Flatliners: The Real MRI Story

March 8, 2018March 2, 2018 / Jordyn Redwood / 3 Comments

As followers of this blog know, I did my own medical review of the recent movie version of Flatliners here and here. I thought there was something off about the MRI scenes, so I asked our resident radiology expert, Shannon Moore, to watch the film and give her thoughts.

Welcome back, Shannon.

I’m a huge fan of the 1990’s version of Flatliners. Kieffer Sutherland and Julia Roberts were brilliant outside of his Lost Boys role and her Pretty Woman phenomenon.

In 2017, an updated version of the Flatliner’s movie was released with Ellen Page. Of course, I had to watch and give my opinion. The movie was as enjoyable as the first one and held my interest and nerves through the entire film.

However, some flaws invaded the magnetic resonance imaging (MRI) scenes.

MRI Magnets

MRI machines contain a highly charged magnet thousands of times beyond the magnetic field of the earth. Metal objects become projectiles when they are close to the machine. Just to give an idea of this device’s strength, click on the link or search You Tube for MRI accidents after reading this post.

With a magnet so powerful, how can these students use a defibrillator right next to the scanner? The metal paddles, as well as other components in the device, would have become projectiles and caused damage not only to the equipment, but also to the people in the room standing next to the system. An MRI safe defibrillator is being explored, but so far not approved or on the market.

Even the argument they turned off the magnet is not logical. To “quench” or shut off an MRI magnet is not as simple as flipping a switch. In a hospital setting, MRI magnets are only “quenched” in case of a fire or if someone is pinned to the machine. Neither of these happen in this movie. The reason the magnets stay on constantly is because the shutdown process demands a release of helium and causes days of down time. The magnet could be damaged from the quenching process. Therefore, the magnet remains active on a daily basis or in this movie’s case, during their experiment.

The residents use the defibrillator to stop and restart the heart with the person on the MRI table. Real-life cardiac arrest procedures, with the patient in an MRI scanner, is to remove the patient from the scanner and place them on an MRI safe stretcher. They are removed from the room and provided life-saving measures.

Other metal objects in the movie’s experiment room are Courtney’s laptop computer, the heating blanket, laryngoscope, etc. – all containing metal objects and life-threatening projectiles.

MRI Images

When the residents are gathered in her apartment reviewing the images on a laptop, bolts of lightning or electrical currents appear on the scans—that is all Hollywood.

The type of scan they were showing on the screen was a Diffusion Tensor Imaging (DTI). This scan is a type of functional MRI that tracts the diffusion of water molecules in the white matter fibers of the brain. The colors in these images are assigned based on orientation. Front and back are usually blue, right to left are red and interior to exterior are green. Recorded electrical pulses are not shown on real MRI images. To be accurate the lightning bolts should not have been added and the actors could have pointed to the areas they were discussing.

MRI Brain Coils

The final inaccuracy is with the brain coil placed on the resident’s heads. It was dainty and petite showing the entire face of the actor.

Here is a real brain coil:

Quite a bit different from what was shown in the movie. In real life, there are a couple of coils to show the face, but they would have hindered the actor’s ability to intubate which again would not be done in an MRI Scan room because of the metal Laryngoscope used.

Overall, the movie was entertaining and interesting, but the MRI scenes need some resuscitation.
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Shannon Moore Redmon writes romantic suspense stories, to entertain and share the gospel truth of Jesus Christ. Her stories dive into the healthcare environment where Shannon holds over twenty years of experience as a Registered Diagnostic Medical Sonographer. Her extensive work experience includes Radiology, Obstetrics/Gynecology and Vascular Surgery.

As the former Education Manager for GE Healthcare, she developed her medical professional network across the country. Today, Shannon teaches ultrasound at Asheville-Buncombe Technical Community College and utilizes many resources to provide accurate healthcare research for authors requesting her services.

She is a member of the ACFW and Blue Ridge Mountain Writer’s Group. Shannon is represented by Tamela Hancock Murray of the Steve Laube Agency. She lives and drinks too much coffee in North Carolina with her husband, two boys and her white foo-foo dog, Sophie.

Love Matt Czuchry, but The Resident Needs Help

February 22, 2018February 16, 2018 / Jordyn Redwood / Leave a comment

As you all know, I’ve been taking my own jabs at The Resident which you can read here and here. Today, our resident radiology expert Shannon Redmon offers her insight of some of the show’s inaccuracies.

https://goo.gl/images/1aLd9x

Welcome back, Shannon!

As a huge fan of Matt Czuchry since his Gilmore Girl days, I must say that his new show, The Resident, is quite entertaining. Too bad several episodes include inaccurate medical information.

For example, two MRI scenes have aired on this series and both are misrepresented as to what happens in a real hospital.

In the first scene, Drs. Conrad and Pravesh are viewing an exam in the MRI control room. No one else is around. No technologists, radiologists or even patients. The reason this is out of character is because most surgeons view the images from their workstations or with a radiologist in their office, not in the technologist control room.

Digital radiographic photos can be accessed from computers all over the hospital. All doctors need is their login and the patient’s name to access any record in the system. Why would both surgeons trek all the way to the MRI room to look at the images? They can pull them up right from where they are sitting and in the operating room before surgery.

The second MRI scene shows Nic, the well-rounded nurse, marching into the MRI room to confront a billing lady who convinced a doctor to order an MRI on a patient with a penile implant – a metallic based penile implant according to the dialogue in the scene. When nurse Nic enters, the patient is already in the machine. She stops the exam because the patient has a metal penile implant which could be “ripped out” by the powerful magnet.

If this patient were going to have any issues from the MRI, then the damage would already be done. MRI magnets are always activated. The patient with a metal implant would not even be allowed in the room. MRI technologists have strict vetting procedures in place to conduct on all patients. These policies keep at-risk patients from harm and are emblazoned into the brains of all technologists. They would have been the ones to prevent the test from being completed, not the nurse from an outside department. This scene makes the MRI tech seem inept.

Also, where does the billing consultant get so much authority? If any employee confronted physicians and nurses the way she did, she’d be tossed out on her head. No surgeon is going to stand there and let a consultant from billing tell them what to order or how to treat their patients. This woman strongly encourages all staff to upcode patient exams for more money. Without proper documentation or a legitimate reason, upcoding is illegal and hospitals can be highly fined for healthcare fraud in violation of the False Claims Act.

Although I cringe when I see such inaccurate scenes, I will continue to watch for two reasons. Because I love Matt Czuchry and … I love Matt Czuchry!
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Shannon Moore Redmon writes romantic suspense stories, to entertain and share the gospel truth of Jesus Christ. Her stories dive into the healthcare environment where Shannon holds over twenty years of experience as a Registered Diagnostic Medical Sonographer. Her extensive work experience includes Radiology, Obstetrics/Gynecology and Vascular Surgery.

Forensic Medical Question: Forensic MRI for Child Abuse

November 18, 2016November 17, 2016 / Jordyn Redwood / 1 Comment

Susan Asks:

mri-782459_1920 Is there such a thing as a forensic MRI? Not to be done on a dead person, but in a child abuse case? Can one tell if a child has been beaten and see healed bruises, etc?

Jordyn Says:

Thanks for your questions.

The only indication I can think of using MRI to discern abuse would be for head trauma. MRI is the most sensitive study when it comes to differentiating old and new bleeds (as in possibly discerning two episodes of shaking), but still an exact time of the bleed could probably not be given. We just would know there were two separate instances of injury that caused bleeding.

Also, it wouldn’t be called a forensic MRI on a live child. We would just call it by the study we’re doing. In this case, a brain MRI, but the reason for doing the study would be concern for child abuse and/or intracranial (inside the brain) bleeding.

You can’t really tell healed bruises because they’re healed after all. The skin would have normal appearance. We could at least take a history of where the bruises were because we know normal versus abnormal bruising patterns in children, but pictures are always more impressive so seeing current injuries will always be better if trying to build a child abuse case.

Perhaps you’re thinking about healed fractures which you could possibly see some evidence of healed fractured on x-rays depending on how significant the fracture was. However, not all healed fractures are visible on x-ray. Healing fractures can be seen on x-ray.