3T MRI induced post-traumatic stress disorder: a case report
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Published on: July 1, 2014
1Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, S100A, Cleveland, OH, 44106, USA. slakhan@gnif.org.
Introduction:
MRI is considered a safe and well tolerated imaging technique with risks largely limited to heating and/or displacement of implanted ferromagnetic metal in the patient's body, worsening anxiety, triggering claustrophobia, and gadolinium induced nephrogenic systemic fibrosis.
Case Presentation:
We present a case of a 26 year old Asian American man with no significant past medical or psychiatric history and two months of left T4 radicular pain. During 3T-MRI of the whole spine, the patient experienced acute agitation, fear, anxiety, tachypnea, tachycardia with palpitations, and dizziness. He felt intense surface heat over segments of his body and very loud noises. He perceived impending serious bodily harm by the scanner. The scan was aborted at the lumbar spine, and cervical and thoracic spine was unremarkable. The patient's pain resolved in the weeks following with over the counter analgesics, however, he developed increased arousal, re-experiencing the event, persistent avoidance, and significant psychosocial impairment consistent with DSM-IV-TR criteria for post-traumatic stress disorder (PTSD).
Conclusion:
This is the first reported case of MRI induced PTSD. Theoretically, the high-magnetic field of the 3T scanner may have contributed to the development of symptoms.
Insights
A 3T MRI scan triggered severe anxiety and symptoms consistent with post-traumatic stress disorder (PTSD) in a patient. This case highlights a potential psychological risk associated with high-field MRI, distinct from known physical risks.
Area of Science:
- Neurology
- Psychiatry
- Radiology
Background:
- Magnetic Resonance Imaging (MRI) is a widely used diagnostic tool.
- Known risks include heating, ferromagnetic object displacement, anxiety, claustrophobia, and nephrogenic systemic fibrosis.
- The safety profile is generally excellent, but psychological reactions are less understood.
Observation:
- A 26-year-old man experienced acute agitation, fear, anxiety, tachypnea, tachycardia, palpitations, dizziness, and perceived bodily harm during a 3T whole spine MRI.
- The patient reported intense heat sensations and loud noises during the scan.
- The MRI was aborted, and subsequent imaging of the cervical and thoracic spine was unremarkable.
Findings:
- Following the MRI, the patient developed symptoms meeting DSM-IV-TR criteria for post-traumatic stress disorder (PTSD).
- These symptoms included increased arousal, re-experiencing the event, and persistent avoidance.
- This is the first reported case of MRI-induced PTSD.
Implications:
- High-magnetic field strength (3T) in MRI may contribute to the development of psychological distress and PTSD.
- Clinicians should be aware of the potential for severe psychological reactions to MRI scans.
- Further research is needed to understand the mechanisms and prevalence of MRI-induced PTSD.
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