MRI

How does MRI work?
Your body is composed of atoms. Water or hydrogen atoms make up 95% of the human body. Usually the hydrogen atoms within the body spin at random. When you have an MRI, you are placed in a strong magnetic field that is up to 8,000 times stronger than that of the earth, which causes these atoms to realign and spin all in the same direction in all 3 planes of the body. MRI acquires images that are a “slice” of anatomy. Using the magnetic fields and radio waves, remarkably detailed cross-sectional images of the body can be obtained.  A computer processes these images to produce detailed pictures of the anatomy.

Can anyone have an MRI?
Because some metals interfere with the function of the MRI equipment, certain patients are not able to have an MRI exam. The following equipment or conditions may create problems with an MRI. Please call with concerns about any of the following metals in your body.

• A pacemaker or pacing wires
• Metal fragments in one or both eyes
• Inner ear implants
• Cerebral aneurysm clips
• Implanted neuro stimulator
• Tens unit
• Medication and Nicotine patches will need to be removed

How long does it take?
The exam usually takes between 30 and 60 minutes. If your doctor orders your MRI exam with contrast, the exam may take longer to complete.

What is contrast?
In some cases, your doctor may order your test with contrast. This is a fluid that is injected into a vein (usually in the arm). This helps to make certain details on the exam clearer and is routine for certain MRI exams. The contrast is called gadolinium and is not iodine based like contrast used for CT and X-ray. Occasionally the technologist may draw a small amount of blood to measure your creatinine level. If you are scheduled for an MRI and have had recent lab work, bring a copy of the lab results on the day of your exam.

What will happen during the MRI exam?
You will be asked to lie down on the examination table on your back. The table will slide smoothly into the opening, and you will be positioned either head first or feet first, depending on the type of exam. Once the exam begins, it is important that you are as still as possible. You will hear “knocking” and “banging” noises, and the hum of the machine.  This is all normal. The technologist will talk to you during the exam between various scans.  You will be able to listen to the radio, or you may bring a favorite CD, or for some exams you will be given earplugs.

What should I wear?
Your technologist will ask you to remove anything metallic, such as dentures, hearing aids, watches, jewelry, hairpins or articles of clothing that may contain metal, such as underwire bras or zippers. These items, along with your purse, wallet, keys, pagers, cell phones or other personal items will be secured in a locker during your exam. You may be asked to change into scrubs, but if you are wearing sweats or clothing without any sort of metal, you may not be asked to change.

What if I feel anxious or claustrophobic?
One of the first things we recommend to anyone who thinks they might feel anxious or claustrophobic during an exam is an advanced trip to our facility to actually look at the scanner. We often find that once patients see how wide the opening is and how short the scanner is, their anxiety is eliminated. Remember, MRI scanners have changed dramatically over the last 10 years, and are no longer made with such small, restrictive openings, and long “tubes” or “tunnels”.

Our technologists are very skilled at helping you feel relaxed and comfortable during your exam.  It often helps to listen to music during your exam. You may have a family member in the room with you if you desire. If anxious or claustrophobic, you can get medication from your doctor to take before you have your scan.

When will I get my results?
You will get your results from the doctor who ordered your scan. It usually takes between 24 to 48 hours for your doctor to get your results.

Breast MRI

What is a Breast MRI?
In 2004, The New England Journal of Medicine and The Journal of the American Medical Association reported that breast MRI surpasses mammography in detecting breast cancer in women with a family history; for example, having a mother with premenopausal breast cancer or two immediate relatives. Cancers were consistently detected at a small size and an earlier stage.

Breast MRI is a procedure that uses Magnetic Resonance Imaging (MRI), an imaging device that creates a combination of magnetic fields and radio waves (no radiation) to produce images of the human anatomy, specifically breast tissue. Each exam produces hundreds of images and 3-dimensional views of the breast. This information allows for improved surgical and treatment decision-making.

What circumstances call for Breast MRI?
In most circumstances, mammography, ultrasound and physical examinations will be sufficient for a diagnostic assessment. Breast MRI is used in two special circumstances:

• When a mammogram and ultrasound is inconclusive
• To detect breast implant rupture

What are the benefits of having a Breast MRI?
Early detection improves survival and expands treatment options.  MRI is more accurate in evaluating these features:

• Size of the tumor
• Lymph node involvement
• Metastases
• Response to treatment (chemo and radiation therapy).

These measurements may influence the type of treatment you receive such as a lumpectomy or a mastectomy.

Who are prime candidates for Breast MRI?

• Women diagnosed with cancer
• Women with any lobular breast cancer (a special cancer tissue type)
• Women at high risk due to a strong family history
• Women with dense breasts and inconclusive findings on a mammogram and ultrasound
• Women with scar tissue from prior surgery
• Women with breast implants

How do I prepare for a Breast MRI?

• No advance dietary or prescription restriction is required
• Do not wear jewelry, including your watch, due to magnetic interference
• If menstruating, you must schedule between 7-10 days after your first day of bleeding
• If previous testing was not done at NDIC, you must bring a copy of your mammogram and ultrasound

If I am claustrophobic, what do I do?
If you wish, you may take a mild sedative in advance of this procedure. You will go into the scanner on your stomach, feet first. Your head is right at the opening and there is a mirror in the head holder. By looking into this mirror, you will see outside the scanner into the room. You will also be given music to listen to.

What will occur during the exam?

• An IV will be inserted into your arm causing little discomfort
• You lie on your stomach while your breasts are placed in a coil (holder) for signals to be collected
• The technologist will gently move the table you are lying on into the center of the magnet (camera) area, and you will be instructed not to move to avoid blurring of images
• You will hear periodic thumping noises at different intensities.

What are the drawbacks to having a Breast MRI?
Tiny tumors detected may not be predestined to becoming cancer, so it is not recommended for women with an average breast cancer risk to have an MRI, since the accuracy rate has not been definitively documented.

When will I get the results and how?
In general, results are available to your referring physician within 24 hours. With our new secure online web viewer, your physician can have instant access to your results. As a service to our patients, you may also request a CD of your results.