MR Imaging of COVID-19 Patients Should Be Avoided

A new guidance statement by the American College of Radiology (ACR; Reston, VA, USA) recommends that radiologists avoid performing magnetic resonance imaging (MRI) exams on patients diagnosed with, or suspected of having, COVID-19.

The ACR guidance, issued on April 8, 2020, recommends that practitioners minimize the use of MRI except where absolutely necessary, and postpone all non-urgent or non-emergent exams. Prerequisites include implementation of site-specific cleaning and disinfecting protocols, including a 60 minute down-time between patients, to be followed by a cleaning protocol with approved cleaning agents that follow a clockwise, linear, top to bottom pattern on all visible surfaces. The ACR cleaning protocols need to be moderated by local policies, and especially the specific clinical needs of the patients and site, and can change over time.

In addition, MRI exams for patients should utilize standard surgical face masks or respirators (non-N95 respirators), that are known to be known MR Safe masks, prior to coming to the radiology department. Alternatively, when this is not possible, al metallic components from a face mask (such as a nose clip) should be removed prior to, or when necessary, upon the patient's arrival. Tape may be applied across the bridge of the nose section after removing the metal strip for fomite control and to maintain the mask’s intended function. If the patient has a tracheostomy, a face mask without metallic component should also be placed over the tracheostomy.

For staff and technologists, personal protective equipment (PPE) should be worn when entering a Zone IV area. The only safety concerns are potentially ferromagnetic components in the PPE (such as staples, metallic band inserts, etc.) and possible translational and rotational forces that the static magnetic field and the static magnetic field gradient may exert upon them. For such equipment, potential risks can be mitigated by such components and replacing them with tape. Powered air-purifying respirators (PAPR) should not be brought into Zone IV, due to the potential risks of adverse interactions with ferromagnetic components of the PAPR system.

Related Links:
American College of Radiology