The National Center for Spinal Disorders was recently expanded with a new CT-MRI Center equipped with a top category Siemens MRI scanner. We asked Mária Puhl, MD, Head of the Radiology Department to answer questions regarding the unit’s diagnostic capacities.
What do we need to know about the equipment?
The National Center for Spinal Disorder’s Radiology Department is first in Hungary to be equipped with a MAGNETOM Amira MRI scanner. The unit is Siemen’s newest product with functions and innovations that make it one-of-a-kind in its category. The scanner’s 1.5 Tesla field intensity makes it possible to examine every organ of the body (the 3T scanner is mostly used for special neurological examinations.)
How will the new MRI change our examination spectrum?
The new MRI will make it possible for us to perform high level orthopedic examinations such as the special examination of the shoulder joint using the shoulder coil (of which there are especially few in Hungary) and the cartilage highlighting sequence. The examination of acute patients will be possible and the shorter examination period required by the new equipment, should increase our capacity one and one half times. Since we will continue to also use our 0.4T open MRI unit, the two units at our disposal should decrease our patients’ waiting period.
What disorders can be diagnosed with the new unit?
The new scanner will broaden our diagnostic pallet while the greater field strength will make finer structures become more visible. Cranioscopy will be possible for patients with practically every indication. Examinations of the facial skeleton, orbits, the cranial cavity and angiography, that is, vascular examinations with or without contrast material, stomach and pelvic examinations, even special gastroenterological examinations will be possible. Unfortunately, we still will not be able to perform breast examinations or examine cardiology or limb-angiography cases.
What specialties are requested the most?
Since we mainly accept patients covered by the National Health Insurance Fund of Hungary (OEP), most of our patients come to us for spine care or orthopedic consultations.
What happens during an examination?
First of all, due to the magnetic field, you will need to remove all metals (jewelry, piercings, hearing aids, etc.) then lie down on your back on the ergonomically designed patient-friendly surface of the MRI scanner. You will slowly be pushed into the scanner’s tube that, thanks to the new lighting techniques, is now bright on the inside. You no longer will be required to lie completely still in a 60 cm diameter completely dark tube. The examination usually takes 15-20 minutes. The sound pressure level of the high intensity acoustic noise has been reduced by 97%, but, since the noise level may still be disturbing to some, we give all our patients a headset to muffle the sounds. You will, of course, be able to signal at anytime if you are not feeling well and would like to stop the examination. If you are afraid of enclosed areas, it would be wise to let your treating doctor beforehand, since in these cases, we usually recommend the open MRI scanner. We only use the open unit for claustrophobic patients.
What are other advantages of the new MRI unit?
Besides the patient friendly design, the unit has numerous functions and software that help the radiologist establish the most precise diagnosis possible. Another fact that is most important to us is that the operation of the new MRI is environment friendly since, due to a special engineering development, it uses 30% less energy when not in use than if it were constantly in ready mode.
Are there patients for whom the MRI is not recommended?
Yes, there are contraindications. For instance, patients with pacemakers that are not adjustable would not qualify for an MRI scan since we would not be able to provide the assistance of a cardiologist before the examination. In cases of certain implanted heart valves a certificate is required from the surgeon or the manufacturer, stating that the patient may be put into an MRI scanner. Also, ear implants or metal ear clips are contraindicated as are MRI scans within three months of a heart stent implant. Metal, such as implanted in the patient’s leg bones are, by themselves, not a contraindication, but, a certificate is required stating that the implant is MRI compatible. Some conditions such as claustrophobia or fear of tight spaces may cause difficulties but, fortunately, we have an open unit which may be used in these cases. It is also important to note, that contrast material should not be administered in cases of kidney function disorders since the gadolinium content may cause nephrosclerosis in some.
Is the MRI suitable for screening examinations?
No, the MRI is not at all suitable for screening examinations. It is best if the patient is not the one to request the examination but that it is performed following medical consultation and when requested by the patient’s doctor. The more precise the request, the better the examination and diagnosis will be.