Imaging tests give your provider a close look at what’s going on inside of your body. Tests like MRI, CT scans, ultrasound and X-rays are important tools for diagnosing a lot of different conditions, from sports injuries to pneumonia to pregnancy complications.
But not everyone can have every type of scan. Sometimes, you can’t have a test, or you need special planning, because of safety concerns, medical conditions or physical limits.
Michelle Brady, associate director of MRI with Banner Imaging, shared more about situations where imaging needs special care, and how you and your provider can find safe ways to get the information you need about your health.
The MRI and pacemaker connection
Magnetic resonance imaging (MRI) uses powerful magnets to create detailed images of areas inside your body. For most people, it’s safe to be exposed to these powerful magnets. But there can be MRI restrictions for people with heart devices like pacemakers.
The magnetic field can:
- Affect how a pacemaker works
- Change its settings
- Heat the leads, which are the thin wires that connect the pacemaker to your heart
An MRI could change the way a pacemaker works or even damage your heart.
Not all pacemakers are the same. Many newer, MRI-safe pacemaker models are designed so you can have an MRI but only under specific conditions. “You’ll need to talk to your cardiologist, who can help you find an imaging center that can perform an MRI safely,” Brady said.
When you schedule the MRI, you’ll need to provide the make, model and implantation date for your pacemaker.
You’ll need to have a cardiologist and nurse there to monitor you when you have the MRI, and possibly a representative from the pacemaker’s manufacturer. Your team will need to put your pacemaker in MRI mode before the scan and reset it after the scan.
“If you have any issues after the scan, you should reach out to your cardiologist right away to make sure the pacemaker is working properly,” Brady said.
In some cases, it’s not safe to have an MRI if you have a pacemaker and you’ll want to talk to your provider about other alternatives:
- Older pacemakers may not be able to safely handle the magnetic field.
- If you had a pacemaker removed or replaced, leads may have been left in place. Because they are not connected to a working device, they can’t be adjusted or turned off.
- Some leads can’t be reprogrammed or disabled.
Other implanted devices that may cause restrictions
Pacemakers aren’t the only devices that can complicate imaging. You may need special care or other options for anything that contains metal, including medical implants. Your care team will consider:
- Type of implant or foreign body
- Manufacturer guidelines
- Type of scan ordered
- Strength of the magnet
- Where in the body the metal is located
“It is important to let your health care team know about anything in your body that you weren’t born with. Based on that information, they will know how to proceed,” Brady said.
Be sure to tell your care team about:
- Cochlear implants, which are devices that help with hearing
- Neurostimulators, which help treat chronic pain or movement disorders
- Certain metal implants or surgical clips, especially older ones
- Shrapnel or metallic fragments in the eye or brain or near sensitive tissues
“I encourage people to learn about scanning restrictions for any devices in their body. People are often surprised when they are told they are not allowed to have an MRI because of the manufacturer’s instructions for their implant,” Brady said.
Brady also points out that with MRI, the magnet is always on. “It is not just on when we are scanning which is different than other imaging tests. This is why it is so important that the entrance is monitored by a trained MRI staff member,” she said.
Health situations that complicate imaging
You could have a health factor that changes what type of imaging you can have:
- Pregnancy: Scans like CT and X-ray use radiation. You should avoid these scans unless they are absolutely necessary.
- Kidney problems: Some MRI or CT scans use contrast dyes that may not be safe if you have kidney function issues.
- Allergies to contrast agents: You may need medication or a different type of imaging if you’ve had reactions to contrast before.
- Claustrophobia: It can be hard to tolerate the enclosed space of an MRI. If you have claustrophobia, you may be able to use an open MRI machine, medication that makes it easier for you (sedation) or a different imaging method.
- Tremors: Movement can make the MRI unclear. Sedation, pausing a medication that causes tremors or another imaging method may be options.
- Sensitivity to noise: “The machine makes a loud knocking or rapping noise, which can be difficult for some people, especially those who have served in the military. We cannot get rid of the noise, but ear plugs or headphones can help minimize it,” Brady said.
“Our main objective is to minimize motion and to get the best exam in the shortest time possible. We don’t want to keep people in the scanners longer than necessary, but we do need to get the best images possible,” Brady said.
Physical and technical limitations
In some cases, the size of the scanner or the way you need to be positioned for the test can cause challenges:
- Your weight or size could be over the limit for the scanner table or opening
- You could have pain or mobility issues that make it hard for you to stay still or lie in one position for long enough to run the scan
Your care team can work with you to find other options or adjust the setup so you can have the scan.
Safe alternatives when an MRI or specific scan isn’t possible
“There are several other imaging options you can talk about with your provider. The right choice will depend on the exams that have already been completed and your diagnosis,” Brady said.
If you can’t get an MRI or a certain scan isn’t safe for you, your provider may recommend MRI alternatives such as:
- CT scans, which use X-rays to create detailed images
- Ultrasound, which uses sound waves, not radiation
- X-rays, which are good for scanning bones and conditions in the chest or abdomen
- PET scans, which are often used in cancer care
- Modifications like open MRI, low-dose CT or non-contrast studies
How Banner Health keeps imaging safe
At Banner Health, patient safety is our first priority. Before any scan, our imaging specialists review your health history, check for implanted devices and discuss your needs. “We ask a lot of questions, but that’s for your safety,” Brady said.
If you need special precautions, we work with your other doctors, like cardiologists, to make sure your test is done in the safest possible way. And if another scan is a better choice, we can provide that too.
Not every imaging test is right for every person. With planning, teamwork and the right technology, we can find the safest and most effective way to get the answers you need.
If you need an imaging scan, make an appointment online with a Banner Health provider and see which test might be right for you.
