Radiology - MRI

Magnetic resonance imaging (MRI) is a procedure that uses magnetic fields and radiowaves to produce an image of the body in cross sections. This enables excellent images, particularly of soft tissue such as the brain and internal organs. MRI is generally used whenever X-Ray or ultrasound examinations do not deliver clear results.

Siemens Magnetom Verio 3 Tesla

Expanding care to wider range of patients with:

70 cms Open Bore:

• Highest comfort even for obese patients
• Reduced Sedation rate-
  even pediatric patients can be easily scanned

No Claustrophobia –
Free –first positioning for almost all examinations –

Enhanced comfort even for patients with:

• Respiratory problems
• Pain & Mobility Issues
• Kyphosis

Faster Head to Toe imaging
at one go with powerful Tim Technology

Non- Contrast Abdominal & Peripheral Angiography
For Patients with Severe Renal Insufficiency

Excellent Image Quality with Advanced Real Time Motion Correction Software

Ultra-Light-Weight Coils

Advance Applications:

Neuro Perfusion Imaging – Provides information regarding the blood flow in case of stroke aiding in treatment decision. It adds in staging brain tumors by evaluating cerebral flow of blood.

o Blood Spectroscopy – Detection of malignancy in brain

• Examine brain tumors, brain metabolic diseases & degenerative changes in brain with 2D and 3D CSI (Chemical Shift Imaging).
• Distinguish between malignant and benign tumor
• Monitor therapeutic results in follow-up studies

Susceptibility Weighted Imaging (SWI) – Detection of microhemorrhages (Intracranial bleeding)

Visualize

• Intracranial bleeding
• Blood products
• Venous Structures
• Get a better look at bleeding in Stroke
• Brain trauma
• Contusions
• Shearing Injuries
• Intracranial Vascular malformations

Non Contrast Angiography (Syngo Native is advanced software for Non Contrast Angiography)

• Contrast-free Thoracic, Abdominal and Peripheral Angiography
• Fast 3D Acquisition in High Spatial Resolution
• Accurate Artery/ Vein Seperation
• Suitable for Patients having a High Risk of Developing NSF (Nephrogenic Systemic Fibrosis)
• Very useful for Diabetic Patients, Renal Impaired Patients and Contrast Allergics

Isotropic High Resolution 3D Imaging for Inner Ear, Spine, Joints, MRCP, etc

• 3D Neuro imaging
• 3D Spine imaging
• 3D Ortho imaging
• 3D Body imaging

Real Time motion correction – all orientations, all contrast, all body parts

Achieve High Quality Images with Syngo Blade (motion correction techniques) which helps visualizing even smallest lessons in case of pediatric, anxious patients or incase of involuntary motion like respiration, pulsation, etc.

Breast Imaging

In Breast Cancer workup, MRI offers the following benefit:

• High Sensitivity
• No exposure to ionizing radiation
• Painless exam, with minimal or no compression needed
• Provides both morphological and functional data

MR Mammography is commonly indicated in:

• To identify clinically or mammographically occult tumor
• Stage and plan treatment
• Contralateral Breast Cancer in Newly Diagnosed Breast Cancer
• Post-operative Scar vs. Tumor Recurrance
• Tumor response to Neo Adjuvant Chemotherapy
• Screen high-risk women
• Evaluate the integrity of breast implants
• Valuable tool for guided breast biopsy

Reasons why Breast MRI is better at 3T:

• Higher signal to noise generates more detailed images (crucial for seeing tumor borders and ductal anatomy)
• Higher resolution, which results in clearer/sharper images (vital for detecting subtle cancers and even less subtle cancers in earlier stage)
• Better fat saturation of the breasts
• Higher sensitivity (two-fold) to contrast enhancement

Fetal MRI

It’s a recognized complimentary method to fetal ultrasound to identify fetal central nervous system (CNS) pathology. It can provide additional and diagnostically-relevant information, add certainty to ultrasound diagnosis and help parental counseling. According to national and international guidelines, fetal MRI is recommended from the second trimester of gestation.

Advantage of MR fetal imaging over USG:

• Visualization of the fetus is not significantly limited by maternal obesity, fetal position, or oligohydramnios
• Visualization of the brain is not restricted by the ossified skull
• Superior soft tissue contrast resolution
• Ability to distinguish individual structures such as lung, liver, kidney, bowel and gray and white matter
• Multiplanar imaging is easier with MRI than it is with US, where it is often a challenge to obtain images in three planes
• MRI provides a large field-of-view, facilitating examination of fetuses with large or complex anomalies, and visualization of the lesion within the context of the entire body of the fetus

Common Indication of Fetal MRI:

• CNS abnormalities: where it has been found to influence or change management and counseling in up to 50% of cases
• Evaluation of ventriculomegaly e.g. agenesis of corpus callosum
• Helpful in evaluating posterior fossa cystic lessons and in distinguishing between the Dandy- walker malformation and variant, posterior fossa arachnoid cyst, and mega cisterna magna
• Scalp masses and cervical teratoma: showing extension of these tumors into the pelvis, abdomen, or spinal canal, which may be underestimated by US
• NTDs in the presence of maternal obesity
• Assessment of fetal lung development
• Foregut cyst, bronchial atresia, tracheal atresia, and lung atresia
• Genitourinary abnormalities
• Antenatal evaluation of conjoined twins

Viability

Non stress examination that provides high resolution detail including function of left ventricle in approx. 10 to 30 minutes. For scar tissue /infarct.

Kinematic studies of the joints

Assessment of movements of joints in movie clippings. Useful in lumbar/cervical spine, ankle, patello-femoral and shoulder joints.

Brain Perfusion

To give prompt treatment of infarct if patient reaches within 3 to 8 hours of starting of symptoms.
For recurrence of tumors.
For chemotherapy assessment.

Spectroscopy

At 3t can confidently diagnose tumors, can differentiate benign from malignant tumors. Better spectrum from 1.5t. Useful in few infections like tuberculomas.

Peripheral Angio

Very reliable for diagnosing the extent and severity of peripheral arterial disease.

Philips Achieva 1.5 Tesla

The clinical capabilities of MR have expanded. Inside and out, the Achieva is a friendly, open system designed for optimal patient comfort and maximizes workflow with high functionality. The Achieva 1.5T can be upgraded to Achieva I/T, with three configurations optimized for MR guided interventions and therapy. It also saves up to 50% of the energy bills. Requires minimal floor space for the entire installation and has a scalable platform with wide range of options and upgrades.

Siemens Magnetom Espree 1.5 Tesla

It’s a level of image quality just not seen in Open MRI before. In today's highly competitive outpatient market, MAGNETOM Espree is sure to be the system of choice for Imaging Centres. MAGNETOM Espree with I-class offers spacious headroom and enough patient gaps. That means: More headroom, more legroom, and more elbowroom. No longer do the patients feel like they’re nose-to-nose with the magnet. Particularly claustrophobic or anxious patients are more relaxed throughout their examination.

G Scan ESOATE

Weight-bearing examinations giving extra diagnostic capability, full set of pre-defined sequences and protocols. User defined sequences and customized examination protocols. Real time imaging tool for patient positioning and windows based user interface. Extensive image viewing, analysis and elaboration tools are used. Sophisticated storage functionality particularly useful for systems connected to PACS network.

FAQ's

Q. What are some of the common applications of the MRI procedure?

For the diagnosis of a broad range of pathologic conditions in all parts of the body more specifically for the brain (including cancer, stroke), spine and musculoskeletal disorders. In addition, MRI of the heart, aorta, coronary arteries and blood vessels is a fast, non-invasive tool for diagnosing heart problems. Physicians can examine the size and thickness of the chambers of the heart and determine the extent of damage caused by a heart attack or progressive heart disease. As an alternative to traditional X-Ray mammography in the early diagnosis of breast cancer. Because no radiation exposure is involved. For examination of the male and female reproductive systems, pelvis and hips and the bladder. Specialized MRI scans.
Diffusion MRI diagnoses an ischemic stroke within 5-10 minutes of the onset of stroke symptoms. Magnetic Resonance Angiography is used to generate pictures of the arteries in order to evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall dilatations, at risk of rupture). Magnetic resonance venography is a similar procedure that is used to image veins. Magnetic resonance spectroscopy (MRS) allows one to study a particular region within an organism or sample and provides a wealth of chemical information about that region.

Q. What does the MRI equipment look like?

The conventional MRI unit is a closed cylindrical magnet in which the patient must lie totally still for several seconds at a time.

Q. How is the procedure performed?

The patient is placed on a sliding table and positioned comfortably. Then the radiologist and technologist leave the room and the individual MRI sequences are performed. The patient is able to communicate with the radiologist or technologist at any time using an intercom. Also we allow a friend or, if a child is being examined, a parent to stay in the room.

Depending on how many images are needed, the exam will generally take 25 to 45 minutes, although a very detailed study may take longer.

Typically an MRI examination consists of two to six imaging sequences, each lasting two to 15 minutes. You will be asked not to move during the actual imaging process, but between sequences some movement is allowed. Patients are generally required to remain still for only a few seconds to a few minutes at a time.

Depending on the part of the body being examined, a contrast material (usually gadolinium) may be used to enhance the visibility of certain tissues or blood vessels. A small needle connected to an intravenous line is placed in an arm or hand vein.

When the exam is over the patient is asked to wait until the images are examined to determine if more images are needed. A radiologist will analyze the images and prepare a report with his or her interpretation.

Q. What will I experience during the MRI procedure?

MRI causes no pain. Some patients can find it uncomfortable to remain still during the examination.

Others experience a sense of being "closed in".

If a contrast injection is needed, there may be discomfort at the injection site and you may have a cool sensation at the site during the injection.

Most bothersome to many patients are the loud tapping or knocking noises heard at certain phases of imaging. Ear plugs are provided which help. For noise-reducing Avanto has a AudioComfort technology that slashes decibel levels up to 97%.

Q. Who interprets the results and how do I get them?

A radiologist, experienced in MRI and other radiology examinations, will analyze the images and prepare a report. This will be done on the same or following day. We can also provide a permanent record on a CD at a nominal additional cost. Please do inform us in advance if you need one.

Q. What are the benefits vs. risks?

Benefits
Images of the soft-tissue structures of the body are clearer and more detailed than with other imaging methods.
MRI can help physicians evaluate the function as well.
MRI contrast material is less likely to produce an allergic reaction than the iodine-based materials used for conventional x-rays and CT scanning.
MRI provides a fast, noninvasive alternative to x-ray angiography for diagnosing problems of the heart and cardiovascular system.
Exposure to radiation is avoided.

Risks
MRI is generally avoided in the first 12 weeks of pregnancy. Doctors usually use other methods of imaging, such as ultrasound, on pregnant women unless there is a strong medical reason to use MRI.
Projectiles: As a result of the very high strength of the magnetic field needed to produce scans (frequently up to 60,000 times the earth's own magnetic field effects), missile-effect accidents, where ferromagnetic objects are attracted to the center of the magnet, have resulted in injury It is for this reason that ferrous objects and devices are prohibited in proximity to the MRI scanner.
Ferromagnetic foreign bodies (e.g. shell fragments), or metallic implants (e.g. surgical prostheses, aneurysm clips) are also potential risks, and safety aspects need to be considered on an individual basis. Interaction of the magnetic and radiofrequency fields with such objects can lead to trauma due to movement of the object in the magnetic field.
Gadolinium based contrast media not to be used in patients of Chronic renal failure as it causes nephogenic fibrosis.
Thermal injury from radio-frequency induction heating of the object, Failure of an implanted device.

Preparations

There’s no special preparation necessary for the MRI examination. Unless the person at the booking counter specifically requests that you not eat or drink anything before the exam, there are no food or drink restrictions. Continue to take any medication prescribed by your doctor unless otherwise directed.

You won’t be allowed to wear anything metallic during the MRI examination, so it would be best to leave watches, jewelry or anything made from metal at home. Even some cosmetics contain small amounts of metals, so it is best to not wear make-up. There is a safe place to lock up valuables if you can’t leave them at home.

In order to prevent metallic objects from being attracted by the powerful magnet of the MR system, you will be given scrubs to change into for your examination. Items that need to be removed by patients before entering the MR system room include:

• Purse, wallet, money clip, credit cards, cards with magnetic strips
• Electronic devices such as beepers or cell phones
• Hearing aids
• Metal jewelry, watches
• Pens, paper clips, keys, coins
• Hair barrettes, hairpins
• Any article of clothing that has a metal zipper, buttons, snaps, hooks, underwires, or metal threads
• Shoes, belt buckles, safety pins

Before the MRI procedure, you will be asked to fill out a screening form asking about anything that might create a health risk or interfere with imaging. You will also undergo an interview by a technologist to ensure that you understand the questions on the form. Even if you have undergone an MRI procedure before at this or another facility, you will still be asked to complete an MRI screening form.

Examples of items or things that may create a health hazard or other problem during an MRI exam include:
• Pacemaker
• Implantable cardioverter defibrillator (ICD)
• Neurostimulator
• Aneurysm clip
• Metal implant
• Implanted drug infusion device
• Foreign metal objects, especially if in or near the eye
• Shrapnel or bullet wounds
• Permanent cosmetics or tattoos
• Dentures/teeth with magnetic keepers
• Other implants that involve magnets
• Medication patch (i.e., transdermal patch) that contains metal foil

Check with the MRI technologist or the Radiologist if you have questions or concerns about any implanted object or health condition that could impact the MRI procedure. This is particularly important if you have undergone surgery involving the brain, ear, eye, heart, or blood vessels.

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