Magnetic resonance imaging (MRI))

Magnetic resonance imaging (MRI)) – It's a medical imaging technique that uses a magnetic field and radio waves to create detailed images of organs and tissues. MRI scans differ from CT scans or X-rays in that they do not use ionizing radiation to produce images. This study combines the data obtained to create a three-dimensional image of internal structures. In some cases, an MR study may require contrast enhancement, which is administered intravenously, to better visualize certain structures and pathological changes.

Indications for MRI are diseases:

• brain and spinal cord
• abdominal organs for evaluation of the liver, bile ducts, spleen, kidneys, etc.
• pelvic organs
• limbs for the study of joint and muscle pathologies
• vessels
• soft tissues of the neck, ENT organs

In the MR study of the brain and intracranial vessels, it is possible to identify:

• Vascular changes - heart attacks, ischemia, vascular encephalopathy
• Demyelinating diseases - multiple sclerosis, etc.
• Dystrophic changes - Alzheimer's disease, etc.
• Tumors of the brain or its membranes (glioma, astrocytoma, menigioma, etc.)
• Consequences of traumatic brain injury
• Congenital and acquired changes in blood vessels (malformations, aneurysms, stenoses, occlusions)

During the MR examination of the spine and spinal cord, it is possible to identify:

• Degenerative-dystrophic diseases (osteochondrosis, spondyloarthrosis, herniated discs)
• Tumoral diseases of the spinal cord and spine
• Secondary lesions of the spine (metastasis)
• Inflammatory diseases of the spine and chronic diseases in the outcome of spinal cord inflammation (spondylitis,spondylodiscitis,syringomyelia)
• Abnormalities and malformations of the spinal cord

In the MR examination of the pelvic organs, it is possible to identify:

• Tumor formations(benign and malignant formations of the uterus, ovaries, bladder, prostate, rectum with an assessment of the spread of the cancer process in the pelvis)
• Inflammatory changes (proctitis, fistulas, abscesses, etc.)
• Developmental abnormalities
• In women, the determination of the presence and spread of endometriosis.

During the MR examination of the abdominal cavity, it is possible to identify:

• Focal changes of the liver, including with the use of hepatospecific contrast enhancement (adenoma, FNG,HCR, metastases, fatty hepatosis)
• Tumour diseases of the liver, pancreas and bile ducts(benign and malignant)
• Inflammatory diseases of the liver, pancreas and bile ducts (cholangitis, pancreatitis, abscesses, etc.)
• Autoimmune diseases (psc)
• Parasitic diseases (echinococcosis, alveococcosis)
• Vascular diseases (cavernous transformation of the portal vein)
• Developmental abnormalities

With an MR study of thecranial joints (hip, knee, shoulder, ankle, elbow), it is possible to identify:

• Mechanical damage to intra-articular and external ligaments, articular cartilage
• Trauma (dislocations, Bankart injuries, Hill Sacks, etc.)
• Degenerative changes in the joints (degree of arthrosis)
• Aseptic necrosis in the dorentgenological stage

Contraindications to MRI

They are divided into absolute and relative values
Absolute contraindications to MRI:

• The presence of an implanted pacemaker or cardioverter defibrillator
• The presence of large metal implants (except for implants made of titanium, titanium nickelide and other non-magnetic metals), metal fragments
• The presence of metal brackets, clamps on the blood vessels
• The presence of an inner ear implant (electronic or ferromagnetic)
• The presence of sewn-in insulin pumps and sewn-in nerve stimulators

In cases where there are metal fixing structures or artificial joints in the body, it is necessary to provide a postoperative statement (or a technical passport of the product) indicating the name of the operation and the name of the metal from which the fixing structure is made (for example, titanium), the name of the manufacturer or the phrase "there are no contraindications for performing MRI".

Relative contraindications to MRI:

• pregnancy (first trimester)
• feeling restless in confined spaces (claustrophobia)
• availability: cava filter, hemostatic clips on the vessels of the lungs, abdomen and pelvis, stents of the heart and kidney vessels (MRI is possible 6 months after surgery),
• the presence of tattoos made with the help of dyes containing metal compounds (possible burns and artifacts)
• the inability to maintain a stationary position (it is possible to conduct a study under anesthesia)
• the transverse dimensions of the patient exceeding the diameter of the magnet lumen, as well as the weight of the patient exceeding 130 kg.

Immediately before performing the MR study, the radiologist makes a final decision on the possibility of performing this diagnostic method, after evaluating the general condition of the patient.

Contraindications to performing MRI with contrast enhancement:

• passing the previous study with contrast (MRI, CT, X-ray) less than 36 hours ago,
• any previous adverse reactions to the contrast agent for MRI,
• a history of polyvalent drug allergy,
• acute and chronic renal failure (reduced glomerular filtration rate from 30 ml / min/1.73 m and below)

Preparing for an MRI exam

MRI of the abdominal organs, MRI of the bile ducts (MRCPG):

• The procedure is performed exclusively on an empty stomach or no earlier than 6 hours after eating. For 3 hours before the study, it is necessary to refrain from taking any liquid, smoking and chewing gum. The exception is the use of medicines (drink a small amount of water).
• It is necessary to take an antispasmodic agent 3 hours before the study (3 tablets of "No-shpa" 40 mg each), which will reduce intestinal peristalsis and avoid research errors. If you are intolerant to "No-shpa", take 2 tablets of the drug "Duspatalin" or "Buscopan".

MRI of the pelvic organs:

General rules:

• 3 days before the study, it is important to exclude flour products, vegetables, fruits, and carbonated drinks from the diet. It is allowed to consume soups, cereals, boiled meat, fish, chicken, cheese, butter, and cookies.
• It is necessary for 3 days before the procedure to take carminative agents (tablets "Espumizan" (1 capsule 3 times a day)), which reduce gas formation in the intestine.
• It is necessary to take an antispasmodic agent 3 hours before the study (3 tablets "No-shpa" of 40 mg). If you are intolerant to "No-shpa", take 2 tablets of the drug "Duspatalin" or "Buscopan".
• It is necessary to empty the bladder before performing the study.

For women:

• It is recommended to perform on the 7-12 day of the menstrual cycle. If necessary, the study can be carried out in the second phase of the cycle.
• In endometriosis, the study is performed starting from the 25th day of the cycle.
• it is possible only after 1.5 months after diagnostic curettage of the uterine cavity and the cervical canal, otherwise-in consultation with the attending physician.

For men:

• MRI of the prostate gland can be performed only 1.5 months after the puncture biopsy, otherwise, consultation and approval of the study with the attending physician is necessary.

MRI of the pelvic organs (rectum):

• Performing an MR examination of the rectum is possible no earlier than 3 days after performing a colonoscopy.
• 3 days before the study, you should completely exclude flour products, vegetables, fruits, and carbonated drinks from the diet. It is allowed to eat boiled meat and chicken, broths, fish, porridge, cheese, butter, cookies.
• It should be taken within 3 days before the procedure, carminative agents (tablets "Espumizan" (1 capsule 3 times a day)).
• The last light meal is 2 hours before the study.
• It is necessary to take an antispasmodic agent 3 hours before the study (3 tablets "No-shpa" of 40 mg). If you are intolerant to "No-shpa", take 2 tablets of the drug "Duspatalin" or "Buscopan".
• It is necessary to empty the bladder before performing the study.

Duration of the MRI scan

The time of the study is affected by the area that needs to be examined:

• brain or one part of the spine –20-30 minutes
• large joint – 30-40 minutes
• abdominal or pelvic organs – 40-60 minutes

If it is necessary to use a contrast agent, the duration of the study is increased by additional preparation of the necessary instruments.

Recovery after the MRI procedure

In most cases, you will be able to leave the medical center immediately after the study. If a sedative has been prescribed for the MRI, you should avoid driving, working with heavy machinery, and drinking alcohol for 24 hours. Otherwise, you can resume your normal activities after an MRI scan.

If you have had an MRI with contrast enhancement, then no dietary restrictions will be required after the scan. In very rare cases, patients experience side effects from the injected contrast agent, including nausea, dizziness, and pain in the area of the contrast injection. In such cases, it is necessary to inform the X-ray technician or radiologist for medical assistance.