Anxiety-Related Reactions Associated With Magnetic Resonance Imaging Examinations

Meléndez, Jorge Carreño; McCrank, E.

doi:10.1001/jama.1993.03510060091039

Cited by 210 publications

(102 citation statements)

References 16 publications

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“…Reasons for this discrepancy are unclear and might be explained by different indications for CT examinations (special role of screening examination leading to different expectancy). Considering the results about MRI-related claustrophobia in the literature, it is remarkable that incidences of such anxieties differ extremely: while low incidences of 2% are documented in some publications (1,8), other authors describe claustrophobia rates of up to 65% (2,5,31). One of the largest patient groups (4821 patients with 5798 examinations) investigated for claustrophobia in MRI was published in 2007 by Eshed et al (1): patient characteristics and the fact that women reached higher anxiety values were concordant with our data.…”

Section: Discussionmentioning

confidence: 99%

Anxiety of Patients Undergoing CT Imaging—An Underestimated Problem?

Heyer¹,

Thüring²,

Lemburg³

et al. 2015

Academic Radiology

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Section: Discussionmentioning

confidence: 99%

Anxiety of Patients Undergoing CT Imaging—An Underestimated Problem?

Heyer¹,

Thüring²,

Lemburg³

et al. 2015

Academic Radiology

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“…Während der Untersuchung muss der Patient in einer engen langen "Röhre" absolut ruhig liegen, um keine Bewegungsartefakte zu verursachen, die die Aussagekraft der Untersuchung deutlich herabsetzen. Bei einem Teil der Patienten (etwa 30%) entwickelt sich unter diesen Umständen ein Angstverhalten, das bei etwa 4-10% der Patienten zu wahren Panikattacken und damit regelhaft zum Abbruch der Untersuchung führt [6,13]. Bei einer mangelnden Kooperation des Patienten muss mit verlängerten Untersuchungszeiten und artefaktgestörten Bildern mit einem schlechteren diagnostischen Aussagewert gerechnet werden.…”

Section: Einführungunclassified

Intranasale Midazolamapplikation zur Anxiolyse bei der Magnetresonanztomographie

Münte¹,

Hollenhorst²,

Friedrich³

et al. 2002

Klinische Neuroradiologie

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ZusammenfassungHintergrund: Bis zu 30% der untersuchten Patienten erleben Angstreaktionen während einer Magnetresonanztomographie (MRT), die zu einem Abbruch der Untersuchung bei 4-10% der Patienten zwingen. Wir haben die Wirkung intranasal applizierten Midazolam-Sprays zur Prävention von Panikattacken während einer MRT untersucht. Patienten und Methoden: Es wurden 54 Patienten, bei denen eine Kernspinuntersuchung durchgeführt wurde, in die Studie eingeschlossen. Angst und Sedierung der Patienten wurden vor der Medikamentenapplikation, direkt vor und nach der Untersuchung gemessen. Hierzu wurden das State-Trait-Angstinventar von Spielberger, eine visuelle Analogskala für die Erfassung des Angstniveaus und eine Fünf-Punkte-Skala für den Sedierungsgrad verwendet. Den Patienten wurden doppelblind und randomisiert entweder sechs Hübe von Midazolam 0,5% (insgesamt 4 mg) oder NaCl 0,9% intranasal appliziert. Die Patienten beurteilten die Intensität des Nasenbrennens anhand einer Drei-Stufen-Skala. Die Bildqualität der Untersuchungsbilder wurde von dem untersuchenden Neuroradiologen anhand einer Fünf-Stufen-Skala beurteilt. Ergebnisse: In der Midazolamgruppe brach kein Patient die Untersuchung ab im Gegensatz zur Plazebogruppe, in der vier von 27 Patienten die Untersuchung abbrachen. Die Patienten der Midazolamgruppe waren weniger ängst-lich und mehr sediert und hatten mehr Nasenbrennen als die Patienten der Kontrollgruppe. Die Bildqualität war in der Midazolamgruppe besser. Schlussfolgerungen: Intranasal appliziertes Midazolam-Spray führt zu einer deutlichen Angstreduktion und einer Verbesserung der Bildqualität der MRT. Außer einem kurzzeitigen brennenden Gefühl der Nasenschleimhaut wurden keine weiteren unerwünschten Wirkungen beobachtet. Diese einfach durchführbare, sichere und kostengünstige Methode kann angewendet werden, die Angst der Patienten vor oder während einer MRT zu reduzieren. Schlüsselwörter: Midazolam · Anxiolyse · MRT AbstractObjective: Magnetic resonance imaging examination evokes anxiety up to 30% of patients, and many describe the experience as comparable to being "in a coffin or tomb". Severe panic or claustrophobia occurs in one third of these patients compelling to additional sequences or to interruption of the procedure. While the use of MRI in resolving diagnostic problems is gaining popularity, methods to handle the claustrophobic fear of patients are still lacking. We evaluated the effectiveness of intranasal administered midazolam spray in preventing phobic responses of patients undergoing MRI scan using a controlled, randomized and double-blind study design. Patients and Methods: 54 patients scheduled for head-first MRI scan were included in the study. Anxiety and sedation of patients was evaluated before the drug administration, immediately before the MRI scan and at the end of the procedure. Spielberger State-Trait Axiety Inventory, visual analogue scale (VAS) of anxiety and a five-point

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“…However, assuming comparability between data from two dissimilar settings may be erroneous, as the scanning environment can be experienced as soporific, distracting or even stressful (Quirk et al 1989). The scanning procedure as such is non-harmful and signed consent ensures that volunteers know this on an intellectual level, but limited mobility and other MR-characteristics can cause discomfort and even distress (Brennan et al 1988;Katz et al 1994;Meléndez and McCrank 1993;Quirk et al 1989). Additionally to self-reported anxiety (Katz et al 1994;McIsaac et al 1998;Quirk et al 1989), observer-rated fearfulness (Katz et al 1994), and psychophysiological measures (Chapman et al 2010) caused by MR-induced discomfort have been investigated.…”

Section: Introductionmentioning

confidence: 99%

MRI scanner environment increases pain perception in a standardized nociceptive paradigm

Ellerbrock

May

2014

Brain Imaging and Behavior

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Functional magnetic resonance imaging (MRI) has been widely used in neuroscientific studies to investigate neural correlates of perception and higher cognitive functions. Early on, the MR-scanning procedure itself has been identified to create discomfort and anxiety in some individuals, which may influence task performance and perception. The present study analyzed behavioral differences in pain intensity ratings obtained in two distinct situations: MR environment and laboratory setting. Within our longitudinal study design twenty healthy volunteers were exposed daily to an identical paradigm consisting of 60 repeated noxious heat stimuli (46 °C) on 21 consecutive days. After each block of ten stimuli, participants were prompted to rate pain intensity on a visual analog scale (VAS). On days 1, 8, 14, and 21 ratings scores were obtained during a functional imaging scan, whereas on the remaining days the sessions were conducted in a laboratory. It has come to our attention that pain intensity ratings acquired in MR environment were significantly higher than behavioral data collected in the lab setting. Given that the stimuli were standardized and no task or distraction confounded the ratings, it is likely that the attentional focus on noxious stimulation was identical in both conditions. It seems that the highly artificial scanner environment as such is sufficient to increase awareness/alertness. Given that salience rather than pure nociceptive input has been suggested to explain functional imaging results in painful conditions, these findings highlight concerns regarding the comparability of behavioral data assembled across inconsistent settings.

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Anxiety-Related Reactions Associated With Magnetic Resonance Imaging Examinations

Cited by 210 publications

References 16 publications

Anxiety of Patients Undergoing CT Imaging—An Underestimated Problem?

Anxiety of Patients Undergoing CT Imaging—An Underestimated Problem?

Intranasale Midazolamapplikation zur Anxiolyse bei der Magnetresonanztomographie

MRI scanner environment increases pain perception in a standardized nociceptive paradigm

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