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MR #: MRI AND IV CONTRAST HISTORY AND SCREENING FORM Patient Name: Date: Sex: MF Height: Weight: DOB: Age: Referring Physician: Are you pregnant: YES NO N/A Last Menstrual Period: Reason you are here
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01
To fill out an MRI with IV contrast, follow these steps:
02
Before the procedure, ensure you have a medical order or prescription from your healthcare provider for the MRI with IV contrast.
03
Check if there are any specific dietary restrictions or preparations you need to follow. This may include fasting for a certain period of time prior to the procedure.
04
Arrive at the imaging facility and inform the staff about your appointment for an MRI with IV contrast.
05
Change into a gown and remove any metallic objects or accessories, as they can interfere with the MRI images.
06
A nurse or technician will then insert an intravenous (IV) line into your arm or hand, which will be used to administer the contrast dye.
07
You will be positioned on the MRI table, usually lying down, and the table will slide into the MRI machine.
08
Follow the instructions provided by the staff, which may include staying still or holding your breath at certain intervals.
09
The technician will operate the MRI machine from a separate room, monitoring your progress through a window or camera.
10
During the procedure, the contrast dye will be injected through the IV line. You may feel a warm or metallic taste in your mouth, which is normal.
11
Once the imaging is completed, the technician will remove the IV line and you can change back into your regular clothes.
12
You may be able to resume your normal activities immediately after the procedure, unless instructed otherwise by your healthcare provider.
13
It is common to experience mild side effects like a metallic taste, nausea, or dizziness after the contrast injection, but these usually subside quickly.
14
The MRI images will be analyzed by a radiologist, who will provide a report to your healthcare provider.
15
Finally, discuss the results and next steps with your healthcare provider.

Who needs mri and iv contrast?

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MRI with IV contrast is typically required for individuals who need enhanced imaging capabilities to better visualize certain structures within the body.
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This may include:
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- Patients suspected or diagnosed with tumors, cancer, or abnormalities in the brain, spine, or other organs.
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- Individuals with vascular conditions, such as aneurysms or arteriovenous malformations (AVMs).
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- Patients with suspected or known infections in the bones, joints, or soft tissues.
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- Individuals with inflammatory or autoimmune disorders, like multiple sclerosis or rheumatoid arthritis.
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- Individuals undergoing treatment follow-up to assess the effectiveness of therapies.
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- Patients scheduled for surgical planning or evaluation of treatment response.
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It is important to consult with your healthcare provider to determine if an MRI with IV contrast is necessary for your specific medical condition.
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MRI stands for Magnetic Resonance Imaging and IV (intravenous) contrast is a substance used to enhance the visibility of certain tissues or blood vessels during an MRI scan.
Medical professionals such as radiologists or healthcare providers are responsible for administering and documenting the use of MRI and IV contrast.
Medical professionals must accurately document the type of contrast used, the dosage, administration method, and any patient reactions or side effects.
The purpose of using IV contrast during an MRI scan is to improve the clarity and visibility of certain structures or abnormalities within the body.
Information such as the type of contrast used, dosage, administration details, patient's medical history, and any adverse reactions must be reported.
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