*3.4.2. MRI*

MRI has the ability to demonstrate neurologic tissue including direct and secondary injury. However, this is a time-consuming modality and probably not suitable for initial assessment in these scenarios. Some concern exists regarding retained metal fragment migration and further neurologic damage when performing the MRI. Copper and lead are the most common materials for bullet manufacturing. These materials are non-ferromagnetic and should not affect MRI [75]. The literature shows that MRI (up to 1.5 T) is safe to use in case of retained bullets [76–79]. Nevertheless, we recommend that the decision should be done on a case-tocase basis, especially if the penetrating missile is not a bullet.
