Reduction of Claustrophobia with Short-Bore versus Open Magnetic Resonance Imaging: A Randomized Controlled Trial

Abstract

BackgroundClaustrophobia 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.MethodsInstitutional 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.ResultsWith 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).ConclusionsEven recent MR cannot prevent claustrophobia suggesting that further developments to create a more patient-centered MR scanner environment are needed.Trial RegistrationClinicalTrials.gov NCT00715806

High-Field Open versus Short-Bore Magnetic Resonance Imaging of the Spine: A Randomized Controlled Comparison of Image Quality

“…Follow-up was performed clinically until 7 months after randomization without another MR imaging session as reported in the Journal [8]. Inclusion criteria were a clinical indication for MR imaging of the head, spine, or shoulder, and a total mean score of at least 1.0 in the Claustrophobia Questionnaire (CLQ, score range: 0 to 4) [16].…”

Effect of team training on improving MRI study completion rates and no‐show rates

“…Claustrophobic patients may initially cancel or fail to show up for their appointment (no-show) as a result of their anxiety, they may be unable to hold still during their study if they do appear, and they may even ask to terminate their study before completion (incomplete study) once their study has been initiated. Incomplete study rates vary from an average of 2.3% (2) to as high as 25–39% in selected anxious populations, even when larger bore claustrophobia-friendly open scanners are used (3). No-shows and incompletions result in ineffective utilization and financial losses (4, 5).…”

Patient Perception of Lower Limb Non-Contrast Magnetic Resonance Angiography and Digital Subtraction Angiography in Diabetic Patients with Peripheral Arterial Disease

“…Ongoing improvements in receiver coil design, such as weight reduction and improvements in the flexibility and shape, may reduce coil-related pressure [46,47]. Issues of claustrophobia (n=1) and large body habitus precluding positioning at the isocenter of the magnet bore (n=1) may be mitigated with wide-bore systems that are commercially available but were not available at our institution, and which have been demonstrated to decrease patient claustrophobia [48,49]. Open MRI systems are also available, although, to our knowledge, there are no such systems demonstrating sufficient extremity arterial image quality.…”