This image shows a threaded jewel that the patient had pierced into her skin. The jewel actually “screwed” out of the metal thread holder that was placed under her skin. She had other types of jewels that she could screw into the metal subcutaneous holder. Even with the jewel removed, the issue of heating and artifact from the subcutaneous holder was of concern.
Many have asked MRI Optimize about body piercings and MRI safety. If the patient cannot or will not remove their body piercing, but the MRI scan has to happen, this creates a dilemma for the patient, the operator and the MRI site. Some patients could be concerned about the closing of the piercing tract while the piercing object is out of their body. If this is the case, discussion of a temporary MRI compatible placement device during the scan will have to be discussed with the patient prior to the scan taking place.
During an MRI scan, radio-frequency waves are sent into the bore of the MRI scanner where the patient lies, flipping the hydrogen protons of the patient to help create the images. This RF energy dissipates into the tissue as heat. That same energy behaves differently when finding metals of various elemental make-ups, especially if any portion of the metal is ferromagnetic, which means it contains iron. The patient could feel a “pull” on the metal item when in or near the MRI, and some have reported feeling piercings vibrate during the noisy acquisition portion of the scans. Sometimes, that energy is absorbed into different metals, and this can create heat, which can then create a burn around the tissue near those metals. The potential for burns is the major concern of body piercings and mri safety.
Additionally, metals will “steal” the signal from an MRI scan, often creating artifacts in the images, making many scans difficult to interpret by the radiologists, for accuracy in pathology and diagnosis.
The safest thing to do is to remove the body piercing. Many hospitals and radiology sites have policies requiring the patients remove all body piercings due to mri safety concerns.
However, some patients will offer serious resistance to removing any body piercing, especially based on the particular anatomical location of that piercing. If the site insists on removing the piercing, often the patients will find another MRI site to perform the exam, one not quite so concerned about body piercings and mri safety.
Often, a patient may state they had the piercing and were scanned in the past at such and such site without any problem. This opens up the opportunity to share with the patient that a low field MRI system, may have performed images in the past, but especially some of the new recently built 1.5T MRI scanners with faster gradient speeds, and even the 3T ultra high field systems find piercings contraindicated.
Body Piercings and MRI Safety
Another part of the issue may be based on the location of the piercing and the location of the ordered exam. For instance, if the piercings were in the back of the neck, such as these images display, and the MRI exam was for a knee, the direct implication of artifact and heat might not be an issue, but one should check with their radiologist. However, if a cervical spine MRI were ordered on the pierced individuals in these images, then the direct implication of artifact and heating could be a serious concern.
If the patient becomes resistant or concerned about removing their piercing, it is often in the best interest of the site to encourage the radiologist to speak to the patient, as they are ultimately the one often responsible for the health and safety of the patient during the scan.
Some radiology sites may require a signed waiver from the patient specifically for body piercings if they want to proceed with the piercings in place for their MRI scan. The waiver might be written with very strong warning language by legal counsel, informing the patient of the potential dangers of the body piercings and mri safety.
The outcome is usually ultimately the responsibility of the radiologist, so it is recommended the operators always check and inform the radiologists prior to scanning any patient with piercings, and allow the radiologist to make the final decision on whether or not to proceed to scan the patient with body piercings.
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