title: Verbal communication in MR environments: effect of MR system acoustic noise on speech understanding.
abstract: OBJECTIVE
  To assess the masking effect of magnetic resonance (MR)-related acoustic noise and the effect of passive hearing protection on speech understanding.
  
  
  METHODS
  Acoustic recordings were made at 1.5 T at patient and operator (interventionalist in the MR suite) locations for relevant pulse sequences. In an audiologic laboratory, speech-to-noise ratios (STNRs) were determined, defined as the difference between the absolute sound pressure levels of MR noise and speech. The recorded noise of the MR sequences was played simultaneously with the recorded sentences at various intensities, and 15 healthy volunteers (seven women, eight men; median age, 27 years) repeated these sentences as accurately as possible. The STNR that corresponded with a 50% correct repetition was used as the measure for speech intelligibility. In addition, the effect of passive hearing protection on speech intelligibility was tested by using an earplug model.
  
  
  RESULTS
  Overall, speech understanding was reduced more at operator than at patient location. Most problematic were fast gradient-recalled-echo train and spiral k-space sequences. As the absolute sound pressure level of these sequences was approximately 100 dB at patient location, the vocal effort needed to attain 50% intelligibility was shouting (>77 dB). At operator location, less effort was required because of the lower sound pressure levels of the MR noise. Fast spoiled gradient-recalled-echo and echo-planar imaging sequences showed relatively favorable results with raised voice at operator location and loud speaking at patient location. The use of hearing protection slightly improved STNR.
  
  
  CONCLUSIONS
  At 1.5 T, the level of MR noise requires that large vocal effort is used, at the operator and especially at the patient location. Depending on the specific MR sequence used, loud speaking or shouting is needed to achieve adequate bidirectional communication with the patient. The wearing of earplugs improves speech intelligibility.
authors.affiliation: Department of Radiology, Erasmus Medical Center Rotterdam, 50 Dr Molewaterplein, PO Box 1738, 3000 DR Rotterdam, the Netherlands. a.moelker@erasmusmc.nl
authors.forename: Adriaan
authors.initials: A
authors.lastname: Moelker
authors.forename: Ronald A J J
authors.initials: RA
authors.lastname: Maas
authors.forename: Peter M T
authors.initials: PM
authors.lastname: Pattynama
mesh_terms: D000162:Acoustics; D000328:Adult; D004430:Ear Protective Devices; D005260:Female; D006309:Hearing; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009623:Noise, Occupational; D010470:Perceptual Masking; D013018:Sound Spectrography; D013067:Speech Perception; D013069:Speech Reception Threshold Test