Insights Imaging. 2024 Oct 7;15(1):238. doi: 10.1186/s13244-024-01813-6.
Despite the absence of ionizing radiation, magnetic resonance (MR) has inherent risks in clinical practice that can have serious health consequences if overlooked. At an international level, there are MR safety guidelines that help define the organization of a radiology department to minimize the risks for patients and personnel. However, competing guidelines exist and not every country and institution adheres to the same standards. In this work, we aim to understand the current situation regarding MR safety practices across Europe, and to identify the points where harmonization, coordination, or further education is needed.
An anonymous survey questionnaire was distributed between April and June 2023 through ESR member societies to healthcare professionals, aimed to assess personnel training, local policies, scanning practices, and accidents.
Seven hundred and ninety-three responses were obtained from 44 different countries. The majority of respondents from five countries reported that MR safety is mandated by law, but we could only confirm two (Italy and Austria). While 77% of the responses said that their institution had a clear MR safety guideline, 52% said that nobody in their institution had received specific MR safety training. MR-conditional cardiac devices are mostly scanned in university hospitals (reported by 75% of respondents from this type of institution) but in only 42% of outpatient facilities. MR-unsafe cardiac devices are only scanned off-label in 27% of university hospitals, and in an even smaller share of other institutions. Approximately 12% of the respondents reported MR-related accidents resulting in patient or personnel injury. Overall, there is the sentiment that MR safety education and regulation are needed.
The European landscape in terms of MR safety is very heterogeneous, with different regulations across countries, and different procedures for MR safety training and their application in clinical routine. The European Society of Radiology is optimally positioned to play an active role in the harmonization of MR safety education and practices across Europe, and we are proposing a four-tiered framework for the development of a teaching curriculum for MR safety training.
There is room for raising awareness of MR safety issues to ensure patient safety, reduce accidents, and benefit more patients. We advocate for radiologist-led standardization and improvement of MR safety training as a way to address this problem.
Our survey of MR safety practices across Europe revealed significant heterogeneity in regulations, training, and scanning practices. There is a widespread lack of awareness and implementation of MR safety guidelines and diffuse uncertainty, under-scanning of eligible patients, and preventable accidents. The ESR proposes a harmonized, four-tiered MR safety training curriculum to standardize, and improve safety practices across Europe.
尽管磁共振成像（MR）不存在电离辐射，但在临床实践中存在固有风险，如果被忽视，可能会导致严重的健康后果。在国际层面，有一些MR安全指南，有助于确定放射科的组织架构，以尽量减少对患者和工作人员的风险。然而，存在相互竞争的指南，并非每个国家和机构都遵循相同的标准。在这项工作中，我们旨在了解欧洲MR安全实践的现状，并确定需要协调、合作或进一步教育的要点。
2023年4月至6月期间通过欧洲放射学会（ESR）成员协会向医疗保健专业人员分发了一份匿名调查问卷，旨在评估人员培训、当地政策、扫描实践和事故情况。
从44个不同国家获得了793份回复。来自五个国家的大多数受访者表示，MR安全受法律强制规定，但我们只能确认两个国家（意大利和奥地利）。虽然77%的回复称其机构有明确的MR安全指南，但52%的回复称其机构中没有人接受过特定的MR安全培训。符合MR条件的心脏设备大多在大学医院进行扫描（此类机构的75%的受访者报告），但门诊设施中只有42%进行扫描。不符合MR安全标准的心脏设备仅在27%的大学医院进行超说明书扫描，在其他机构中的比例更小。约12%的受访者报告了导致患者或工作人员受伤的MR相关事故。总体而言，人们认为需要进行MR安全教育和监管。
欧洲在MR安全方面的情况非常多样化，各国的法规不同，MR安全培训及其在临床常规中的应用程序也不同。欧洲放射学会最适合在协调欧洲范围内的MR安全教育和实践方面发挥积极作用，我们提议建立一个四层框架来制定MR安全培训的教学课程。
提高对MR安全问题的认识，以确保患者安全、减少事故并使更多患者受益，仍有空间。我们主张由放射科医生主导标准化和改进MR安全培训，以此来解决这一问题。
我们对欧洲MR安全实践的调查显示，在法规、培训和扫描实践方面存在显著差异。普遍缺乏对MR安全指南的认识和实施，存在广泛的不确定性、符合条件的患者扫描不足以及可预防的事故。欧洲放射学会提议制定一个统一的四层MR安全培训课程，以规范和改进欧洲各地的安全实践。
