were being scanned in was a CT scanner, not an MRI scanner (they can look very similar from the outside). Also, any implant would likely be stainless steel (or an even less magnetic material). The magnetic field of the MRI (had it been an MRI) would not / could not levitate you based on a hip replacement (even if it were raw iron). There are no red warning lights that I’m aware of that are a part of any MRI scanner. And lastly, while it is possible to easily stop an MRI scan, it is not easy to turn off the magnetic field of an MRI scanner (in virtually all scanners used for clinical care in hospitals). The magnetic field doesn’t turn on-and-off… it’s on 24/7.

    I’m not suggesting that the things you are remembering didn’t happen, only that the what you remember may be out of sequence and your mind seeks to fill in the missing fragments and construct a narrative that helps make sense of the pieces you remember.

    I wish you well.

  4. Karen

    Hi, I have Titanium rods,screws and bolts holding my back together due to cancer in my spine.
    I need regular scans to check the tumour has not spread as it is inoperable due to it’s location.
    I am unable to have any more MRI scans due to all the metal but i can have CT scans.
    Are MRI scans more thorough than CT scans?
    Thanks.
    Karen.

  5. Nikki

    I came across this article online while looking up… what happens If a person has metal on inside an MRI. I had a mri done on my head and neck today. The first part of the mri was fine. The usual uncomfortable feeling of being enclosed. The second mri for my neck I noticed a tingling almost immediately in my left hand. Soon in intervals my right elbow started feeling hot then my body temperature I could feel rising. I noticed that I began sweating and my elbow getting hotter and hotter. I shifted my elbow just enough not to disturb the imaging however the further into the scan my body temperature was almost unbareable. I felt a conduction across my right elbow across my stomach into my clasped hands and and especially fingertips of my left hand. Then it was over. I complained the source…. a metal snap button on the hospital gown. Now I wonder will there be short or long term side effects?

  6. Nikki

    Also… I would say a bare 1st degree burn on my elbow I treated with burn solution 5 hours later mild irration at the site.

  7. Tobias Gilk Post author

    Karen,

    Sorry for the slowness in replying.
    MRI scanners work on entirely different principles than do CT scans. It’s not a question of which is more thorough, but which imaging methodology is best for a specific part of the body or given set of conditions.

    One of the disadvantages of MRI is that it is disrupted by metal implants. This can distort, or even ‘erase’ the area right around the implant. If the doctors are looking for indications right around the hardware in your spine, MRI would then present a problem.

    I hope this helps.

    Tobias

  8. Tobias Gilk Post author

    Nikki,

    You mentioned metal being with you in your first post… but you didn’t say what metal that might have been (or where).

    There is the potential for metal materials to heat up during an MRI exam, but this depends on their size, shape, and location within the MRI scanner during the exam.

    Completely independent of any metal heating, it is entirely normal for your body to warm during an MRI exam. The RF energies used for the imaging do convert to heat inside your body, so an overall warming can happen (depending on the MRI machine and the exam).

    Elbow burns, on the other hand, are a particular known risk that can / should be prevented. If your elbow was allowed to touch the side-wall of the MRI (or had something only as thick as a sheet or shirt sleeve to keep it from touching), then your elbow may have received some concentrated RF energies. This is not dangerous in the way that an over-exposure to X-rays might be, but it can (and sounds as if it did) produce something roughly equivalent to a sunburn.

    There should, however, be no lasting effects from your MRI exam or from the irritating burn on your elbow (once it heals).

    I hope this helps.

    Tobias

  9. Helen

    I had an MRI on my knee today. I took off everything metal before the scan but when I left the building I realised I hadn’t taken my hip belt off during the MRI which contained some coins in it.

    I’m assuming the MRI will now be distorted as a consequence? Will I suffer any ill effects?

  10. AJ

    Hey, wonder if I could get some advice. I have the remains of a bullet in my neck (tongue) – about 1 cm cubed in size – should I be concerned about having an MRI? I suspect the metal is lead as I was shot with a shot gun but I cannot be sure. My worry is that the MRI could move the foreign body and cause further injury. I have no need to have an MRI at present but my concern is if I should ever be involved in an accident where I understand it is often routine to perform a scan. I currently wear an ID chain around my neck requesting no MRI – just in case!

  11. Tobias Gilk Post author

    Distortions from metal in the MRI vary depending on the type of metal and the specific type of scan that’s being performed. In all cases, however, the distortions’ reach diminishes as you move away from the location of the metal. While it is always wise to remove all metal, in your case I would expect that if there was a problem, the technologist / radiographer administering the exam would have seen it on the screen and not let the exam continue without investigating.

    The fact that there had been metal in the scanner with you should not have any negative effects on you (if it didn’t fly at you during the exam, or produce a burn). If you have any concerns about the presence of the metal somehow negatively affecting the image, you should be able to contact the place where you had the MRI done and verify with them.

    I hope this helps.

  12. Tobias Gilk Post author

    The concerns about retained metal have to do with whether it will move… if it does, what structures is it near that the movement could impact… and how much will this metal negatively affect the image of that area…

    1 cm is pretty large fragment, and the neck is full of critical structures. If it is a ferromagnetic material and not lead, this could result in significant risks in an MRI. If it were to be lead, then the risks associated with movement (from the magnetic fields of the MRI) would drop to near zero.

    Unless / until you can verify what the foreign object is made of, or have a physician perform a risk:benefit evaluation of performing an MRI on you, in my opinion I think it is prudent to be cautious and avoid any unnecessary exposure to the powerful magnetic fields of an MRI scanner.

    I hope this helps.

Leave a Reply

Your email address will not be published. Required fields are marked *

CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>