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Magnetic
resonance imaging (MRI) is defined by the National Institute of
Health as a non-invasive procedure that uses powerful magnets and
radio waves to construct pictures of the body. Unlike
conventional radiography and Computed Tomographic (CT) imaging,
which make use of radiation (X-rays), MRI imaging is based on the
magnetic properties of atoms.
A
powerful magnet generates a magnetic field roughly 10,000 times
stronger than the natural background magnetism from the earth. A
very small percentage of hydrogen atoms within a human body will
align with this field. When focused radio wave pulses are broadcast
towards the aligned hydrogen atoms in tissues of interest, they
will return a signal. The subtle differences in that signal from
various body tissues enables MRI to differentiate organs, and potentially
contrast benign and malignant tissue.
Any
imaging plane (or "slice") can be projected, stored in a computer,
or printed on film. MRI can easily be performed through clothing
and bones. However, certain types of metal in the area of interest
can cause significant errors in the reconstructed images.
An
MRI can provide additional imaging information for the clinician
based upon it's superior tissue contrast resolution. Combined with
other imaging modalities, a more definitive diagnosis can be given
in the work up of a patient's disease.
Sequences
performed with intravenous contrast may provide additional data
regarding the vascular nature of masses. An MRA, or magnetic resonance
angiogram, is a special type of MR which creates three-dimensional
reconstructions of vessels containing flowing blood and is often
utilized when conventional angiography cannot be performed due to
renal failure or other contraindications.
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General
Information for Patients
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What
to Expect |
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There
is no pain during an MRI. The magnetic field and radio waves are
not felt.
The
primary possible discomfort is the claustrophobic feeling that some
experience from being inside the scanner.
The
table may be hard or cold, but you can request a blanket or pillow.
The
machine produces loud thumping and humming noises during normal
operation. Ear plugs are usually given to the patient to reduce
the noise.
A technologist
observes the patient during the entire procedure and may be spoken
to through an intercom in the scanner. Some MRI scanners are equipped
with televisions and special headphones to help the examination
time pass.
Excessive
movement can blur MRI images and cause certain artifacts. If the
patient has difficulty lying still or is very anxious, an oral or
intravenous sedative may be given.
There
is no recovery time, unless sedation was necessary. If sedation
is used, there are associated risks of over-sedation. The technologist
monitors the patient's vital signs, including heart rate and respiration
as needed.
There
is no ionizing radiation involved in MRI, and there have been no
documented significant side effects of the magnetic fields and radio
waves used on the human body to date. The most common MR intravenous
contrast agent, gadolinium, is very safe, and although there have
been documented allergic reactions to it, this is extremely rare.
After
an MRI scan, you can resume normal diet, activity, and medications.
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How
to Prepare for an MRI
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No
preparatory tests, diets, or medications are usually needed. An
MRI can be performed immediately after other imaging studies.
Depending
on the area of interest, the patient may be asked to fast for 4
to 6 hours prior to the scan.
Because
of the strong magnets, certain metallic objects are not allowed
into the room. Items such as jewelry, watches, credit cards, and
hearing aids can be damaged. Pins, hairpins, metal zippers, and
similar metallic items can distort the images. Removable dental
work should be taken out just prior to the scan. Pens, pocketknives,
and eyeglasses can become dangerous projectiles when the magnet
is activated and should not accompany the patient into the scanner
area.
Because
the strong magnetic fields can displace or disrupt the action of
implanted metallic objects, people with cardiac pacemakers cannot
be scanned and should not enter the MRI area. MRI also should not
be used for people with metallic objects in their bodies, such as:
Inner ear (cochlear) implants, brain aneurysm clips, some artificial
heart valves, older vascular stents, recently placed artificial
joints.
Sheet
metal workers, or persons with similar potential exposure to small
metal fragments, will first be screened for metal shards within
the eyes with X-rays of the skull.
Because
the effects of strong magnetic fields on a fetus are not well documented
at this time, pregnant women are usually advised to avoid MRI scans.
MRI
is usually not recommended for acute trauma situations, because
traction and life-support equipment cannot safely enter the scanner
area and scan times are relatively lengthy.
The
patient will be asked to sign a consent form confirming that none
of the above issues apply before the study will be performed.
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Chest
MRI |
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Purpose:
MRI provides detailed pictures of tissues within the chest cavity,
without obstruction by overlying bone. It may be used to clarify
findings from previous X-rays or CT scans. It can show the structures
of the chest from multiple planes. It is useful in the diagnosis
of abnormal growths, and can provide information for the staging
(such as the size, extent, and spread) of thoracic tumors. MRI clearly
shows lymph nodes and blood vessels, and is a noninvasive procedure
that can evaluate blood flow. MRI can distinguish tumors or other
lesions from normal tissues. MRI is sometimes used to avoid the
dangers of angiography or of repeated exposure to radiation.
Prior
Preparation: None
Administration:
The patient will be asked to lie on a narrow table which slides
into a large tunnel-like tube within the scanner. If contrast is
to be administered, intravenous access will be placed, usually in
a small vein of the hand or forearm.
Scan
Time: Several sets of images are usually required, each taking
from 2 to 15 minutes. A complete scan, depending on the sequences
performed,and need for contrast enhancement, may take up to one
hour or more. Newer scanners with more powerful magnets utilizing
updated software and advanced sequences may complete the process
in less time.
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Abdominal
MRI |
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Purpose: MRI provides detailed pictures of soft tissues without
obstruction by overlying bone. It is often used to clarify findings
from previous X-ray studies or CT scans. It can show or demonstrate
wide areas of the abdomen from multiple planes. MRI can evaluate
certain organ functions. It clearly shows lymph nodes and blood
vessels, and is a noninvasive imaging method for evaluation of blood
flow.
MRI
may be used in diagnosing abnormal growths. It can distinguish tumors
or other lesions from normal tissues and can provide information
for the staging (determination of the size, extent, and spread)
of abdominal tumors. MRI is sometimes used to avoid the dangers
of angiography, repeated exposure to radiation, or for patients
that cannot receive iodinated contrast dye.
Prior
Preparation: No preparatory tests, diets, or medications are
usually needed, unless the colon needs to be cleansed (with preparations
such as a laxative or an enema). An MRI can be performed immediately
after other imaging studies. Depending on the area of interest,
the patient may be asked to fast for 4 to 6 hours prior to the scan.
Administration:
The patient will be asked to lie on a narrow table which slides
into a large tunnel-like tube within the scanner. In addition, small
devices may be placed around the head, arm, or leg, or adjacent
to other areas to be studied. These are special body coils which
send and receive the radio wave pulses, and are designed to improve
the quality of the images. If contrast is to be administered, an
IV will be placed, usually in a small vein of the hand or forearm.
Scan
Time: Several sets of images are usually required, each taking
from 2 to 15 minutes. A complete scan, depending on the sequences
performed, and need for contrast enhancement may take up to one
hour or more. Newer scanners with more powerful magnets utilizing
updated software and advanced sequences may complete the process
in less time.
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Heart
MRI |
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Purpose:
MRI provides detailed pictures of the heart and blood vessels and
can distinguish tissues from moving blood. It can differentiate
between heart muscle and surrounding tissues and can clarify findings
from previous X-rays or CT scans. MRI excels at showing the heart
from multiple imaging planes. MRI is useful in the diagnosis of
congenital abnormalities, abnormal growths, and tumors.
MRI
is sometimes used to avoid the dangers of angiography, repeated
exposure to radiation, or exposure to iodinated contrast dye. It
may provide additional information when an echocardiogram is unclear,
since bone and air do not interfere with imaging. In addition, cardiac
MRI provides a wider view and better spatial resolution (detail)
than echocardiogram.
Prior
Preparation: No preparatory tests, diets, or medications are
usually needed. An MRI can be performed immediately after other
imaging studies. Depending on the area of interest, the patient
may be asked to fast for 4 to 6 hours prior to the scan.
Administration:
The patient will be asked to lie on a narrow table which slides
into a large tunnel-like tube within the scanner. In addition, small
devices may be placed around the head, arm, or leg, or adjacent
to other areas to be studied. These are special body coils which
send and receive the radio wave pulses, and are designed to improve
the quality of the images. If contrast is to be administered, an
IV will be placed, usually in a small vein of the hand or forearm.
Scan
Time: Several sets of images are usually required, each taking
from 2 to 15 minutes. A complete scan, depending on the sequences
performed, and need for contrast enhancement may take up to one
hour or more. Newer scanners with more powerful magnets utilizing
updated software and advanced sequences may complete the process
in less time.
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Cranial
MRI |
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Purpose:
MRI provides detailed pictures of brain and nerve tissues from multiple
planes without obstruction by overlying bone. In fact, approximately
90% of all MRI scans are for cranial or spine disorders.
MRI
is the procedure of choice for most brain disorders. MRI is particularly
useful in brain and neurologic disorders, because it can clearly
show various types of nerve tissue. It provides clear pictures of
the brainstem and posterior brain, which are difficult to view on
CT scan. It is also useful for the diagnosis of demyelinating disorders
(disorders such as multiple sclerosis that cause destruction of
the myelin sheath of the nerve).
MRI
is a noninvasive procedure that can evaluate blood flow and the
flow of cerebrospinal fluid (CSF). MRI can distinguish tumors or
other lesions from normal tissues. MRI is sometimes used to avoid
the dangers of angiography or of repeated exposure to radiation.
Prior
Preparation: No preparatory tests, diets, or medications are
usually needed. You may be asked to fast for 4 to 6 hours prior
to the scan. You must sign a consent form before the scan.
Administration:
The patient will be asked to lie on a narrow table which slides
into a large tunnel-like tube within the scanner. In addition, a
small device may be placed around the head to be studied. This is
special body coil which send and receive the radio wave pulses,
and is designed to improve the quality of the images. If contrast
is to be administered, intravenous access will be placed, usually
in a small vein of the hand or forearm.
Scan
Time: Several sets of images are usually required, each taking
from 2 to 15 minutes. A complete scan may take up to one hour or
more. Newer scanners with more powerful magnets utilizing updated
software and advanced sequences may complete the process in less
time.
Click
here for more information about Brain
MRIs in autonomic disorders.
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Lumbosacral
Spine MRI |
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Purpose:
After plain radiographs of the lower spine, MRI is usually the next
non-invasive imaging examination in the work-up of back pain and
radiating leg pain. MRI is excellent at visualizing degenerative
changes, such as from arthritis, which may be narrowing the spaces
through which the spinal nerves travel. As well, MRI can demonstrate
disease of the lumbar dics between vertebral levels which may be
bulging and compression the spinal cord.
An
MRI may be performed in a trauma setting to rule out acute compression
of the spinal cord in the setting of weakness or paralysis. MRI
is also superior to Computed Tomography (CT) in the evaluation of
abscesses, tumors, or other masses near the spinal cord. While CT
is better at detecting fractures of the vertebrae, MRI can detect
subtle changes in the bone which may be due to infection or tumor.
Prior
Preparation: None
Administration:
The patient will be asked to lie on a narrow table which slides
into a large tunnel-like tube within the scanner. If contrast is
to be administered, intravenous access will be placed, usually in
a small vein of the hand or forearm.
Scan
Time: Several sets of images are usually required, each taking
from 2 to 15 minutes. A complete scan may take up to one hour. Newer
scanners with more powerful magnets utilizing updated software and
advanced sequences may complete the process in less time.
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Spine
MRI |
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Purpose:
MRI may show the exact location of tumors or other lesions of the
spine, spinal cord, or intervertebral disks. It provides detailed
pictures of hard-to-view areas of the spine, including the spinal
canal, bony segments, and soft tissue. MRI is sometimes used to
avoid the dangers of exposure to contrast dye or radiation.
An
MRI may be performed in a trauma setting to rule out acute compression
of the spinal cord in the setting of weakness or paralysis. MRI
is also superior to Computed Tomography (CT) in the evaluation of
abscesses, tumors, or other masses near the spinal cord. While CT
is better at detecting fractures of the vertebrae, MRI can detect
subtle changes in the bone which may be due to infection or tumor.
Prior
Preparation: None
Administration:
The patient will be asked to lie on a narrow table which slides
into a large tunnel-like tube within the scanner. If contrast is
to be administered, intravenous access will be placed, usually in
a small vein of the hand or forearm.
Scan
Time: Several sets of images are usually required, each taking
from 2 to 15 minutes. A complete scan may take up to one hour. Newer
scanners with more powerful magnets utilizing updated software and
advanced sequences may complete the process in less time.
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Contact
Us |
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Magnetic
Resonance Imaging (MRI) Program
Box 1234
One
Gustave L. Levy Place
New York, NY 10029
For
information about Magnetic Resonance Imaging, call 212-241-8775.
To
Find
a Doctor click here or
call our toll-free Physician Referral Service at 1-800-MD-SINAI.
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| Some
of the material on this site is courtesy of the National Institute
of Health |
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