Claustrophobia still influences small percentage of MRI procedures

A study of more than 4800 hospital patients has established that claustrophobia remains an impediment for MRI practice and a difficult experience for about 2% of patients undergoing MR procedures.

By reviewing imaging records, Dr. Iris Eshed and colleagues at Charité Medical Center in Berlin learned that 1.97% (95) of 4821 patients complained of claustrophobia during routine clinical MR imaging on 1.5T scanners at the hospital in 2004. Among those 95 cases, 59 (1.22% of total) were severe enough to prematurely halt imaging. The results were reported in the July issue of the Journal of Magnetic Resonance Imaging

Eshed's results come close to matching one of the few other large cohort studies of MR-related claustrophobia (Australas Radiol 1998;42:293-295). That investigation, based on 0.5T MRI, found that 1.5% of 3000 studies induced a claustrophobic reaction.

Other published studies in the 1980s and 1990s found claustrophobia rates as high as 37% and exam failure rates because of claustrophobic reactions of 0.5% to 14.5%. Most of those trials, however, involved few subjects and were performed on now-obsolete narrow gantry systems, Eshed said. The U.S. public at the time was concerned enough about the risk of claustrophobia to spawn an industry of open-style midfield MRI centers that catered to their anxiety.

All three 1.5T Siemens scanners used in Eshed's trial had a bore width of 60 cm. Two had bore heights of 60 cm, while the third's was 58 cm. The bore lengths of the Magnetom Vision II, Symphony Vision, and Sonata scanners were 202 cm, 141 cm, and 90 cm, respectively.

A majority of the claustrophobia cases in Eshed's study involved head and neck applications. The head coil for such procedures may have exacerbated patient anxiety about placement in a confined space. Only a single incident of premature MRI termination occurred during imaging of the lower extremity with only the legs within the bore.

Age and sex did not significantly affect the results. Children under the age of five were excluded from the trial.

Eshed recommended partial sedation and prone positioning when possible to control the number of prematurely terminated studies because of claustrophobia.

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