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Updated: Jun 18, 2026
Protocol for the Evaluation of MRI Artifacts Caused by Metal Implants to Assess the Suitability of Implants and the Vulnerability of Pulse Sequences
Published on: May 17, 2018
Is magnetic resonance imaging safe for patients with retained metal fragments from combat and terrorist attacks?
Iris Eshed1, Tamar Kushnir, Noga Shabshin
1Department of Diagnostic Imaging, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. iris.eshed@sheba.health.gov.il
Background:
Increasing numbers of military confrontations and terrorist attacks have led to increasing reports of retained metal fragments among patients referred for magnetic resonance imaging (MRI). The potential hazard of retained metal fragments for patients undergoing MRI has been studied among patients with retained metal fragments from domestic violence but not from combat and terrorist attacks.
Purpose:
To retrospectively evaluate the safety of MRI in patients with subcutaneous warfare-metal fragments.
Material And Methods:
10,322 consecutive metal screening forms of patients scheduled for 1.5 Tesla (T) MR examination were retrospectively reviewed. All patients reported to have retained metal fragments were contacted by telephone and asked to describe the event in which they were exposed to the fragments and for any adverse sequelae or sensations during and after MRI. Their radiographs were evaluated for the number and size of the fragments. The data were analyzed for correlations between these factors.
Results:
Seven of the 24 patients who reported retained metal fragments were excluded, since there was no validating evidence of their presence. Fragments in the remaining 17 patients (18 MRI examinations) were inflicted by military or terrorist attacks that occurred 2-39 years prior to the MRI. The fragment size ranged between 1 and 10 mm. One patient reported a superficial migration of a 10-mm fragment after MRI. No other adverse reactions were reported.
Conclusion:
Conducting 1.5T MRI examinations is safe in patients with retained metal fragments from combat and terrorist attacks not in the vicinity of vital organs. However, caution is advised.
Insights
Magnetic resonance imaging (MRI) is safe for patients with metal fragments from combat or terrorist attacks. Caution is advised, but no adverse reactions were reported in this study of warfare-related fragments.
Area of Science:
- Radiology
- Medical Imaging
- Trauma Surgery
Background:
- Increasing military confrontations and terrorist attacks result in more patients with retained metal fragments.
- Previous studies on MRI safety with metal fragments focused on domestic violence, not combat or terrorism.
- The safety of magnetic resonance imaging (MRI) in patients with warfare-related metal fragments is not well-established.
Purpose of the Study:
- To retrospectively evaluate the safety of 1.5 Tesla (T) MRI in patients with subcutaneous warfare-metal fragments.
- Assess potential risks associated with MRI in individuals with metallic fragments from combat and terrorist incidents.
Main Methods:
- Reviewed 10,322 metal screening forms for patients scheduled for 1.5T MR examinations.
- Contacted patients with reported fragments via telephone to inquire about adverse events during or after MRI.
- Evaluated radiographs for fragment presence, number, and size, analyzing correlations with patient-reported outcomes.
Main Results:
- 17 patients (18 MRI examinations) with fragments from attacks 2-39 years prior underwent MRI.
- Fragment sizes ranged from 1 to 10 mm.
- One patient reported superficial fragment migration post-MRI; no other adverse reactions were noted.
Conclusions:
- 1.5T MRI is generally safe for patients with retained metal fragments from combat and terrorist attacks, provided fragments are not near vital organs.
- While generally safe, caution is advised when performing MRI on these patients.
- Further research may be warranted to establish definitive safety guidelines.
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