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  Aktueller Fall: Januar - März 2008 JOURNAL OF MAGNETIC RESONANCE IMAGING 26:1322-1327 (2007)
  Claustrophobia During Magnetic Resonance Imaging:
Cohort Study in Over 55,000 Patients
  Marc Dewey, MD,1* Tania Schink, PhD,2 and Charles F. Dewey, MD, PhD3
  Study Limitations

Our study is by a factor of 3 larger than the sum of other studies published on claustrophobia during MRI (Table 1). Nevertheless, it is important to note that our findings are limited by the fact that the patients were not prospectively randomized to be imaged using one of the two MR scanners. Due to the consecutive nature of the trial and the inclusion of all patients, the cohort is representative of patients undergoing an outpatient MR scan. Also, we cannot rule out the possibility that a before-after bias might have influenced the present study. However, we adjusted for confounders and different distributions in both groups with logistic regression, and the adjusted ORs favoring the recent MR scanner were even higher than the unadjusted ORs. Furthermore, given the sequential sampling design of the study, it is conceivable that a referral bias could have influenced the results; this effect was extensively addressed in our secondary analyses. Finally, characteristics such as patient weight and height were not available from the patients’ electronic health card used at the time the trial was conducted. Psychological claustrophobia severity, image quality, and examination duration evaluation was likewise not performed. To analyze claustrophobia in a large cohort like this would be impractical using a randomized design; however, small randomized studies might provide further insights into claustrophobic reactions. Given that despite the higher rate of head-first examinations, there was significantly less claustrophobia on the short-bore scanner and because of the similar results in the intraindividual substudy, we believe our findings are valid.
 In conclusion, the present study compared claustrophobic reactions in a conventional and a recent shortbore MR scanner in a consecutive cohort of patients scheduled to undergo MRI and found that the incidence of claustrophobia can be reduced by a factor of 3 by using MR scanners with a patient-centered design. This might further increase the clinical utility and applicability of MRI.


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