ASA monitoring standards and magnetic resonance imaging

Some patients, often because of age or altered mental state, require general anesthesia or monitored anesthesia care and sedation if adequate magnetic resonance imaging (MRI) is to be accomplished. This study evaluated whether patients can be monitored during MRI with 1.5-tesla scanners in a manner which complies with ASA monitoring standards without causing degradation of image quality. Ten volunteers were scanned in the MRI without sedation. Monitors meeting ASA standards were placed and electronic artifact produced by the magnetic resonance (MR) scanner was evaluated, after which two scans of the head and two of the chest were performed. One of each pair of scans was obtained with the monitors functioning and one with them turned off. Four radiologists, blinded as to whether the monitors were turned on or off, independently evaluated the 20 pairs of scans. Differences in diagnostic quality and image degradation between the scans were evaluated and scores assigned. All monitors functioned appropriately during the scans, with the exception of the electrocardiogram (ECG) which was grossly distorted to the extent that only ventricular rate could be evaluated. None of the head or body scans was nondiagnostic; however, images with the monitors off were of better quality overall than with them on. Two types of noise were generated and are described. During the head scans, three of seven monitoring combinations caused degradation of the images, while four were judged clinically adequate. During the body scans, two of six monitoring combinations created noticeable noise, while four introduced no significant noise. Ungated cardiac scans were nondiagnostic.(ABSTRACT TRUNCATED AT 250 WORDS)