ACR MAUNUAL and MRI SAFTY QUESTIONS WITH
COMPLETE SOLUTIONS
1. MR Equipment Vendor Templates:
Design templates provided by MR equipment manufacturers are
invaluable in developing suites that meet the minimum technical
siting requirements for the specific equipment. Vendor design
templates, however, typically depict only the control and
equipment rooms, in addition to the magnet room, Zone IV.
Patient/family waiting, interview areas, physical
screening/changing areas, access controls, storage, crash carts,
induction, medical gas services, post-screened patient holding
areas, infection control provisions, and interventional
applications, among many other issues, are not addressed in
typical vendor-provided drawings. These issues are left to
facility owners, operators, and their design professionals to
resolve. The guidance that follows is designed to address many
of these issues, which directly impact safety within the MR
suite. Correct Answers
1. Water Damage
Whether from roof failure, burst pipes, storm surges, or rising
water levels, every facility has the potential for water damage to
equipment and facilities. It takes only a small quantity of water
in contact with an MRI scanner to incapacitate or destroy the
equipment.
,In the event of impending water damage, facilities may decide to
prepare by covering gantries and equipment with sturdy plastic,
taped in place. Where possible, electronic components should be
raised from the ground. Radiofrequency (RF) shields,
particularly the floor assembly, may be significantly damaged
and may need to be replaced following a flood if not designed to
protect against water damage.
Temporary electrical power may be provided either through on-
site or portable emergency generators. Facilities should evaluate
risks from water damage and assess their preparations for failure
of the building enclosure and be especia Correct Answers
10. Cryogen Safety (Zone IV)
Cryogenic liquids are used in superconductive MR
environments. The physical properties of these cryogenic liquids
present significant potential safety hazards. If exposed to room
air, these cryogenic liquids will rapidly boil off and expand into
a gaseous state. This produces several potential safety concerns,
including
• asphyxiation potential as cryogenic gases replace oxygenated
air,
• frostbite considerations at the exceedingly low temperatures of
these cryogenic liquids,
• existence of fire hazards in the unlikely event of a quench,
especially if some of the cryogenic gases escape into the magnet
room/Zone IV, and
,• rare existence of pressure considerations within Zone IV in the
unlikely event of a quench in which some of the cryogenic gases
escape into the magnet room/Zone IV. Correct Answers
11. MR Conditional Devices (Zone IV) The normal or safe
operation of many medical devices designed for use in the MR
environment may be disrupted by exposure to conditions
exceeding the device's conditional rating thresholds. It is
advisable for MR facilities to identify and label the approved
conditional labeling for static field (B0) and spatial field
gradient (dB/dx) exposure (as well as RF power rate/duration
limitations, and [if any] gradient dB/dt-tested exposure limits)
for each MR Conditional device that may be brought into Zones
III and IV. MR Conditional devices may be safe at 1 specific
static magnetic field strength but unsafe at higher or lower field
strength. Additionally, MR Conditional devices may be safe in 1
region of the magnet but not in another (eg, a device may be
labeled as MR Conditional at 1.5 T yet stipulate that it should
not be exposed to a magnetic field of greater than 200 G [0.02
T], an Correct Answers
12. Infection Control (Zone IV)
Magnet system room finishes and construction details should be
designed to facilitate cleaning by appropriately trained staff with
nonmotorized equipment. Additionally, as the numbers of MR-
guided procedures and interventional applications grow, basic
infection control protocols, such as seamless floorings,
scrubbable surfaces, and hand-washing stations should be
considered. Correct Answers
, 13. Disclaimers and Recommendations
The facility design issues identified in this appendix only
address general safety design issues for MRI suites. There are a
multitude of site-specific and magnet-specific operational and
technical design considerations relevant to MR facility design
and construction that are not addressed in this appendix. These
issues include, but are not limited to, patient acuity, staff access,
modality conflicts, vibration sensitivity, throughput/efficiency,
HIPAA considerations, magnetic contamination, sound
transmission, magnet shim tolerances, shielding design, moving
metal interferences, MR equipment upgrades, and
electromagnetic interference.
In addition to incorporating the guidance from this appendix, a
facility would be well advised to seek expert assistance in the
planning and design of MRI and multimodal radiology suites.
Correct Answers
2. Patient Interview/Clinical Screening Areas (Zone II)
Reviewing the patient Safety Screening Form and MR Hazard
Checklist requires discussing confidential personal information.
To facilitate full and complete patient disclosure of their medical
history, this clinical screening should be conducted in an area
that provides auditory and visual privacy for the patient.
Facilities should prospectively plan for electronic patient
medical records, which are useful in clinical screening, and
COMPLETE SOLUTIONS
1. MR Equipment Vendor Templates:
Design templates provided by MR equipment manufacturers are
invaluable in developing suites that meet the minimum technical
siting requirements for the specific equipment. Vendor design
templates, however, typically depict only the control and
equipment rooms, in addition to the magnet room, Zone IV.
Patient/family waiting, interview areas, physical
screening/changing areas, access controls, storage, crash carts,
induction, medical gas services, post-screened patient holding
areas, infection control provisions, and interventional
applications, among many other issues, are not addressed in
typical vendor-provided drawings. These issues are left to
facility owners, operators, and their design professionals to
resolve. The guidance that follows is designed to address many
of these issues, which directly impact safety within the MR
suite. Correct Answers
1. Water Damage
Whether from roof failure, burst pipes, storm surges, or rising
water levels, every facility has the potential for water damage to
equipment and facilities. It takes only a small quantity of water
in contact with an MRI scanner to incapacitate or destroy the
equipment.
,In the event of impending water damage, facilities may decide to
prepare by covering gantries and equipment with sturdy plastic,
taped in place. Where possible, electronic components should be
raised from the ground. Radiofrequency (RF) shields,
particularly the floor assembly, may be significantly damaged
and may need to be replaced following a flood if not designed to
protect against water damage.
Temporary electrical power may be provided either through on-
site or portable emergency generators. Facilities should evaluate
risks from water damage and assess their preparations for failure
of the building enclosure and be especia Correct Answers
10. Cryogen Safety (Zone IV)
Cryogenic liquids are used in superconductive MR
environments. The physical properties of these cryogenic liquids
present significant potential safety hazards. If exposed to room
air, these cryogenic liquids will rapidly boil off and expand into
a gaseous state. This produces several potential safety concerns,
including
• asphyxiation potential as cryogenic gases replace oxygenated
air,
• frostbite considerations at the exceedingly low temperatures of
these cryogenic liquids,
• existence of fire hazards in the unlikely event of a quench,
especially if some of the cryogenic gases escape into the magnet
room/Zone IV, and
,• rare existence of pressure considerations within Zone IV in the
unlikely event of a quench in which some of the cryogenic gases
escape into the magnet room/Zone IV. Correct Answers
11. MR Conditional Devices (Zone IV) The normal or safe
operation of many medical devices designed for use in the MR
environment may be disrupted by exposure to conditions
exceeding the device's conditional rating thresholds. It is
advisable for MR facilities to identify and label the approved
conditional labeling for static field (B0) and spatial field
gradient (dB/dx) exposure (as well as RF power rate/duration
limitations, and [if any] gradient dB/dt-tested exposure limits)
for each MR Conditional device that may be brought into Zones
III and IV. MR Conditional devices may be safe at 1 specific
static magnetic field strength but unsafe at higher or lower field
strength. Additionally, MR Conditional devices may be safe in 1
region of the magnet but not in another (eg, a device may be
labeled as MR Conditional at 1.5 T yet stipulate that it should
not be exposed to a magnetic field of greater than 200 G [0.02
T], an Correct Answers
12. Infection Control (Zone IV)
Magnet system room finishes and construction details should be
designed to facilitate cleaning by appropriately trained staff with
nonmotorized equipment. Additionally, as the numbers of MR-
guided procedures and interventional applications grow, basic
infection control protocols, such as seamless floorings,
scrubbable surfaces, and hand-washing stations should be
considered. Correct Answers
, 13. Disclaimers and Recommendations
The facility design issues identified in this appendix only
address general safety design issues for MRI suites. There are a
multitude of site-specific and magnet-specific operational and
technical design considerations relevant to MR facility design
and construction that are not addressed in this appendix. These
issues include, but are not limited to, patient acuity, staff access,
modality conflicts, vibration sensitivity, throughput/efficiency,
HIPAA considerations, magnetic contamination, sound
transmission, magnet shim tolerances, shielding design, moving
metal interferences, MR equipment upgrades, and
electromagnetic interference.
In addition to incorporating the guidance from this appendix, a
facility would be well advised to seek expert assistance in the
planning and design of MRI and multimodal radiology suites.
Correct Answers
2. Patient Interview/Clinical Screening Areas (Zone II)
Reviewing the patient Safety Screening Form and MR Hazard
Checklist requires discussing confidential personal information.
To facilitate full and complete patient disclosure of their medical
history, this clinical screening should be conducted in an area
that provides auditory and visual privacy for the patient.
Facilities should prospectively plan for electronic patient
medical records, which are useful in clinical screening, and
