Magnetic Resonance Imaging

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When is MRI used?
MRI has become the gold standard in imaging the extremities, especially the joints. Some departments use CT scan as the screening test for imaging the brain, but most consider MRI scan to be the best choice for imaging the upper spine and lower back. CT and MRI are equally useful for the neck. For chest and abdomen, CT scan continues to dominate, although MRI is continually coming up with new applications.

Ultrasound is still the way to examine the female pelvis, though MRI has made inroads in imaging the uterus and ovaries, and CT is helpful in certain cases. As for the scrotal contents, ultrasound use is prevalent in most departments, while MRI and radionuclide imaging may also be used.

Risks and Complications
During an MRI scan, you are placed inside an enormously powerful magnet, so it makes sense that you will not have anything on your person that could be even remotely attracted to this magnet. Obviously, you won't bring your keys in, but what about those little pieces of metal inside your body that you may or may not know about? What about very small metal filings that may have penetrated your skin years ago, or the tiny clips that were used years ago to tie off an aneurysm in your brain, and so on? For the full list, you will need to talk to a representative of the MRI facility at which you plan to have your study. The MRI technologist will be able to give you a more complete list as well as answer any questions that you may have.

As is the case in CT scan, your MRI may require the injection of intravenous contrast. The most commonly used dye is gadolinium, which basically does to MRI what iodine does to CT. The good news is that unlike the CT dye, with its rare complication, complications from gadolinium are even more rare, and gadolinium can be injected by a skinny needle that hurts less.

What Actually Happens?
This can be an unpleasant test. If you are obese, you may be in for some additional trouble. More often than not you will be confined in a tight space within the magnet and asked not to move.

Some patients are too claustrophobic to undergo this procedure. The space is confining and noisy. Some departments give patients earphones with music to help block the noise and distract them. The newer MRI gantries have a much wider bore and are much less confining. If you receive contrast, the technologist, nurse, or radiologist will generally inject it through a small gage needle that should not be particularly painful.

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