Assessment of Patient Knowledge Level Towards MRI Safety Before the Scanning in Saudi Arabia

Dhafer M Alahmari,1 Fahad M Alsahli,1 Sami A Alghamdi,2 Othman I Alomair,2 Abdulrahman Alghamdi,3 Mohammed J Alsaadi4 1Department of Medical Imaging, King Saud Medical City, Riyadh, Saudi Arabia; 2Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 3Department of Medical Imaging, Aseer Central Hospital, Abha, Saudi Arabia; 4Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi ArabiaCorrespondence: Mohammed J Alsaadi, Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, 145, PO Box 422, Al-Kharj, 11942, Saudi Arabia, Tel +00966541001006, Email [email protected]: Magnetic resonance imaging (MRI) is an important diagnostic method in modern clinical medicine. Patients’ ‎‎knowledge about MRI is of utmost importance for optimizing the workflow, ‎safety, and patient comfort and saving valuable time for the MRI department. This study investigates patient knowledge levels regarding MRI safety before an MRI examination.Patients and Methods: A cross-sectional survey was completed by 200 patients who required MRI. Recruitment occurred over eight weeks in ‎governmental and private hospitals in Saudi ‎Arabia; both hospitals and participants were selected randomly. The ‎questionnaire was given to the patients prior to ‎their MRI scans. Descriptive statistics and chi-square tests were performed to identify relationships between knowledge of MRI safety and selected demographic groupings (age, gender, education level, income level). It also evaluates their source of information and assesses the patient’s previous experience regarding MRI scans.&#x200EResults: The study sample consisted of 200 patients from 230 surveys distributed in ‎Saudi Arabia, and the response rate was ∼ 87%. Depending on the P-values of the chi-square statistical test to find the relationship between ‎socio-demographic factors and patient’ knowledge level, the results showed a significant association (p-value=0.006) between age and gender and the level of knowledge relating to MRI safety issues. A similar significance (p-value=0.042) is observed between the knowledge level of patients and their educational level and annual income. In addition, a highly significant association (p-value< 0.001) is found between education level or previous experience and whether people seek information about MRI safety.Conclusion: The study findings suggest that a complex combination of factors affects patient knowledge regarding MRI safety before an MRI examination. Hence, the hospital and radiological department must ‎‎provide the ‎patient with accurate information about MRI.&#x200EKeywords: safety, knowledge, assessment, MRI, environmen

Diffusion tensor imaging detects ventilation-induced brain injury in preterm lambs

PURPOSE: Injurious mechanical ventilation causes white matter (WM) injury in preterm infants through inflammatory and haemodynamic pathways. The relative contribution of each of these pathways is not known. We hypothesised that in vivo magnetic resonance imaging (MRI) can detect WM brain injury resulting from mechanical ventilation 24 h after preterm delivery. Further we hypothesised that the combination of inflammatory and haemodynamic pathways, induced by umbilical cord occlusion (UCO) increases brain injury at 24 h. METHODS: Fetuses at 124±2 days gestation were exposed, instrumented and either ventilated for 15 min using a high tidal-volume (VT) injurious strategy with the umbilical cord intact (INJ; inflammatory pathway only), or occluded (INJ+UCO; inflammatory and haemodynamic pathway). The ventilation groups were compared to lambs that underwent surgery but were not ventilated (Sham), and lambs that did not undergo surgery (unoperated control; Cont). Fetuses were placed back in utero after the 15 min intervention and ewes recovered. Twenty-four hours later, lambs were delivered, placed on a protective ventilation strategy, and underwent MRI of the brain using structural, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) techniques. RESULTS: Absolute MRS concentrations of creatine and choline were significantly decreased in INJ+UCO compared to Cont lambs (P = 0.03, P = 0.009, respectively); no significant differences were detected between the INJ or Sham groups and the Cont group. Axial diffusivities in the internal capsule and frontal WM were lower in INJ and INJ+UCO compared to Cont lambs (P = 0.05, P = 0.04, respectively). Lambs in the INJ and INJ+UCO groups had lower mean diffusivities in the frontal WM compared to Cont group (P = 0.04). DTI colour mapping revealed lower diffusivity in specific WM regions in the Sham, INJ, and INJ+UCO groups compared to the Cont group, but the differences did not reach significance. INJ+UCO lambs more likely to exhibit lower WM diffusivity than INJ lambs. CONCLUSIONS: Twenty-four hours after injurious ventilation, DTI and MRS showed increased brain injury in the injuriously ventilated lambs compared to controls. DTI colour mapping threshold approach provides evidence that the haemodynamic and inflammatory pathways have additive effects on the progression of brain injury compared to the inflammatory pathway alone