Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose and treat medical conditions.
MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ionizing radiation (x-rays).
Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD.
What are some common uses of the procedure?
MR imaging is usually the best choice for examining the:
- body's major joints.
- spine for back pain.
- soft tissues (muscles, tendons and ligaments) and bones of the extremities.
MR imaging is typically performed to diagnose or evaluate:
- degenerative joint disorders such as arthritis.
- tears of the menisci, ligaments and tendons (knee) or rotator cuff (shoulder) and labrum (shoulder and hip).
- fractures (insufficiency or stress fractures in elderly and athletes).
- spinal disk abnormalities (such as herniated disk).
- the integrity of the spinal cord after trauma.
- sports-related injuries and work-related disorders caused by repeated strain, vibration or forceful impact.
- infections (such as osteomyelitis).
- tumors (primary tumors and metastasis) involving soft tissues around the joints and extremities (such as muscles, bones and joints).
- pain, swelling or bleeding in the tissues in and around the joints and extremities.
How should I prepare?
You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners.
Some MRI examinations may require you to receive an injection of contrast material into the bloodstream. The radiologist, radiographer or a nurse may ask if you have allergies of any kind, such as an allergy to iodine or x-ray contrast material, drugs, food, or the environment, or if you have asthma. The contrast material most commonly used for an MRI exam contains a metal called gadolinium. It is far less common for a patient to have an allergy to a gadolinium-based contrast agent used for MRI than the iodine-containing contrast for CT. You should also let the radiologist know if you have any serious health problems, or if you have had any recent surgeries. Some conditions, such as severe kidney disease, may prevent you from being given gadolinium contrast for an MRI. If you have a history of kidney disease or liver transplant, it will be necessary to perform a blood test to determine whether the kidneys are functioning adequately.
Women should inform their physician or radiographer, if there is any possibility that they are pregnant. MRI has been used for scanning patients since the 1980s with no reports of any ill effects on pregnant women or their unborn babies. However, because the unborn baby will be in a strong magnetic field, pregnant women should not have this exam in the first trimester of pregnancy unless the potential benefit from the MRI exam is assumed to outweigh the potential risks.
If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for a prescription for a mild sedative prior to your scheduled examination.
Infants and young children usually require sedation or anesthesia to complete an MRI exam without moving. Whether a child requires sedation will depend on the child’s age and the type of exam being performed.
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 items are not allowed in the exam room.
These items include:
- jewelry, watches, credit cards and hearing aids, all of which can be damaged
- pins, hairpins, metal zippers and similar metallic items, which can distort MRI images
- removable dental work
- pens, pocket knives and eyeglasses
- body piercings
In most cases, an MRI exam is safe for patients with orthopaedics implants but people with the following implants cannot be scanned and should not enter the MRI scanning area:
- cochlear (ear) implant
- some types of clips used for brain aneurysms
- some types of metal coils placed within blood vessels
- nearly all cardiac defibrillators and pacemakers
You should tell the radiographer if you have medical or electronic devices in your body. These objects may interfere with the exam or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will have a pamphlet explaining the MRI risks for that particular device. If you have the pamphlet, it is useful to bring that to the attention of the technologist or scheduler before the exam.
Some implanted devices require a short period of time after placement (usually six weeks) before being safe for MRI examinations. Examples include but are not limited to:
- artificial heart valves
- implanted drug infusion ports
- artificial limbs or metallic joint prostheses
- implanted nerve stimulators
- metal pins, screws, plates, stents 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 and identify 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. You should notify the technologist or radiologist of any shrapnel, bullets, or other pieces of metal which may be present in your body due to prior accidents. Foreign bodies near and especially lodged in the eyes are particularly important. 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.