MRI Safety Update
 (This article represents the views of its author only and does not reflect those of the International Society for Magnetic Resonance in Medicine and are not made with its authority or approval)
 

MRI and Body Piercing Jewelry

The patient should be instructed to immediately inform the MR system operator if any heating
or other unusual sensation occurs in association with the body piercing jewelry.


Frank G. Shellock, Ph.D.
Adjunct Clinical Professor of Radiology and Medicine
Keck School of Medicine, University of Southern California

Adjunct Professor of Clinical Physical Therapy
Division of Biokinesiology and Physical Therapy
School of Dentistry, University of Southern California

Director for MRI Studies of Biomimetic MicroElectronic Systems
National Science Foundation, Engineering Research Center
University of Southern California

Institute for Magnetic Resonance Safety, Education, and Research

www.MRIsafety.com
www.IMRSER.org
www.MRIsafetybook.com
 

   Ritual or decorative body piercing is extremely popular as a form of self-expression. Different types of materials are used to make body piercing jewelry including ferromagnetic and nonferromagnetic metals, as well as non-metallic materials. The presence of body piercing jewelry that is made from ferromagnetic or conductive material of a certain shape may present a problem for a patient referred for a magnetic resonance imaging (MRI) procedure or an individual in the MR environment.

Risks include uncomfortable sensations from movement or displacement that may be mild-to-moderate depending on the site of the body piercing and the ferromagnetic qualities of the jewelry (e.g., mass, degree of magnetic susceptibility, etc.). In extreme cases, serious injuries may occur. In addition, for body piercing jewelry made from electrically conducting material, there is a possibility of MRI-related heating that could cause excessive temperature increases and burns.

Because of potential safety issues, metallic body piercing jewelry should be removed prior to entering the MR environment. However, patients or individuals with body piercings are often reluctant to remove their jewelry. Therefore, if it is not possible to remove metallic body piercing jewelry, the patient or individual should be informed regarding the potential risks. In addition, if the body piercing jewelry is made from ferromagnetic material, some means of stabilization (e.g., application of adhesive tape or bandage) should be used to prevent movement or displacement.

To avoid potential heating of body piercing jewelry made from conductive materials, the use of gauze, tape, or other similar material should be used to wrap the jewelry in such a manner as to insulate it (i.e., prevent contact) from the underlying skin is recommended. The patient should be instructed to immediately inform the MR system operator if any heating or other unusual sensation occurs in association with the body piercing jewelry.
   
 

According to Muensterer (2004), even temporary or short-term piercing jewelry removal may lead to closure of the subcutaneous tract. Therefore, temporary replacement with a nonmetallic spacer may be indicated. This can be accomplished using the following procedure, as it was applied to umbilical piercing jewelry:

(1) Disinfect the piercing and umbilical area with 70% isopropyl alcohol,
(2) Open the piercing jewelry by removing the bead from the bar,
(3) Place the tip of a tight-fitting intravenous catheter (14 or 16 gauge, without the needle) over the threaded tip of the bar,
(4) Advance the intravenous catheter caudally, pushing the piercing out of the skin tract, and
(5) Remove the jewelry and leaving the intravenous catheter in the subcutaneous skin tract as a spacer. After the intervention (or MRI examination), reinserted the umbilical piercing jewelry by following the described steps in reverse.

Piercing jewelry located in other areas on the body may be replaced for MRI examinations in the same way, with minor modifications.

REFERENCES
Armstrong ML, Elkins L. Body art and MRI. Am J Nurs. 2005;105:65-6.
Deboer S, Seaver M, Angel E, Armstrong M. Puncturing myths about body piercing and tattooing. Nursing. 2008;38:50-54.
Laumann AE, Derick AJ. Tattoos and body piercings in the United States: a national data set. J Am Acad Dermatol. 2006;55:413-21.
Muensterer OJ. Temporary removal of navel piercing jewelry for surgery and imaging studies. Pediatrics. 2004;114:e384-6.
Shellock FG. MR safety and body piercing jewelry. Signals, No. 45, Issue 2, pp. 7, 2003.