Magnetic Resonance Imaging Unit Research Articles

Anthropogenic gadolinium in the Tone River (Japan): an update showing a 7.7-fold increase from 1996 to 2020

BackgroundAnthropogenic gadolinium (Gd), originating from Gd-based contrast agents (GBCAs) used in magnetic resonance imaging (MRI), is widely identified in the aquatic environment with concerns about toxicity and accumulation. We aimed to present new data on anthropogenic Gd in the Tone River, which has the largest drainage area in Japan, and then to compare the current data with those obtained in 1996.MethodsThe water samples were collected on August 9−10, 2020, at 15 different locations of the Tone River in Japan. The concentrations of the rare earth elements (REEs) were measured by inductively coupled plasma-mass spectrometry and normalized to Post-Archean Australian Shale to construct shale-normalized REE patterns. The degree of Gd-anomaly was defined as the percentage of anthropogenic Gd to the geogenic background and used to compare the water samples from different locations. Pearson’s correlation coefficients were calculated.ResultsAll the samples displayed positive Gd anomalies. The Gd-anomaly ranged from 121 to 6,545% and displayed a repeating decrease-and-increase trend. The Gd-anomaly showed strong positive correlations to the number of hospitals (r = 0.88; p < 0.001) and their MRI units (r = 0.89; p < 0.001).ConclusionsOur study revealed notable anomalies of Gd concentrations in river water in Japan, with strong positive correlations to the number of major hospitals and their MRI units. Compared with the previous report in 2000, the Gd-anomaly in Tone River increased from 851% (sampled in 1996) to 6,545%, i.e., 7.7 times, reflecting the increased use of GBCAs in hospitals.Relevance statementNotable Gd concentration anomalies in river water in Japan were observed. This result underlines the importance of more extensive research on anthropogenic gadolinium, and investigations of risks to human health as well as the development of effective removal technologies may be necessary.Key points• All water samples from Tone River displayed positive Gd anomalies.• The Gd anomalies increased to 7.7 times higher over the past 24 years.• Correlations between Gd values and the number of hospitals and MRI units were observed.Graphical

Comparison of Detomidine or Romifidine in Combination with Morphine for Standing Magnetic Resonance Imaging in Horses.

The aim of this study was to determine the most appropriate sedation protocol for a standing magnetic resonance imaging (MRI) examination in horses, comparing continuous rate infusions (CRIs) of detomidine and romifidine combined with a single bolus of morphine. Sixteen horses referred for standing low-field open-magnet MRI were randomly assigned to one of two sedation protocols. The horses were premedicated with 0.03 mg/kg of intramuscular acepromazine, and those animals belonging to Group D received an intravenous (IV) loading dose of detomidine (0.01 mg/kg) 30 min later, while those of Group R received romifidine (0.04 mg/kg). If the horses were inadequately sedated, an additional dose of IV detomidine (0.005 mg/kg) or romifidine (0.02 mg/kg) was administered, according to the animal's group. During the MRI, a single IV bolus of morphine (0.05 mg/kg) was administered, and according to which group it belonged to, the animal started the administration of detomidine (0.01 mg/kg/h) or romifidine (0.02 mg/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), depth of sedation, and degree of ataxia were evaluated every 10 min during MRI. Two horses belonging to Group D and four horses from Group R needed additional sedation before entering the MRI unit because they were unsatisfactorily sedated. No side effects were observed following morphine bolus administration. During the MRI procedure, five horses in Group R received an additional IV romifidine bolus (0.01 mg/kg) because the depth of sedation score was 1 and the ataxia score was 0. Any substantial differences were recorded between the two treatments in terms of HR, RR, and RT. In conclusion, at the doses used, a detomidine-morphine combination following a CRI of detomidine appears more suitable than a romifidine-morphine combination following a CRI of romifidine for maintaining an adequate depth of sedation and adequate immobility in horses undergoing standing MRI.

Correlation Between Common Carotid Artery Intima-Media Thickness and Lumbosacral Intervertebral Disc Degeneration

Background: Lumbosacral intervertebral disc degeneration (IDD) is a common cause of low back pain and has recently been attributed to ischemic causes. Magnetic resonance imaging (MRI) can accurately assess the presence and degree of IDD, while the common carotid artery (CCA) intima-media thickness (IMT) measured on ultrasound (US) has been accepted as a reliable imaging marker for the presence of atherosclerosis. Aim of the Study: To assess the association between CCA-IMT with the presence and grade of lumbosacral IVD as evident on MRI in patients with LBP. Patient and Methods: This cross-sectional study was done on 200 patients with LBP (115 females and 85 males) referred for lumbosacral spinal MRI at the MRI unit in AL-Sader Medical City for eight months duration. MRI examination involved L1/L2 ,L2/L3,L3/4 ,L4/L5 \&amp; L5/S1 intervertebral discs levels. Patients with a history of lumbosacral surgery, trauma, or tumor were excluded. CCA-IMT was measured using a B-mode US scan, while the degree of IDD was assessed on MRI using I-V Pfirrmann's grading system. Results: Older age, male gender, higher body mass index, presence of cardiovascular comorbidities, and specific occupations were associated with a higher grade of IDD. However, the mean CCA-IMT was independently associated with the advancing grade of IDD at all levels with a statistically significant difference (P&lt;0.001). A significantly larger mean CCA-IMT was found in relation to grade V (0.946 ±0.28), and the lowest mean was found in those with grade I (0.468 ±0.1). The grading of IDD was fair in the prediction of thicker CCA-IMT. Conclusion: IDD was directly correlated with CCA-IMT, and patients with higher grades of IDC tend to have thicker mean CCA-IMT. IDD may be a manifestation or predictor of atherosclerosis. However, future long-term cohort studies to assess causal association are recommended.

Overcoming Operational Challenges: A Case Study of MRI Functionality in Resource-Scarce Regions

Magnetic resonance imaging(MRI) is a veritable radiological diagnostic tool for the in-depth diagnosis of various ailment involving virtually all organ systems of the human body. The machinery for this radiological investigation tool is quite huge and needs installation in a spacious, well ventilated and air-conditioned room. It also must have verified working alternative power source as the essential lithium gas needed for its proper working must be kept cool at all times, and the environment where the MRI equipment is installed must always be kept at an ambient room temperature. This requirement means that a regular power supply must be assured as the lack of it may impact negatively on the functional ability of the equipment, which was procured at a great cost, its installation and maintenance also at a great deal of scarce fund. So, all care must be put in place not to endanger the perfect workings of the MRI equipment. Angry hospital workers deliberately shut off the electrical and water supply to the MRI unit in protest, aiming to force management to address their grievances. However, this action had severe consequences for the MRI machine, as its cooling system for the essential helium gas was disrupted, leading to gas depletion from the cannisters. This incident underscores the critical need for uninterrupted power and cooling systems in MRI installations to ensure their proper functioning and avoid costly damage.

Magnetic resonance imaging-guided renal biopsy shows high safety and diagnostic yield: a tertiary cancer center experience.

To evaluate the technical success and outcomes of renal biopsies performed under magnetic resonance imaging (MRI) using a closed-bore, 1.5-Tesla MRI unit. We retrospectively reviewed our institutional biopsy database and included 150 consecutive MRI-guided biopsies for renal masses between November 2007 and March 2020. We recorded age, sex, BMI, tumor characteristics, RENAL nephrometry score, MRI scan sequence, biopsy technique, complications, diagnostic yield, pathologic outcome, and follow-up imaging. Univariate logistic regression was used to assess the association between different parameters and the development of complications. McNemar's test was used to assess the association between paired diagnostic yield measurements for fine-needle aspiration and core samples. A total of 150 biopsies for 150 lesions were performed in 150 patients. The median tumor size was 2.7 cm. The median BMI was 28.3. The lesions were solid, partially necrotic/cystic, and predominantly cystic in 137, eight, and five patients, respectively. Image guidance using fat saturation steady-state free precession sequence was recorded in 95% of the biopsy procedures. Samples were obtained using both fine-needle aspiration (FNA) and cores in 99 patients (66%), cores only in 40 (26%), and FNA only in three (2%). Tissue sampling was diagnostic in 144 (96%) lesions. No major complication developed following any of the biopsy procedures. The median follow-up imaging duration was 8 years and none of the patients developed biopsy-related long-term complication or tumor seeding. MRI-guided renal biopsy is safe and effective, with high diagnostic yield and no major complications. Image-guided renal biopsy is safe and effective, and should be included in the management algorithm of patients with renal masses. Core biopsy is recommended. • MRI-guided biopsy is a safe and effective technique for sampling of renal lesions. • MRI-guided biopsy has high diagnostic yield with no major complications. • Percutaneous image-guided biopsy plays a key role in the management of patients with renal masses.

Time-of-flight and black-blood MRI to study intracranial arteries in rats

Intracranial aneurysms (IAs) are usually incidentally discovered by magnetic resonance imaging (MRI). Once discovered, the risk associated with their treatment must be balanced with the risk of an unexpected rupture. Although clinical observations suggest that the detection of contrast agent in the aneurysm wall using a double-inversion recovery black-blood (BB) sequence may point to IA wall instability, the exact meaning of this observation is not understood. Validation of reliable diagnostic markers of IA (in)stability is of utmost importance to deciding whether to treat or not an IA. To longitudinally investigate IA progression and enhance our understanding of this devastating disease, animal models are of great help. The aim of our study was to improve a three-dimensional (3D)-time-of-flight (TOF) sequence and to develop a BB sequence on a standard preclinical 3-T MRI unit to investigate intracranial arterial diseases in rats. We showed that our 3D-TOF sequence allows reliable measurements of intracranial artery diameters, inter-artery distances, and angles between arteries and that our BB sequence enables us to visualize intracranial arteries. We report the first BB-MRI sequence to visualize intracranial arteries in rats using a preclinical 3-T MRI unit. This sequence could be useful for a large community of researchers working on intracranial arterial diseases.Relevance statement We developed a black-blood MRI sequence to study vessel wall enhancement in rats with possible application to understanding IAs instability and finding reliable markers for clinical decision-making.Key points• Reliable markers of aneurysm stability are needed for clinical decision.• Detection of contrast enhancement in the aneurysm wall may be associated with instability.• We developed a black-blood MRI sequence in rats to be used to study vessel wall enhancement of IAs.Graphical

Provision of Safe Anesthesia in Magnetic Resonance Environments: Degree of Compliance with International Guidelines in Saudi Arabia.

The lack of local guidelines and regulations for the administration of anesthesia in magnetic resonance imaging (MRI) units presents a potential risk to patient safety in Saudi Arabia. Hence, this study aimed to evaluate the extent to which hospitals in Saudi Arabia follow international guidelines and recommendations for the safe and effective administration of anesthesia in an MRI environment. This study used a questionnaire that was distributed to 31 medical facilities in Saudi Arabia that provided anesthesia in MRI units. The findings of the study revealed that the mean compliance with the 17 guidelines across the 31 sites was 77%; 5 of the 31 sites (16.1%) had a compliance rate of less than 50% with the recommended guidelines. Only 19.4% of the institutes provided general safety education. Communication breakdowns between anesthesia providers and MRI teams were reported. To conclude, this survey highlights the status of anesthesia standards in Saudi Arabian MRI units and emphasizes areas that require better adherence to international guidelines. The results call for targeted interventions, including the formulation of specific national anesthesia guidelines for MRI settings. Communication breakdowns between anesthesia providers and MRI teams were reported at a rate of 83.9% during the administration of a gadolinium contrast agent. There were additional breakdowns, particularly for high-risk patients with implants, such as impaired respirators (74.2%), thus requiring further investigation due to potential safety incidents during MRI procedures. While considering the limitations of this study, such as potential biases and the low response rate, it provides a valuable foundation for refining protocols and promoting standardized practices in Saudi Arabian healthcare.

Global helium shortage leading to the shutting of imaging modalities is the world’s next medical crisis-driving factors, future of helium-free magnetic resonance imaging systems, and alternatives to magnetic resonance imaging

Global helium shortage leading to the shutting of imaging modalities is the world’s next medical crisis-driving factors, future of helium-free magnetic resonance imaging systems, and alternatives to magnetic resonance imaging

Letter: Evaluating Brain Tumor Surgical Management Capacity in Sub-Saharan Africa.

Letter: Evaluating Brain Tumor Surgical Management Capacity in Sub-Saharan Africa.

Muscular morphometric study of the canine shoulder for the design of 3D-printed endoprostheses in dogs with osteosarcoma of the proximal humerus: a pilot cadaveric study by MRI.

Osteosarcoma frequently affects the proximal humerus in dogs. In veterinary medicine, no therapeutic option for the treatment of osteosarcoma satisfactorily preserves limb function. 3D-printed personalized endoprosthesis offers a promising treatment option. Morphometric data, necessary for the design of the endoprosthesis, are currently lacking in canine patients. Our objective was to acquire the morphometric data necessary to refine the design of the endoprosthesis. A single canine cadaveric thoracic limb. Sagittal proton-density, and sagittal, dorsal, and transverse T1-weighted sequences of the thoracic limb were acquired with a 1.5 Tesla Magnetic Resonance Imaging (MRI) unit. Nineteen muscles of interest were subsequently identified using medical imaging software (Mimics©) and their volume was reconstructed in 3D using computer-aided design (CATIA©). Mormophetric data were recorded for each of the 19 muscles. The same canine cadaver was then dissected to measure the same parameters. All muscles were successfully identified with data consistent with the dissected cadaveric data. Certain muscles were more challenging to isolate on MRI, namely the heads of the triceps brachii, superficial pectoral, and latissimus dorsi. The relative distribution of muscle volumes was similar to historical data. Muscle tissue density was not significantly affected by freezing (1.059 g/cm3). MRI is a useful tool to collect morphometric data but imperfect if used alone. This approach was the first attempt to validate more general morphometric data that could be used to refine the design of custom 3D-printed prostheses for limb-sparing of the proximal humerus. Further imaging studies are warranted to refine our model.

Asset Performance Management Command Center for Saudi Ministry of Health

This article describes the journey of developing, implementing, and evaluating a unique state-of-the-art Asset Performance Management Command Center for the Ministry of Health in Saudi. Several successful pilots have been established to test the usability and performance of the Asset Performance Management tools that are developed and planned to be scaled for all (~300) ministry of health hospitals. To accommodate the complexity of the mission, several proof of concepts have been established including inventory management for 7 types of medical equipment on kingdom-level covering ventilators: anesthesia, blood gas analyzers, magnetic resonance imaging, computed tomography, renal and dental units in addition to inventory management platform for all ministry of health hospitals hospitals. A basic computerized maintenance management system is then implemented at 1 Ministry of health hospital, and another equipment direct connectivity use case was implemented at another hospital. Continuously refreshed data for medical equipment at the targeted hospitals are reported at the national command center of the Ministry of Health situated in Riyadh digital City, including inventory information related to 200+ hospitals in addition to key performance indicator dashboards illustrating downtime, work order status, basic utilization, and many other key performance indicators related to assets specifically developed and verified for Ministry of health needs.

Potential Role of Room Temperature Superconductor LK 99 in MRI and Radiology

Magnetic Resonance Imaging (MRI) is a vital diagnostic tool in medical imaging, revolutionizing radiology and enhancing medical diagnoses. The key component enabling MRI is the superconducting magnet, which operates at extremely low temperatures using liquid helium cooling. However, the apparently recent discovery of the room-temperature superconductor LK- 99 if true holds the potential to transform MRI technology. If LK-99 can be successfully integrated into MRI machines, it could eliminate the need for cryogenic cooling, resulting in smaller, lighter, and more affordable machines. The higher magnetic fields enabled by LK-99 could enhance image resolution and scanning speed, leading to improved accuracy in diagnoses and better patient outcomes. The unique properties of superconductors, such as zero electrical resistance and perfect diamagnetism, make them ideal for MRI applications, offering enhanced image quality and faster scanning times. The integration of superconductors in MRI technology has already led to significant advancements, including high-field MRI systems and mobile MRI units. However, challenges remain, such as the stability and cost of LK-99 and the development of MRI machines compatible with this new material. Despite these challenges, the potential benefits of LK-99 in MRI machines are promising and could revolutionize medical imaging if successfully implemented. Further research and development are necessary to explore LK-99's capabilities fully

Benchmarking Health Infrastructure in Türkiye and Other OECD Countries: Health Workforce, Medical Technology and R&amp;D Activities in Health

As it has been seen during the COVID-19 pandemic period, medical technologies as well as the health personnel, especially the physicians (medical doctors) and nurses in health care resources played a crucial role in the early diagnosis and in the prevention of the disease. Advances in medical technologies allow the physicians and nurses to devote more time to patients and to deal with them in more detail.In OECD countries, total health and social employment was 67.2 million and 20% of them, which was 13.45 million, were practising nurses, 6.3% of them, which was 4.2 million, were practising physicians in 2021. According to the WHO, total global nursing health workforce is 28.9 million, whereas total physicians are 12.8 million in 2020. There were 36.7 “mammographs”, 7.6 “radiation therapy equipment”, 19.1 “gamma cameras”, 3.4 “positron emission tomography (PET) scanners, 35.7 “computed tomography (CT) scanners”, 25.1 “magnetic resonance imaging (MRI) units” per million population in OECD in 2021. Gross domestic expenditure share on research and development (R&amp;D) in medical and health sciences in GDP was 0.56% and the share of patent publications in medical technology in total patent applications was 6.2% in OECD in 2021. Health expenditure per capita was 5,597dolar and health expenditure as a share of GDP was 13.2% in OECD in 2021. It seems that health expenditure and human resources are not at the same level in every country. In addition, foreign trade of technological medical devices used in the diagnosis of disease is not distributed equally, since the purchasing power due to economic growth is not the same and sufficient resources are not allocated for R&amp;D expenditures. This study aims to investigate to benchmark the health infrastructure in Türkiye and other OECD countries considering the health workforce, medical technology and R&amp;D activities in health.

Pediatrik hastalarda manyetik rezonans görüntüleme sırasında anestezi uygulamalarında görülen komplikasyonların insidansı

Purpose: The aim of this study was to investigate complications during sedation of pediatric patients undergoing Magnetic Resonance Imaging (MRI) to determine precautions to take to minimize complications while providing a safer environment for patients and healthcare workers. Materials and Methods: The files of consecutive patients taken for 6 months in the MRI unit of our hospital were reviewed retrospectively, and a total of 122 pediatric patients were included. Primary parameter in the study is set as peroperative and postoperative complication incidence. Interventions to treat, demographic data, ASA scores, accompanying diseases, agents and their doses for sedation, sedation and recovery time are the secondary parameters and their correlation to complication incidence is assessed. Results: Using the data of 122 patients, complication rate is found as 6.6% (8/122). During sedation, desaturation in 6, bradycardia and desaturation in 1 and airway obstruction in 1 of the patients was observed. Desaturation was seen in 2, bradycardia was seen in 1 of the patients during recovery. Use of ketamine didn’t decrease the dose of midazolam or propofol used for maintenance but decreased the dose of propofol used for induction. Conclusion: Complications may occur despite the presence of an experienced anesthesia team. It is important to anticipate such complications and intervene in a timely manner.

Magnetic resonance imaging-guided conventional catheter ablation of isthmus-dependent atrial flutter using active catheter imaging.

Interventional cardiac magnetic resonance (iCMR) has been established as a radiation-free alternative compared to standard fluoroscopy-guided catheter ablation for cavotricuspid isthmus (CTI)-dependent atrial flutter to image anatomy, structural alterations, and further catheter guidance. The purpose of this study was to explore the safety, feasibility, and efficacy of CTI ablations performed completely in the iCMR suite using active catheter imaging. Consecutive patients underwent iCMR-guided catheter ablation for CTI-dependent atrial flutter. Procedures were performed in a 1.5-T magnetic resonance (MR) imaging unit with MR-conditional ablation catheters. Catheter guidance was achieved using active catheter imaging via integrated MR receive tip coils. Acute success, periprocedural complications, and short-term follow-up were collected for further analysis. All patients (N = 15; 73% male; median age 70 years; interquartile range [67-82]) achieved acute procedural success without any complication. Median procedural time was 43 minutes [33-58] with median radiofrequency delivery time of 18 minutes [12-26]. Postprocedural lesion visualization scanning was completed in a median of 32 minutes [10-42]. None of the patients with 6-month follow-up had atrial flutter recurrence. In the iCMR suite, CTI-dependent atrial flutter ablation could be achieved safely using active catheter imaging without any complication. It further allows detailed anatomic visualization of the CTI, intraprocedural lesion visualization, and exclusion of pericardial effusion.

Post-mortem magnetic resonance imaging with computed tomography-guided biopsy for foetuses and infants: a prospective, multicentre, cross-sectional study

BackgroundPost-mortem imaging has been suggested as an alternative to conventional autopsy in the prenatal and postnatal periods. Noninvasive autopsies do not provide tissue for histological examination, which may limit their clinical value, especially when infection-related morbidity and mortality are suspected.MethodsWe performed a prospective, multicentre, cross-sectional study to compare the diagnostic performance of post-mortem magnetic resonance imaging with computed tomography-guided biopsy (Virtopsy®) with that of conventional autopsy in foetuses and infants. Cases referred for conventional autopsy were eligible for enrolment. After post-mortem imaging using a computed tomography scanner and a magnetic resonance imaging unit, computed tomography-guided tissue sampling was performed. Virtopsy results were compared with conventional autopsy in determining the likely final cause of death and major pathologies. The primary outcome was the proportion of cases for which the same cause of death was determined by both methods. Secondary outcomes included the proportion of false positive and false negative major pathological lesions detected by virtopsy and the proportion of computed tomography-guided biopsies that were adequate for histological examination.ResultsOverall, 101 cases (84 fetuses, 17 infants) were included. Virtopsy and autopsy identified the same cause of death in 91 cases (90.1%, 95% CI 82.7 to 94.5). The sensitivity and specificity of virtopsy for determining the cause of death were 96.6% (95% CI 90.6 to 98.8) and 41.7% (95% CI 19.3 to 68.0), respectively. In 32 cases (31.7%, 95% CI 23.4 to 41.3), major pathological findings remained undetected by virtopsy, and in 45 cases (44.6%, 95% CI 35.2 to 54.3), abnormalities were diagnosed by virtopsy but not confirmed by autopsy. Computed tomography-guided tissue sampling was adequate for pathological comments in 506 of 956 biopsies (52.7%) and added important diagnostic value in five of 30 cases (16.1%) with an unclear cause of death before autopsy compared with postmortem imaging alone. In 19 of 20 infective deaths (95%), biopsies revealed infection-related tissue changes. Infection was confirmed by placental examination in all fetal cases.ConclusionsVirtopsy demonstrated a high concordance with conventional autopsy for the detection of cause of death but was less accurate for the evaluation of major pathologies. Computed tomography-guided biopsy had limited additional diagnostic value.Trial registrationClinicalTrials.gov (NCT01888380).

Assessment of Diagnostic Imaging Sector in Public Hospitals in Northern Jordan.

The most effective diagnostic methods in the medical field are diagnostic imaging techniques such as radiography, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine, which are used to visualize internal body to diagnose it, determine potential treatment, and evaluate and forecast care results. Therefore, the purpose of this research is to assess the diagnostic imaging sector, at three major public hospitals in the northern part of Jordan, according to regional and global requirements. The assessment approach was based on knowledge of the accessibility of diagnostic imaging equipment and its quality assurance and performance, the quantity and efficiency of radiological technologists, and the design of radiology units and medical imaging chambers in many aspects based on the use of two tools, a questionnaire and checklists, to accomplish a comprehensive evaluation. The response rate of radiological technologists was 66%. The assessment reveals a noticeable increase in the number of radiological technologists in general with high academic qualification level. Additionally, the number of diagnostic imaging equipment in Jordan revealed a large deficiency in the population–device balance, and through checklists that evaluated both CT and MRI units, it was revealed that the rate of following global requirements and occupational health and safety (OHS) standards was high. The basic supplies available in both the CT and MRI units alike were high, which indicates the high quality of healthcare provided in Jordan.

Safety related for lone working magnetic resonance technologists in Southern Saudi Arabia

ObjectiveWorking in the magnetic resonance imaging unit as a lone MR technologist is associated with high risk (such as projectile and thermal burns). The safety in the MRI environment could be a major concern for a single worker in absence of a partner. This study aims to assess the safety of lone MR technologists in Saudi Arabia's Southern Regions. Material and methodsA cross-sectional study using a self-report questionnaire was carried out in 23 hospitals, between public and private in Southern regions of Saudi Arabia. Data were analyzed using descriptive and inferential statistics. ResultsThe response rate from MR technologists was 79% (73/92). The study found that most MR technologists have an experience with lone working (84%), the privet hospitals tends to arrange MR technologists to work alone (p-value 0.044). Lone working is associated with a higher rate of occurrence of accidents/mistakes and concerns (64.3% and 65.57%, respectively) compared to working as an MR technologist in the presence of other medical staff (such as nurses) which appeared as follows (54.8% and 59.65%, respectively); both types of workers individually showed a high level of self-confidence. The MRI safety policies were followed in 84% of departments. However, 71% of participants showed poor awareness about the regulations of lone working, and only about half of the technologists got training in MRI safety. ConclusionMR technologists from Southern Saudi Arabia regions had experience with lone working in the MRI unit. The rate of working alone was associated with a higher level of concerns and accidents/mistakes. There is a need to raise MR technologists’ awareness regarding MRI safety regulations.

An Analysis of the Referral Pattern of Urgent MRI in an Acute Unit

Background : Urgent MRI (Magnetic Resonance Imaging) in clinical management is quite often required in the modern hospitals. In many cases, it may be needed for emergency patients and may save a valuable life. A few previous papers show MRI provision needs to be improved and many clinical situations need urgent MRI for management. This project was done with the objective to explore the range of urgent applications of MRI and aim to provide information supporting development of MRI service with the null hypothesis: "there is no need to introduce on call service for urgent MRI”.&#x0D; Materials and methods: This thesis explored the applications of MRI as urgent investigations both retrospectively and prospectively in the busy MRI unit of the John Radcliffe Hospital, Oxford, UK, from 2004 to 2005.To assess the necessity of introducing an on-call service in the unit, a null hypothesis was developed: "There is no need to introduce on call service for urgent MRI”. To test the hypothesis, patients’ records were analysed to observe the effect in clinical management of MRI carried out as an urgent basis.&#x0D; Results: The results explored the demographic trend, common examination areas, types of indications and the nature of MRI reports among the urgent patient referrals. The retrospective and prospective results showed similarity between the two years’ practices. The results of clinical effect of urgent MRI were found to be positive in the majority cases and the null hypothesis was rejected.&#x0D; Conclusion: Overall, the thesis argues that the urgent MRI is not being carried out sufficiently in comparison to routine MRI, although urgent MRI has a good effect on clinical management. The study showed the necessity to develop the on call service in MRI.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 14-18

Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging.

The purpose of this study was to find the differences in the subtalar ligaments between patients with talocalcaneal (TC) coalition and control subjects using 3-dimensional isotropic magnetic resonance imaging. Magnetic resonance imaging of 27 ankles with TC coalition and 27 age- and sex-matched controls were retrospectively reviewed. Absence of cervical ligament, anterior capsular ligament (ACL), interosseous TC ligament (ITCL), and partial or complete absence of 3 roots of the inferior extensor retinaculum was analyzed. Thickness and width of ACL and ITCL were measured when possible. Absence of ACL and ITCL was significantly more frequent in TC coalition patients than in controls (59.2% vs 7.4%, P < 0.0001; 44.4% vs 7.4%, P = 0.004). Absence of cervical ligament and 3 roots of the inferior extensor retinaculum did not differ between the 2 groups. Thickness and width of ACL were significantly smaller in TC coalition patients than in control subjects (0.81 ± 0.23 vs 1.27 ± 0.41 mm, P < 0.0001; 5.26 ± 1.17 vs 7.07 ± 1.46 mm, P = 0.001). Thickness and width of ITCL did not differ between the 2 groups. In the TC coalition group, the absence of ACL and ITCL did not differ according to coalition type, patient demographics, and magnetic resonance imaging units. Anterior capsular ligament and ITCL are frequently absent in TC coalition patients. Even when present, the ACL is attenuated in TC coalition patients compared with controls.