![]() ![]() Common foreign bodies that represent contraindications to MR imaging include: ![]() The magnetic field strength of the unit needs to be considered. Objects with ferromagnetic properties need to be assessed for size, shape and anatomical location. The most important concern is whether or not the object is ferromagnetic. 4Ībsolute contraindications to MR imaging generally involve implants or foreign bodies. It is important that the patient is aware of the benefits and risk of the examination and any alternatives if applicable. The referring physician feels that the test is necessary and cannot be postponed. ![]() The emergent data could affect the care of the patient and/or fetus The information cannot be obtained by non-ionizing means 1 The necessity for the imaging procedure should be made on an individual clinical basis if a variety of circumstances arise, including the following: ![]() 1 The first trimester of pregnancy also requires caution with regard to MR imaging. Sedatives, open tube architecture, headphones and prisms that allow the patients to see outside the unit may help to calm these individuals and allow the acquisition of higher quality images. Also, there are several options offered to these patients to minimize the discomfort. It is important that the process is thoroughly explained to the patient in order to decrease stress and anxiety prior to the procedure. 4Ĭaution needs to be taken when referring patients experiencing claustrophobia, anxiety, or panic attacks for MR imaging examination. Before undergoing an MR imaging examination, the facility performing the procedure should screen the patient but it is important that referring doctors are familiar with common contraindications and cautions to better inform the patient and avoid referring inappropriately. The following situations are common but do not compose an inclusive list and should merely serve as a guide for patient screening and consideration. Whilst MR imaging is generally considered safe, the procedure does have a few cautions and contraindications. Additionally, depending on the clinical question or differential diagnoses, intravenous contrast use may be recommended. Table 2 details symptoms and presentations associated with back pain that indicate the need for spine imaging.1, 2, 3 It is important that the clinician orders MR imaging only with valid clinical suspicion and with appropriate history and exam findings because, without these, the results of the study may be misleading.Īfter determining the indications for MR imaging, it is important to clearly communicate them to the facility or attending radiologist although few, the risks and contraindications need to be evaluated on a case-by-case basis. Computed tomography may only show an advantage over MRI for the evaluation of post-operative stenosis due to arthrosis however, CT does not allow for distinction between post-surgical fibrosis/scarring and a recurrent disc lesion even with the use of intrathecal contrast agents (Fig. It allows visualization of both components of the intervertebral disc and direct imaging of the bone marrow. 1 Magnetic resonance imaging has been shown to be superior to both these modalities in the evaluation of degenerative disc conditions, infections, spinal neoplasms and intrinsic cord diseases. In many situations it is preferred over computed tomography (CT) and myelography. MR imaging is well established as an imaging modality in the assessment of the lumbar spine. Familiarity with these topics will allow for appropriate examination and optimization of this diagnostic tool. The following is an overview of the basics of MR imaging for the lumbar spine, the indications for imaging and relevant procedures for the ordering clinician. It is important to understand the appropriate applications and indications for the use of this diagnostic imaging modality in order to gain the most clinically useful information. Magnetic resonance (MR) imaging is an invaluable tool to the clinician assessing the lumbar spine. ![]()
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