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MRI

Magnetic resonance imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions using a powerful magnetic field and radio frequency pulses. The images that created can be examined on a suitable monitor.

Detailed MR images allow physicians to better evaluate parts of the body and certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning).

MRI of the body is performed to evaluate all major organs like:

  • Heart, liver, biliary tract, kidney, spleen and pancreas and adrenal glands
  • Pelvic organs including the reproductive organs in the male (prostate and testicles) and the female (uterus, cervix and ovaries)
  • Pelvic and hip bones
  • Blood vessels (MR Angiography)
  • Tumors of the chest, abdomen or pelvis
  • Coronary artery disease and heart problems including the aorta, coronary arteries and blood vessels, by examining the size and thickness of the chambers of the heart and the extent of damage caused by a heart attack or progressive heart disease
  • Tumors and other abnormalities of the reproductive organs (e.g., uterus, ovaries, testicles, prostate)
  • Abnormalities of the heart
  • Liver diseases such as cirrhosis and that of other abdominal organs
  • Congenital arterial and venous vascular anomalies and diseases of the chest, abdomen and pelvis
  • Conditions involving the bile duct, gallbladder and pancreatic ducts
  • Breast cancer and implants

Before the start of the procedure a loose fitting gown will be given.

A contrast material will be given orally or as an injection of into the bloodstream. The radiologist or technologist may ask if you have allergies of any kind, such as allergy to iodine or x-ray contrast material, drugs, food, the environment, or asthma. The contrast material used for an MRI exam, called gadolinium, does not contain iodine and is less likely to cause an allergic reaction.

If there is any severe abnormality with the kidney the same has to be reported to the radiologist before the start of the procedure. The kidney is a part of the excreatory system through which the contrast material passes out of the body. Women should always inform their physician or technologist if there is any possibility that they are pregnant. MRI has been used for scanning patients since the 1980's with no reports of any ill effects on pregnant women or their babies. However, because the baby will be in a strong magnetic field, pregnant women should not have this exam unless the potential benefit from the MRI is assumed to outweigh the potential risks.

If you have claustrophobia or anxiety, you may want to ask your physician for a prescription for a mild sedative.

Jewelry and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic objects are not allowed in the exam room. These items include:

All metal and electronic belongings should be removed namely jewelry, watches, credit cards, pins, hairpins, metal zippers and hearing aids, removable dental work, pens, pocketknives and eyeglasses, body piercings, etc

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI scanning area unless explicitly instructed to do so by a radiologist or technologist who is aware of the presence of any of the following:

  • Internal defibrillator or pacemaker
  • Cochlear implant
  • Clips used for brain aneurysms

You should tell the technologist if you have medical or electronic devices in your body, because they may interfere with the exam or potentially pose a risk.

  • Artificial heart valves
  • Implanted drug infusion ports
  • Implanted electronic device, including a cardiac pacemaker
  • Artificial limbs or metallic joint prostheses
  • Implanted nerve stimulators
  • Metal pins, screws, plates or surgical staples

In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect the presence of any metal objects.

Patients who might have metal objects in certain parts of their bodies may also require an x-ray prior to an MRI. Dyes used in tattoos may contain iron and could heat up during MRI, but this is rarely a problem. Tooth fillings and braces usually are not affected by the magnetic field but they may distort images of the facial area or brain, so the radiologist should be aware of them.

MRI units are of different types, short-bore systems, where the magnet does not completely surround you; others are open on all sides (open MRI). These units are especially helpful for examining patients who are fearful of being in a closed space and for those who are very obese. Newer open MRI units provide very high quality images for many types of exams in comparison with open MRI units with older magnets.

BRIEF ABOUT THE PROCEDURE

MRI examinations may be performed on outpatients or inpatients.

You will be strapped to help you stay still and maintain the correct position and positioned appropriately on a moveable examination table. Small devices that contain coils capable of sending and receiving radio waves may be placed around or adjacent to the area of the body being studied.

In the event of a contrast material being used, a nurse will insert an intravenous (IV) line into a vein in your hand or arm. A saline solution will drip through the IV to prevent blockage of the IV line until the contrast material is injected. If a contrast material is used during the examination, it will be injected into the intravenous line (IV) after an initial series of scans. Additional series of images will be taken following the injection.

The entire examination is usually completed within 45 minutes.

It is normal for the area of your body being imaged to feel slightly warm, but if it bothers you, notify the radiologist. It is important that you remain perfectly still while the images are being recorded, which is typically only a few seconds to a few minutes at a time. For some types of exams, you may be asked to hold your breath. You will know when images are being recorded because you will hear tapping or thumping sounds when the coils that generate the radiofrequency pulses are activated. You will be able to relax between imaging sequences, but will be asked to maintain your position as much as possible.

You will be alone in the exam room during the MR imaging, however, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centers allow a friend or parent to stay in the room.

You may be offered or you may request earplugs to reduce the noise of the MRI scanner, which produces loud thumping and humming noises during imaging. MRI scanners are air-conditioned and well-lit. Some scanners have music to help you pass the time.

When the contrast material is injected, it is normal to feel coolness and a flushing for a minute or two. The intravenous needle may cause you some discomfort when it is inserted and once it is removed, you may experience some bruising. There is also a very small chance of irritation of your skin at the site of the IV tube insertion.

If you have not been sedated, no recovery period is necessary. You may resume your usual activities and normal diet immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local pain. Very rarely, patients are allergic to the contrast material and experience hives, itchy eyes or other reactions.

It is recommended that nursing mothers not breastfeed for 36 to 48 hours after an MRI with a contrast material.

Benefits

  • MRI is a noninvasive imaging technique that does not involve exposure to radiation
  • MR images of the soft-tissue structures of the body—such as the heart, liver and many other organs— is more likely to identify and characterize abnormalities and focal lesions than other imaging methods. This detail makes MRI an invaluable tool in early diagnosis and evaluation of many focal lesions and tumors
  • MRI has proven valuable in diagnosing a broad range of conditions, including cancer, heart and vascular disease and muscular and bone abnormalities
  • MRI enables the detection of abnormalities that might be obscured by bone with other imaging methods
  • MRI allows physicians to assess the biliary system noninvasively and without contrast injection
  • The contrast material used in MRI exams is less likely to produce an allergic reaction than the iodine-based materials used for conventional x-rays and CT scanning
  • MRI provides a fast, noninvasive alternative to x-ray angiography for diagnosing problems of the heart and blood vessels
SOME ASSOCIATED RISKS
  • The MRI examination poses almost no risk to the average patient when appropriate safety guidelines are followed
  • If sedation is used there are risks of excessive sedation. The technologist or nurse monitors your vital signs to minimize this risk
  • Although the strong magnetic field is not harmful in itself, medical devices that contain metal may malfunction or cause problems during an MRI exam
  • There is a very slight risk of an allergic reaction if contrast material is injected. Such reactions usually are mild and easily controlled by medication
  • Nephrogenic systemic fibrosis is currently a recognized, but rare complication of MRI believed to be caused by the injection of high doses of MRI contrast material in patients with poor kidney function
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