Original Research Claustrophobia and Premature Termination of Magnetic Resonance Imaging Examinations Iris Eshed, MD, Christian E. Althoff, MD, Bernd Hamm, MD, and Kay-Geert A. Hermann, MD * Purpose: To evaluate the incidence of MRI-related claus- trophobia and prematurely terminated MRI (ptMRI) exam- inations due to claustrophobia in a large-scale cohort study. Materials and Methods: The hospital’s computerized radi- ology information system (RIS) was retrospectively analyzed for all 1.5-Tesla MRI examinations and reports during the year 2004. Data collected included demographic informa- tion, body part examined, known claustrophobia, and whether the examination was prematurely terminated. All information available on the MRI examinations and the patient-based data (i.e., excluding any additional examina- tions per patient) were analyzed. Results: A total of 5798 MRI reports of 4821 patients were evaluated. A total of 95 patients (1.97%) suffered from claustrophobia and 59 (1.22%) prematurely terminated the examination due to claustrophobia. The incidence of ptMRI was higher in women than men (no statistical significance). The majority of patients with ptMRI were between 20 and 80 years old. Patients undergoing head MRI showed the highest incidence of ptMRI and those undergoing extrem- ity, breast, or pelvic MRI had the lowest. Prone compared to supine positioning results in the lowest ptMRI incidence (P  0.05). Conclusion: Claustrophobic reactions cause a relatively low incidence of ptMRI and are influenced by sex, body part examined, and positioning within the MR scanner. Seda- tion and prone positioning might help overcome these re- actions. Key Words: MRI; claustrophobia; safety; anxiety; safety management; anxiolysis J. Magn. Reson. Imaging 2007;26:401– 404. © 2007 Wiley-Liss, Inc. SINCE ITS INTRODUCTION in the 1980s, MRI has be- come a popular diagnostic procedure. MRI evaluation usually involves the patient being inserted head-first into a relatively narrow tunnel and remaining motion- less for up to and beyond one hour. Anxiety-related reactions during MRI have been extensively reported and researched, with a reported incidence of up to 37% (1– 4). Claustrophobia is an anxiety disorder that in- volves the fear of enclosed or confined spaces (5). The reported incidence of premature termination, or failure of the MRI examination due to claustrophobic reactions ranges between 0.5% and 14.5%. The available data has mostly been obtained with relatively old MRI scan- ners and in small study cohorts (1,2,6 –9). The purpose of the current study was to evaluate the incidence of MRI-related claustrophobia and prema- turely-terminated MRI examinations in a large-scale cohort study of patients undergoing 1.5-Tesla MRI. MATERIALS AND METHODS Our university-based department of radiology uses a computerized radiology information system (RIS). For every MRI examination performed, the patient and ex- amination data are manually stored in the data base. Additional information (i.e., if a patient misses the MRI appointment, prematurely terminates the examination, etc.) is also coded into the RIS. An extensive computerized search of all MRI exami- nations and reports performed during the year 2004 was carried out. For each examination, data collected included demographic information of the patient (age, sex), body part examined, whether contrast medium or premedication was administered, known claustropho- bia, and whether the examination was prematurely ter- minated. Only routine MRI examinations were in- cluded, while all study-based MRI examinations were excluded. Then, a manual search of all written MRI reports was performed to verify the computerized data and the information about the reason for premature termination and for premedication indications was added. Terminated MRI examinations for reasons other than known claustrophobia (N = 97) as well as reports with incomplete or unclear data (N = 14) were excluded (see summary in Table 1). Children under the age of five years (N = 30) were also excluded. Claustrophobia-related termination of the MRI exam- ination was defined as severe anxiety (5) upon being positioned in the MRI tunnel with the patient request- ing to be taken out while the attending radiologist could Department of Radiology, Charite ´ Medical School, Berlin, Germany. *Address reprint requests to: K-G.A. Hermann, MD, Department of Radiology, Charite ´ Medical School, Campus Mitte, Charite ´platz 1, 10117 Berlin, Germany. E-mail: kgh@charite.de Received August 2, 2006; Accepted February 22, 2007. DOI 10.1002/jmri.21012 Published online in Wiley InterScience (www.interscience.wiley.com). JOURNAL OF MAGNETIC RESONANCE IMAGING 26:401– 404 (2007) © 2007 Wiley-Liss, Inc. 401