WHAT IS AN MRI? Magnetic Resonance Imaging, or more commonly known as MRI or MR, is painless, non-invasive and is one of the safest, most comfortable imaging techniques available. It combines a powerful magnetic field, radio frequency waves (similar to that produced by microwave ovens) and an advanced computer system to produce accurate, detailed pictures of organs and tissues to diagnose a variety of medical conditions. MRI is superior in imaging soft tissue areas of your body and specific diseases which cannot be evaluated or assessed with other imaging methods such as X-ray, CAT scans or Ultrasound. MRI also has no ionizing radiation involved.

All MRI scanners have what is called a “field strength”, measured in Tesla’s, which determines the magnets strength.  The higher or stronger the field strength or Tesla, the better your exam outcome is. The pictures or images are clearer and smaller details and abnormalities are detected as well as much shorter exam times.

There are several different types of MR machines. One that is most commonly known is typically referred to as a “closed” magnet or tunnel. This traditional MR scanner is a large cylinder shaped tube or tunnel in which you are slid into for your MRI. There are also “open” scanners in which the machine is open on all sides. These scanners are very helpful for scanning patients who are claustrophobic or fearful of being in tight enclosed environments, as well as those people who are obese.

Frequently, contrast material or Gadolinium, is requested to further enhance your study. This is given through the vein of your arm with a very small needle. With some MRI and MRA exams, an IV is started in the vein, once the exam is over it is of course removed. The contrast can show certain organs or soft tissues more clearly than without the contrast and is not needed on all MR studies. Your doctor will decide if contrast is needed. The radiologist or technologist may ask if you have allergies such has hay fever, asthma, kidney/renal disease or have had an allergic reaction to MR contrast before. If you are allergic to anything or have had a previous adverse reaction, must inform the technologist prior to the exam. Gadolinium or MR contrast is completely different from X-ray or CAT Scan dye, there is no iodine in MR contrast, so allergic or adverse reactions are less likely.

As with any test or procedure, you should not have an MR Scan if you are pregnant, as this could be harmful to the baby. While there are no known potential or harmful risks with MR, if you are pregnant, talk to your doctor prior to having an MRI scan.

WHY DO I NEED AN MRI?
There are many reasons why your physician may order an MRI. Some include diseases such as metastatic disease/cancer, spine or joint (knee, shoulder ect) injury, headaches, dizziness, stroke, high blood pressure, prior back surgery with continuing pain, many types of neurological disorders as well as abdominal or pelvic pain. MR is the best exam for imaging ligaments and tendons, as well as cartilage or loss of “cushion” of the joints.

WHAT WILL HAPPEN WHEN HAVING AN MRI/MRA?
An MRI scanner is a  large machine which has a circular opening with a table to lie on while having your study, usually on your back. “Coils” or special devices are often used and placed around the area being examined; these coils send and receive the radio waves used to produce the image or picture of your body. The table slides into the opening and stops when the body part being examined has reached the center most part of the magnet or MR scanner known as isocenter. It is very important during this process that you remain as still as possible. Depending on the exam you are having done, the technologist performing your study will ask you to hold your breath for a brief moment and then will tell you when to breathe normally. The technologist performing your study can see you at all times during the exam. There is also an intercom system which allows the technologist to talk to you, and you to talk to them. While the exam is being performed, you will hear loud knocking or banging noises coming from within the MR scanner. These noises are necessary and important in allowing the magnetic field to best 'see' the appropriate part of the body. You are given ear plugs and most MRI centers offer music during the exam, if so, you will be given a set of headphones as well. Depending on the type of MR scanner you are being examined on, your study can take anywhere from 30 minutes to 1 ½ hours.

When having an MR with intravenous contrast, you may be asked not to eat or drink anything approximately 8 hours prior to study. A small needle is used and inserted into the vein of your arm and the contrast is injected. You may feel a warm or flushed sensation while the contrast is being injected as well as a metallic taste in your mouth. These only last a few very short minutes. Very rarely people can have an allergic reaction to the contrast injection. The reaction most commonly starts with sweating, dizziness, nausea and difficulty breathing. Hives and itching may also be associated with the injection. If this happens, the radiologist and technologist know exactly what to do. If you are allergic to anything or have had a previous adverse reaction, inform the technologist prior to the exam.

In most cases, MR is safe for patients with metal implants with a few exceptions:

• Pacemaker, internal implanted defibrillator

• Cochlear (ear) implant

• Aneurysm Clips

You should notify the technologist prior to your exam if you have any of the following:

• Artificial heart valves

• Implanted drug infusion ports or pumps

• IUD (females)

• Implanted electronic devices

• Metal pins, screws, plates or surgical staples

You should also notify the technologist prior to examination if you have ever worked with metal, around metal or had metal shaving or particles in your eye. You will then have an X-ray of your eyes to make sure there are no small metallic pieces still there as this could be harmful once you enter into the MR scanning room.

WHAT TO EXPECT WHEN HAVING AN MR SCAN AT ICN
An ICN associate will notify you the day prior to your appointment to confirm your arrival time and provide you with specific instructions to prepare for your exam, if any is needed, as well as review your health insurance information.

When you arrive at ICN, you will walk into a very comfortable and relaxing atmosphere, just as if you were at home and will be promptly greeted by our friendly staff. They will walk you through the paperwork you need to fill out. Once you have completed the paperwork, you will be asked to have a seat in the waiting room until you are called for your exam.

When you are called for your exam, you will be lead to the dressing area where you will be asked to remove any jewelry. You may also be given a gown or a set of scrubs and asked to change your clothes. Lockers are provided so you may lock your personal belongings in the locker during your exam.

Once you have changed and are ready for your exam, you will be lead to the MR suite. The technologist will explain to you the exam you are having done, give you a set of ear plugs and/or a headset for listening to music. If you have any questions or concerns, feel free to ask!

You will then be asked to lie down on the table, typically on your back. Our technologist will then make sure you are comfortable and position you in the scanner. Once you are positioned, you are ready to begin. Our technologist will exit the suite and notify you over the intercom the study is going to start. For some studies, the technologist will come over the intercom and ask you to hold your breath for a few seconds and then let you know when to breathe normally.

Once the scan is completed, our technologist will then lead you back to the dressing area so you can change back into your clothes. Once you have changed, you are all done.

We will give you a CD containing the pictures of your MR Scan.

Once your scan is completed, our radiologist, a physician specially trained to interpret radiology exams, will “read” your study and a typed, signed report will be faxed to your doctor within 24 hours, quite frequently the same day. If requested, we will deliver the images on CD or film to your doctor. Your doctor will then discuss the results of the MR Scan with you as well as a treatment plan if needed.

HOW TO PREPARE FOR AN MR SCAN
Typically with MRI/MRA, there is no preparation. If your exam involves imaging the abdomen or pelvis area you may be asked not to eat or drink anything for 6-8 hours. You may go about your daily routine as normal with no limitations or special preparations.

If you have had previous diagnostic exams on the same body part we are imaging, it is always helpful that you bring those images with you so our radiologist can compare the two studies to note any changes since the last exam.

 

How do I prepare to have this exam?

Because we use a large magnet in the MRI, no metallic objects or mechanical devices can enter the imaging room. You may want to keep this in mind when deciding what to wear to your MRI appointment. Below is a list of suggestions to help you prepare.

Clothing: Wear something light weight and comfortable which is easy to take on and off. Avoid wearing clothing which has a lot of metal snaps, zippers or hooks.

Jewelry: All metal jewelry and watches must be removed.

Hair products: Many hair products, such as "Topik" to cover hair loss, or attachable hair weaves contain magnetic particles, and they must be removed.

Hair accessories: Any hair clips, ties, or pins which are made of metal or have metal parts on them must be removed.

Make-up: Because some make up, particularly mascara, is made with a metallic base, it is best not to wear much make up the day of your appointment.

Dental devices: If you wear dentures, or partial dental plates, they must be removed.

Medication & diet: You may continue to take any routine medications prescribed by your physician and there are no dietary restrictions unless you are instructed otherwise by your referring physician.

Special considerations: Because we use a strong magnet in the MRI, patients who have pacemakers cannot have an MRI exam. You will be asked to complete an MRI Patient Screening form prior to your exam. Additional information or testing may be needed prior to your MRI exam to ensure that it is safe for you to have this test:

• if you have any other implanted medical devices such as cochlear implants, penile implants, aneurysm clips, artificial heart valves, or recent cardiac stent
• or if you have metal shavings or gunshot shrapnel in the face or eye.