Patient preparation for MRI CT and Nuclear Medicine

1. Patient Preparation for MRI-CT-Patient Preparation for MRI-CT-
Nuclear MedicineNuclear Medicine
ANIL HARI
Clinical Imaging Technologist

2. What is MRI?What is MRI?
A magnetic resonance imaging (MRI) scan is a painless
procedure that lasts 15 to 90 minutes, depending on the size of
the area being scanned and the number of images being taken.
MRI uses a powerful magnetic field, radio frequency pulses and
a computer to produce detailed pictures of organs, soft tissues,
bone and virtually all other internal body structures. MRI does
not use ionizing radiation (x-rays). Detailed MR images allow
physicians to evaluate various parts of the body and determine
the presence of certain diseases. The images can then be
examined on a computer monitor, transmitted electronically,
printed or copied to a CD.

3. PREPARATION FOR MRI PROCEDURE
TIME OF APPOINTMENT
Patient should give Serum creatinine Blood Test before scan ( Diabetic patient done with in
one month, inpatient with in a week and other out patient with in three months )
One hour fasting ( except adenosine –12 hrs and other abdominal MRI- 4hrs)
Asthmatic preparation( Asthma contra indicated for Adenosine stress MRI )
For adenosine MRI 12 hour fasting. Avoid Tea, coffee and caffeine items, smoking, coco
cola for 24-48 hours
For adenosine patient stop beta blockers 12 hrs prior.
Please inform the department if there is any possibility you may be pregnant or lactating.
Please bring valid patient identification on the day of procedure(Health card/QID or
passport).
Clerk should be check in Cerner/PACS availability of contact number.

4. BEFORE SCAN
Patient may be asked to wear a gown during the exam or may be allowed to wear own
clothing if it is loose-fitting and has no metal fasteners.
Jewellery and other accessories should be left at home if possible, or removed prior to
the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal
and electronic items are not allowed in the exam room. These items include: jewellery,
watches, credit cards and hearing aids, all of which can be damaged pins, hairpins, metal
zippers and similar metallic items, which can distort MRI images removable dental work
pens, pocket knives and eyeglasses body piercings.
Sign the safety check list.(Important)
If a contrast material will be used in the MRI exam, a physician, nurse or technologist
will insert an intravenous (IV) catheter, also known as an IV line, into a vein in hand or
arm. A saline solution may be used to inject the contrast material.
For female in child bearing age.

5. DURING THE SCAN
 An MRI scanner is a short cylinder that's open at both ends. Patient will lie on a
motorized bed that's moved inside the scanner. He will enter the scanner either
head first or feet first, depending on the part of the body being scanned.
 In some cases, a frame may be placed over the body part being scanned, such as
the head or chest. This frame contains receivers that pick up the signals sent out by
the body during the scan and it can help to create a better-quality image.
 A computer is used to operate the MRI scanner, which is located in a different room
to keep it away from the magnetic field generated by the scanner.
 The radiographer operates the computer, so they'll also be in a separate room.
However, will be able to talk to them, usually through an intercom.
 Children will be given appropriately sized earplugs or headphones during the exam.
The MRI scanner will make loud tapping noises at certain times during the
procedure.
 MRI scanners are air-conditioned and well-lit. Music may be played through the
headphones to help patient pass the time.
• Patient may be asked to hold breath during short scans. Depending on the size of
the area being scanned and how many images are taken, the whole procedure will
take 15 to 90 minutes.

6. AFTER THE SCAN
• Patient may be asked to wait while the radiographer checks the quality of the
pictures. In some cases, he may be asked to get back into the MRI scanner so
that more pictures can be taken. If the pictures are satisfactory, he can get
dressed and go home.
• After the scan, he can resume normal activities immediately.
• If he had sedative before the scan it will not be safe for him to drive or drink
alcohol for 24 after having scan.
• Ask the patient to drink more water (around 2-3 litters ) for 2-3 days.

8. What is CT?What is CT?
A computerized tomography (CT) scan combines a series of X-ray
images taken from different angles around your body and uses
computer processing to create cross-sectional images (slices) of
the bones, blood vessels and soft tissues inside your body. CT
scan images provide more-detailed information than plain X-rays
do.

9. PREPARATION FOR CT PROCEDURE
TIME OF APPOINTMENT
•Please be fasting for 6 hours before your appointment.
•Please do not consume any caffeinated beverages or food (coffee, caffeinated soda,
chocolate)
•Patient should continue BP medications.
•Discontinue the use of Metformin /Glucophage the night before procedure, day of
procedure and the day after procedure.
•Patient should give Serum creatinine Blood Test before scan ( Diabetic patient done with in
one month, inpatient with in a week and other out patient with in three months )
•If you are asthmatic or have a known contrast allergy or had a reaction to contrast dye,
please inform the department.
For ladies
•Please inform the department if there is any possibility you may be pregnant or lactating.
•Please bring old X-ray films if any, or X-ray films and patient’s documentation from outside
HMC
•Please bring valid patient identification on the day of procedure(Health card/QID or
passport)

10. BEFORE SCAN
Check patient ID card.
If a contrast material will be used in the CT exam, nursing staff check the serum
creatinine level and other vital signs.
If a contrast material will be used in the CT exam, patient should sign consent.
If a contrast material will be used in the CT exam, a physician, nurse or technologist will
insert an intravenous (IV) catheter, also known as an IV line, into a vein in hand or arm. A
saline solution may be used to inject the contrast material. The solution will drip through
the IV to prevent blockage of the IV catheter until the contrast material is injected.
Patient may be asked to wear a gown during the exam .
Jewellery and other accessories should be left at home if possible, or removed prior to
the CT scan depends on the area to be scanned. Because if the jewellery area is same as
scanning area cause metal artifacts.

11. DURING THE SCAN
 An CT scanner is a short cylinder that's open at both ends. Patient will lie on a
motorized bed that's moved inside the scanner. He will enter the scanner either
head first or feet first, depending on the part of the body being scanned.
 Technologist explain the procedure to patient.
 Immediately after giving contrast nursing staff should check the patient.

12. AFTER THE SCAN
• Patient may be asked to wait while the radiographer checks the quality of the
pictures.
• If a contrast material will be used in the CT exam, nursing staff check vital signs
and ask the patient to wait for 10 min to check any contrast reaction. If any
reaction noted inform the radiologist immediately.
• After the scan, he can resume normal activities immediately.
• Ask the patient to drink more water (around 2-3 litters ) for 2-3 days.

14. PATIENT PREPRATION FOR NUCLEAR MEDICINE
PROCEDURES
• It’s a vast topic to explain as there are
more than 50 procedures excluding the
therapeutic procedures
• We will concentrate on the commonly
done procedures in HMC, which are
stated below.

15. Myocardial perfusion scintigraphy
1. Physical stress with treadmill / bicycle ergometer
o Stop taking any beta-blocker
o Nothing to eat or drink (NPO) for 6 hours before stress
test.
2. Myocardial Perfusion Imaging, with Regedenoson
(Lexiscan), Adenosine, or Percentile Stress
• No caffeine products (coffee, decaf coffee, tea, chocolate, cola) for
24 hours before test.
• Nothing to eat or drink (NPO) for at least 6 hours before stress test.
• Allow 3 to 4 hours for an entire rest/stress one-day exam.
• No Theophylline or Xanthine medications (such as asthma
medications, Aggrenox, etc.) for 48 hours. OK to use inhalers.

16. Skeletal scintigraphy
• Patient should be away from the pregnant
ladies and small children for 12 hrs.
• Advised to drink lot of fluids for the whole day
even after the scan is finished

17. 99mTc-thyroid scintigraphy
• Stop carbimazole 1 week before
procedure
• No IV iodinated contrast for 6 to 8 weeks
from the date of appointment
• Avoid high iodine containing diet and
supplements 1 day prior to procedure.

18. 99mTc DTPA/MAG3 renogram
• Patient should be well hydrated
• Patient should stop ACE inhibitors for
captopril renogram, for base line
renogram.