Novel MRI Designs Have Little Effect on Patient Claustrophobia

It turns out open panoramic or short-bore MRI scanners don’t do much to reduce patients’ claustrophobia. Researchers found the two approaches, developed to ease patient comfort, did not significantly reduce the number of claustrophobia events for those at high-risk for the condition, according to the results of a study published recently in Plos One.

“The present study in high-risk patients demonstrated claustrophobia precluding MR imaging in more than 25 percent of examinations despite using scanner designs expected to lower the rate of claustrophobic events,” wrote researchers, led by Judith Enders, MD, from the department of radiology at Humboldt University, Berlin, Germany.

Claustrophobia is a common challenge for patients who undergo MRI with up to as many as 15 percent of patients having examinations that cannot be completed due to symptoms, according to research background.

Enders and colleagues compared the use of two more recent MRI scanner configurations to see if they helped reduced claustrophobia: an open panoramic scanner and a short-bore scanner.

[[{"type":"media","view_mode":"media_crop","fid":"12407","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_8062972480888","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"501","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"margin: 5px; width: 300px; height: 140px; float: right;","title":"(A) Open panoramic MRI and (B) short-bore MRI; Image courtesy PLoS ONE.","typeof":"foaf:Image"}}]]The study included 174 patients with an overall mean score of 2.4 on the Claustrophobia Questionnaire (CLQ). All patients were enrolled between June 2008 and August 2009 and had a clinical indication for imaging. In addition, patients were assessed for claustrophobia, general anxiety, depressions and health-related quality of life. Patients were randomly assigned to undergo imaging with either the open or the short-bore scanner.

Fifty-six claustrophobia events occurred during the study: 33 in the short-bore group compared with 23 in the open MR group, not a significant difference.

On average, patients were in the examination room for 3.8 minutes before an event occurred in the short-bore group and 8.5 minutes in the open MR group (P=.004).

“Although the results support an advantage of open MR, events did occur earlier in the imaging procedure in the short-bore group, which can facilitate interventions and prevent waste of valuable examination time,” the researchers wrote.

Those patients who had a claustrophobia event were identified as having a higher CLQ score compared to those who did not (2.6 vs. 2.3; P=.009). The difference in scores was associated with high CLQ suffocation subscale scores.

“Thus, the CLQ might be a useful tool to identify patients at increased risk for claustrophobia during MR imaging which allows for early interventions such as by relaxation techniques, social support or conscious sedation,” the researchers wrote.

When the researchers conducted a psychological follow-up at seven months, they found that 32 percent of patients who experienced an event had increased perceived claustrophobia compared with 11 percent of patients who did not experience an event.

“Interestingly, patients rated their pre-imaging anxiety at the first MR appointment significantly higher in retrospect at seven-month follow-up compared with the assessment directly before MR imaging,” the researchers wrote. “Further developments towards a more patient-centered MR scanner environment are clearly needed to make this important diagnostic test available to all patients.”