Magnetic Resonance Imaging (MRI) uses a strong magnetic field and radio waves to create detailed images of organs and tissues. Its ability to produce high-resolution pictures without using ionizing radiation makes it a powerful diagnostic tool. However, a traditional MRI scanner is designed as a long, narrow tube, or bore, and this confined space can trigger intense anxiety and claustrophobia in many patients, often preventing them from completing the necessary procedure.
Adapting the MRI Environment
The most immediate solution involves modifying the imaging hardware itself to reduce the feeling of enclosure. Modern Open MRI scanners are a physical departure from the traditional cylindrical design, often featuring magnets above and below the patient with open space on the sides. This configuration virtually eliminates the tunnel experience, which is particularly beneficial for severely claustrophobic patients, children, and those with larger body types. Open systems, however, sometimes operate at lower magnetic field strengths, which can result in less detailed images or longer scan times compared to high-field closed units.
Wide-Bore and Short-Bore MRI systems retain the cylindrical design necessary for high-field strength but offer a significantly larger opening, typically around 70 centimeters in diameter. The “short-bore” design means the tunnel is shorter, allowing the patient’s head or feet to remain outside the machine for many common body scans. These adaptations offer a compromise by maintaining high diagnostic quality while increasing patient comfort and reducing the feeling of confinement.
Environmental modifications within the MRI suite help create a calmer experience. Many facilities incorporate Ambient Features such as specialized mirrors that project a view of the scanning room or ceiling onto the patient’s line of sight. Patients can wear headphones to listen to calming music or audiobooks, which serves to distract them and dampen the loud, repetitive knocking noises generated by the machine’s gradient coils.
Managing Anxiety Through Medical and Psychological Interventions
When physical changes to the machine are not enough or not available, interventions targeting the patient’s anxiety are employed. For moderate anxiety, a physician may prescribe Oral Anti-Anxiety Medications, such as benzodiazepines like Lorazepam or Diazepam, to be taken shortly before the scan. These medications work by enhancing the effect of the neurotransmitter GABA in the brain, inducing a state of relaxation and drowsiness that allows the patient to tolerate the confined space.
This pharmacological approach requires careful planning, including a pre-scan consultation and arranging a ride home, as the sedative effects preclude driving. For patients with severe phobia or those who require lengthy or complex scans, Intravenous (IV) Sedation or General Anesthesia (GA) may be necessary. These deeper levels of sedation require a hospital or specialized facility setting, the presence of a dedicated anesthesiologist for continuous monitoring, and strict pre-procedure fasting guidelines.
Behavioral and Psychological Techniques are effective for managing scan-related anxiety. Simple strategies like deep, rhythmic breathing exercises and visualization, such as mentally placing oneself in a peaceful, open environment, can give the patient a sense of control. Constant, reassuring communication from the technologist throughout the procedure is a powerful tool, providing real-time updates and ensuring the patient knows they can stop the scan at any moment using a call button.
Non-MRI Imaging Technologies
Alternative imaging technologies can provide necessary diagnostic information. Computed Tomography (CT) Scans use X-rays and computer processing to create cross-sectional images. The machines are shaped like a large, short, open ring, or gantry, making them less confining than an MRI. CT scans are also much faster, often taking only minutes, but they use ionizing radiation and do not provide the same level of soft tissue contrast as an MRI.
Ultrasound uses high-frequency sound waves to create real-time images of soft tissues, blood vessels, and certain organs. Because the procedure is performed with a handheld probe on an examination table, it involves no confinement and no radiation. However, ultrasound is not effective for imaging structures encased in bone, such as the brain or spinal cord, which are often the domain of MRI.
Nuclear Medicine scans, such as Positron Emission Tomography (PET) or Single-Photon Emission Computed Tomography (SPECT), are functional imaging methods. PET and SPECT scanners, often combined with a CT scanner, are designed with a large, short, doughnut-shaped opening, which is far less restrictive than a traditional MRI bore. While these techniques are excellent for showing metabolic function and are less claustrophobic, they require the injection of a radioactive tracer and may not offer the anatomical detail needed for all diagnoses.