August, 2006

The Value of MRI
Magnetic Resonance Imaging (MRI) is among the safest and most valuable procedures in all of medicine. Over 24.2 million MRI procedures were performed in the United States in 2003 (Prochaska, 2005), many of them to diagnose and evaluate injury, tumor growth, structural abnormalities and various disease processes.

MRI has several advantages over X-ray and computerized tomography (CT). Cross-sectional views can be taken from any angle, while CTs can view from only one direction at a time. By using different scanning parameters, MRI operators can highlight different aspects of the tissues they investigate, yielding more complete information.

Problems with MRI
Because patients must remain still in the tight space of the MRI scanner for up to two hours or more, MRIs frequently create anxiety and panic. This can cause significant harm to patients and greatly increasing costs. Five to ten percent of patients undergoing MRI experience severe claustrophobia or panic attacks, and 30% report milder distress (Melendez and McCrank, 1993).

Severe anxiety can require the procedure to be canceled and rescheduled, increasing costs and delaying medical evaluation (Koechling, Spevack, et al, 1996; Quirk, Letendre, et al, 1989a). Over 14% of patients require sedation to complete the examination, adding new costs and risks to the procedure (Murphy and Brunberg, 1997).

Many patients report that their MRI continued for several months after the exam (McIsaac, 1996; Quirk, Letendre, et al, 1989a). Patient anxiety can lead to patient movement during the test, leading to poor quality images (Melendez and McCrank; Thompson and Coppens, 1994).

The Role of Relaxation and Imagery
Many studies have shown that relaxation with guided imagery or hypnosis can reduce patient anxiety and movement, even in children (Smart, 1997), increase patient tolerance of and satisfaction with the procedure, and reduce need for sedation in MRI (Friday and Kubal, 1990; Lukins, Davan, and Drummond, 1997; Quirk, Letendre, et al, 1989b; Smart; Thompson and Coppens, 1994).

Similar benefits have been found in other medical procedures (Cataldo, 1996; Lang, Joyce, et al, 1996). Reduced sedation decreases complications and cuts the need for expensive monitoring, as well as allowing patients and caregivers a more rapid return to their daily lives (Cataldo, 1996). Increased satisfaction improves willingness to have future procedures, if necessary.

Guided imagery can reduce patient anxiety and movement during MRI, improving quality of images. The use of guided imagery can save money by reducing need for sedation and/or cancellation of procedures, and increase patient satisfaction with the procedure.

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