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MRI
- How do I prepare for an
MRI?
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What does the MR scanning center staff need to know
about me to perform the scan?
- What will happen
when I get scanned?
- Isn't an MRI scan
basically the same as a CAT/CT scan?
- Do
you need a prescription for an MRI?
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If I have an MRI scan, how will I find out the results?
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Can I choose the kind of MRI scan I want?
- Do
I have to lie still when I have an MRI?
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When is an MRI called for?
PET
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What is a PET scan?
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How does a PET scan work?
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Why are PET scans performed?
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How do I prepare for a PET scan?
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Are there any risks involved with PET scans?
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What will I experience during the PET exam?
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How long will the PET scan take?
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What is "contrast" used for during a PET scan?
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When will I receive the results of the PET scan?
CT (CAT)
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What is a CT (CAT) scan?
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How does a CT scan work?
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Why are CT scans performed?
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How do I prepare for a CT scan?
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Are there any risks involved with CT scans?
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What will I experience during the CT exam?
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How long will the CT scan take?
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What is "contrast" used for during a CT scan?
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When will I receive the results of the CT scan?
| MRI Frequently
Asked Questions |
Preparing for an MR scan is very easy.
You can take all your normal medications and follow usual eating schedules
unless your doctor gives you special instructions. The only unusual preparation
for an MR scan is that all removable metallic objects must be left outside the
scanning room, including removable hearing aids, dentures and other prosthetic
devices. Credit cards cannot be brought into the scanner room since the magnetic
codes on them can be affected by the magnet. For optimal image quality when
performing head scans, all makeup must be removed since it may contain metallic
powders which are magnetic and thus degrade image quality. You may be asked to
wear a hospital gown, since clothes may have metallic fasteners or metallic
fibers that can interfere with the imaging.
Besides complete information about your
medical history, your doctor and the MR staff must know if you have any metal in
your body which cannot be removed, including: pacemakers, implanted insulin
pumps, aneurysm clips, vascular coils and filters, heart valves, ear implants,
surgical staples and wires, shrapnel, bone or joint replacements, metal plates,
rods, pins or screws, contraceptive diaphragms or coils, penile implants, and
permanent dentures. In most cases, you can be scanned even though you have metal
implants. Nevertheless, the radiologist and MRI staff must be aware of them.
Also, tell a member of the staff if you are pregnant or if there is a
possibility you are pregnant.
IMPORTANT: DO NOT ALLOW YOURSELF TO BE SCANNED IF YOU HAVE A
PACEMAKER OR OTHER IMPLANTED MECHANICALLY, ELECTRICALLY OR
MAGNETICALLY ACTIVATED DEVICE. UNLESS SPECIFICALLY ORDERED BY
THE RADIOLOGIST, YOU WILL NOT BE SCANNED IF YOU HAVE METAL
IMPLANTS IN THE HEAD REGION.
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A trained MR professional will help
you into position on the scanner bed. This narrow bed slides directly
into the scanner. Ask for a blanket if you are cold. It may be necessary
to place a special band or ring on the area to be scanned. This band or
ring is actually a special antenna that enables the scanner to pick up
signals with more clarity from that portion of anatomy that is being
scanned. Once you are positioned, all you have to do is relax and lie as
still as you can. You will
be able to talk to a member of the staff in the next room who will be
able to see and hear you during the entire scan. You can have a
companion stay in the scanning room with you throughout the scan. In
fact, whenever possible, parents are encouraged to be in the room with
their children during the scan. The procedure will take from 20 to 60
minutes depending on your doctor's instructions. After the scan, you can
resume all normal activities immediately. Infrequently, certain types of
scans require the use of an injected contrast agent. If your doctor
ordered this type of scan, our staff member will explain the contrast
agent to you and answer your questions. |
No, except for the fact that they both
use computers and they are both used for medical diagnosis, they really have
very little in common. One of the most important differences between a CAT scan
and an MRI is the fact that CAT scans use X-ray radiation and MRI scans do not.
In other words, CAT scans are nothing more than computerized X-rays. As you
probably already know, X-rays can be harmful and it is important therefore to
avoid unnecessary exposure to them. Although there are still some situations in
which a CAT scan should be instead of an MRI-your physician will be able to tell
you when this is the case and why-for the most part, MRI's are diagnostically
superior, especially if soft tissue is involved. If a CAT scan and an MRI are
diagnostically equivalent in a particular situation, an MRI is the better choice
because it will not subject you to any ionizing radiation. Instead, MRI's use
harmless radio waves. In addition to the superior portrayal of soft tissue, MRI's
provide much more flexibility in portraying cross-sectional planes of the body.
Unlike a CAT scanner which is relatively limited to when it comes to plane
selection, an MRI can provide a cross-sectional image taken at any plane in the
human body.
Yes. If you have reason to believe that
an MRI would be beneficial in diagnosing your physical condition more
accurately, discuss it with your doctor. If your doctor agrees, he or she will
refer you to a local MRI diagnostic center for a scan.
Typically, your MRI scan will be examined
or 'read' by a radiologist who is specially trained in MRI technology. The
radiologist in turn will report to your physician, and your physician will then
discuss the findings with you.
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Yes, you can. Your physician may have a
business relationship with a particular diagnostic center and therefore prefer
sending you to that particular site. The imaging centers will have closed bore
scanner or open type scanners. You could ask your doctor if both types are
available in your area.
Yes, you can. Your physician may have a
business relationship with a particular diagnostic center and therefore prefer
sending you to that particular site. The imaging centers will have closed bore
scanner or open type scanners. You could ask your doctor if both types are
available in your area.
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Whenever your doctor
requires top-quality anatomic portrayal, especially soft tissue,
chances are that an MRI will be the modality of choice.
Unfortunately, the decision to prescribe or not to prescribe an
MRI will not always be made on the basis of diagnostic quality.
Sometimes, in a well-meaning attempt to save money for the
patient or the insurance company, a physician will choose a
less-expensive procedure, hoping that he or she will receive
sufficient information to make a correct diagnosis. If the
less-expensive test proves inadequate, however, and an MRI is
prescribed later, the attempt to save money will have been
futile. Even worse, the condition may be inaccurately diagnosed
using a less definitive, non-MRI procedure.
Because MRI portrays soft
tissue with such diagnostically-useful clarity, it is relied
upon frequently for revealing abdominal abnormalities-mid-field
scanners are clearly superior to high-field scanners in this
regard-and a wide variety of other ills as diverse as
malfunctioning temporomandibular joints (TMJs) in the jaw,
pinched nerves in the spinal column, heart disease and multiple
sclerosis. (Nothing is superior to MRI for revealing MS.) From
the beginning, of course, one of the great strengths of MRI has
been its ability to reveal tumors.
The second largest
application for MRI at present is musculoskeletal disease.
Orthopedic physicians regularly refer patients for MRI's for a
wide variety of conditions. That's why you hear so much, for
example, about professional athletes getting MRI scans. Many
MRI's have a new development of a number of specialized MRI
diagnostic methods used in sports medicine. These have led the
way, for example, in providing anatomical motion studies. These
studies enable technologists to electronically sequence a series
of MRI images to create an accurate portrayal of how a
malfunctioning joint in a patient is working dynamically.
Individual MRI images reveal static conditions, just as a photo
snapshot reveals a person's likeness just for an instant of
time, but misses the facial expression that occurred a second or
two earlier and the one that followed immediately after. A
dynamic portrayal of a joint helps a physician understand how a
particular joint-a shoulder, a knee, a neck or a TMJ-functions
in "real life." Incidentally, open-environment MRI scanners are
clearly superior for these motion studies as they provide the
space required for a patient to move their arm, leg or neck
through a wide range of positions.
Magnetic resonance
angiography (MRA) is a well-utilized procedure that will only
increase in use by cardiologists in the future. Although CAT
scans are better able to show calcified plaque that has built up
in an artery, physicians will increasingly turn to MRA in the
future to reveal the presence and severity of soft
atherosclerotic plaque. In other words, it will reveal newer,
more recent plaque which has formed, enabling physicians to view
the extent of artery disease more accurately and to treat that
disease more appropriately.
Nothing is superior to an
MRI for imaging breast implants. It shows the implants much more
clearly than other modalities and it has the added advantage of
not using X-rays, a particular concern when imaging the breast.
MRI is also superior to ultrasound, X-ray mammograms or CAT
scans when it comes to revealing malignancies in very dense
breasts. This is still a developing area for MRI, one which will
become much more dominant in the future.
The MRI applications
mentioned above are just a small portion of the applications for
which MRI is the modality of choice. If you have further
questions, discuss them with your physician or speak with a
radiologist who specializes in MRI. MRI is still a developing
modality whose diagnostic power is becoming more and more
appreciated with time. Already, it has replaced a great number
of X-ray-based procedures and it is certain to replace even more
in the future. |
| PET
Frequently Asked Questions |
What is
a PET scan?
Positron emission tomography, also called PET imaging or a PET scan, is
a diagnostic examination that involves the acquisition of physiologic
images based on the detection of radiation from the emission of
positrons. Positrons are tiny particles emitted from a radioactive
substance administered to the patient. The subsequent images of the
human body developed with this technique are used to evaluate a variety
of diseases.Back to PET Top
How does a
PET scan work?
Before the examination begins, a radioactive
substance is produced in a machine called a
cyclotron and attached, or tagged, to a natural body
compound, most commonly glucose, but sometimes water
or ammonia. Once this substance is administered to
the patient, the radioactivity localizes in the
appropriate areas of the body and is detected by the
PET scanner.Different colors or degrees of
brightness on a PET image represent different levels
of tissue or organ function. For example, because
healthy tissue uses glucose for energy, it
accumulates some of the tagged glucose, which will
show up on the PET images. However, cancerous
tissue, which uses more glucose than normal tissue,
will accumulate more of the substance and appear
brighter than normal tissue on the PET images.
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Back to PET Top
Why are
PET scans performed?
PET scans are used most often to detect cancer and to examine the
effects of cancer therapy by characterizing biochemical changes in the
cancer. These scans can be performed on the whole body. PET scans of the
heart can be used to determine blood flow to the heart muscle and help
evaluate signs of coronary artery disease. PET scans of the heart can
also be used to determine if areas of the heart that show decreased
function are alive rather than scarred as a result of a prior heart
attack, called a myocardial infarction. Combined with a myocardial
perfusion study, PET scans allow differentiation of nonfunctioning heart
muscle from heart muscle that would benefit from a procedure, such as
angioplasty or coronary artery bypass surgery, which would reestablish
adequate blood flow and improve heart function. PET scans of the brain
are used to evaluate patients who have memory disorders of an
undetermined cause, suspected or proven brain tumors or seizure
disorders that are not responsive to medical therapy and are therefore
candidates for surgery.
Back to PET Top
How do I
prepare for a PET scan?
PET is usually done on an outpatient basis. Your
doctor will give you detailed instructions on how to
prepare for your examination. You should wear
comfortable, loose-fitting clothes. You should not
eat for four hours before the scan. You will be
encouraged to drink water. Your doctor will instruct
you regarding the use of medications before the
test.
Note: Diabetic patients should ask for any
specific diet guidelines to control glucose levels
during the day of the test.
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Back to PET Top
Are
there any risks involved with PET scans?
- Because PET allows study of body function,
it can help physicians detect alterations in
biochemical processes that suggest disease
before changes in anatomy are apparent with
other imaging tests, such as CT or MRI.
- Because the radioactivity is very
short-lived, your radiation exposure is low. The
substance amount is so small that it does not
affect the normal processes of the body.
- The radioactive substance may expose
radiation to the fetus in patients who are
pregnant or the infants of women who are
breast-feeding. The risk to the fetus or infant
should be considered in relation to the
potential information gain from the result of
the PET examination. If you are pregnant, you
should inform the PET imaging staff before the
examination is performed.
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Back to PET Top
What will I experience during the PET exam?
The administration of the radioactive substance will feel like a
slight pinprick if given by intravenous injection. You will then be made
as comfortable as possible before you are positioned in the PET scanner
for the test. You will be asked to remain still for the duration of the
examination. Patients who are claustrophobic may feel some anxiety while
positioned in the scanner. Also, some patients find it uncomfortable to
hold one position for more than a few minutes. You will not feel
anything related to the radioactivity of the substance in your body.
Back to PET Top
How long
will the PET scan take?
Back to PET Top
What
is "contrast" used for during a PET scan?
Contrast is a radioactive substance is administered as an intravenous
injection (although in some cases, it will be given through an existing
intravenous line or inhaled as a gas). It will then take approximately
30 to 90 minutes for the substance to travel through your body and
accumulate in the tissue under study
Back to PET Top
When
will I receive the results of the PET scan?
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Patients undergo PET because their referring
physician has recommended it. A radiologist who has
specialized training in PET will interpret the
images and forward a report to your referring
physician. It usually takes one to three days to
interpret, report and deliver the results. In order
to facilitate interpretation, you may be asked to
bring any previous radiological images with you,
such as recent CT (CAT) scans or MRI images.
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Back to PET Top
| CT
Frequently Asked Questions |
What is a
CT (CAT) scan?
CT (computed
tomography) angiography (CTA) is an examination that uses
x-rays to visualize blood flow in arterial and venous vessels
throughout the body, from arteries serving the brain to those bringing
blood to the lungs, kidneys, and arms and legs. CT combines the use of
x-rays with computerized analysis of the images. Beams of x-rays are
passed from a rotating device through the area of interest in the
patient's body from several different angles to create cross-sectional
images, which then are assembled by computer into a three-dimensional
picture of the area being studied. Compared to
catheter angiography, which involves placing a sizable catheter and
injecting
contrast material into a large artery or vein, CTA is a much less
invasive and more patient-friendly procedure—contrast material is
injected into a small peripheral vein by using a small needle or
catheter. This type of exam has been used to screen large numbers of
individuals for arterial disease. Most patients undergo CT angiography
without being admitted to a hospital.
Back to CT Top
How does a
CT scan work?
During the examination, the rotating device spins around the patient,
creating a fan-shaped beam of
x-rays, and the detector takes snapshots of the beam after it passes
through the patient. As many as one thousand of these pictures may be
recorded in one turn of the detector. The real work of CTA comes after
the images are acquired, when powerful computer programs process the
images and make it possible to display them in different ways, for
instance, in cross-sectional slices or as three-dimensional "casts" of
the blood vessels.
Back to CT Top
Why are CT
scans performed?
CTA is commonly used to:
- Examine the pulmonary arteries in the lungs
to rule out
pulmonary embolism, a serious but treatable
condition.
- Visualize blood flow in the renal arteries
(those supplying the kidneys) in patients with
high blood pressure and those suspected of
having kidney disorders. Narrowing (stenosis) of
a renal artery is a cause of high blood pressure
(hypertension) in some patients and can be
corrected. A special computerized method of
viewing the images makes renal CT angiography a
very accurate examination. Also done in
prospective kidney donors.
- Identify
aneurysms in the aorta or in other major
blood vessels. Aneurysms are diseased areas of a
weakened blood vessel wall that bulges out—like
a bulge in a tire. Aneurysms are
life-threatening because they can rupture.
- Identify dissection in the aorta or its
major branches. Dissection means that the layers
of the artery wall peel away from each
other—like the layers of an onion. Dissection
can cause pain and can be life-threatening.
- Identify a small aneurysm or arteriovenous
malformation inside the brain that can be
life-threatening.
- Detect
atherosclerotic disease that has narrowed
the arteries to the legs.
- Detect thrombosis (clots) in veins, for
example large veins in the pelvis and legs. Such
clots can travel to the lungs and result in
pulmonary embolism.
CTA is also used to
detect narrowing or obstruction of arteries in the
pelvis and in the carotid arteries, which bring blood
from the heart to the brain. When a
stent has been placed to restore blood flow in a
diseased artery, CTA will show whether it is serving
its purpose. Examining arteries in the brain may
help reach a correct diagnosis in patients who
complain of headaches, dizziness, ringing in the
ears or fainting. Injured patients may benefit from
CTA if there is a possibility that one or more
arteries have been damaged. In patients with a
tumor, it may be helpful for the surgeon to know the
details of arteries feeding the growth.
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Back to CT Top
How do I
prepare for a CT scan?
Depending on the part of the body to be examined, you may be asked to
take only clear liquids by mouth before CTA. You may be asked whether
you have asthma or any allergies to foods or drugs, and what medications
you are currently taking. If you are pregnant, you should inform the
technologist before the procedure. You probably will not have to
undress if you are undergoing an exam of the head, neck, arms or legs
but you will have to remove any jewelry, hair clips, dentures and the
like that could show up on the
x-rays and make them hard to interpret.
Back to CT Top
Are there
any risks involved with CT scans?
- There is a risk of an allergic
reaction—which may be serious—whenever contrast
material containing iodine is injected. If you
have a history of allergy to x-ray dye, your
radiologist may advise that you take special
medication for 24 hours before CTA to lessen the
risk of allergic reaction. Another option is to
undergo a different exam that does not call for
contrast material injection.
- CTA should be avoided in patients with
kidney disease or severe diabetes, because x-ray
contrast material can further harm kidney
function.
- If a large amount of x-ray contrast material
leaks out under the skin where the IV is placed,
skin damage can result. If you feel any pain in
this area during contrast material injection,
you should immediately inform the technologist.
- If you are breastfeeding at the time of the
exam, you should ask your radiologist how to
proceed. It may help to pump breast milk ahead
of time and keep it on hand for use after CTA
contrast material has cleared from your body.
- Women should always inform their doctor or
x-ray
technologist if there is any possibility
that they are pregnant.
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Back to CT Top
What
will I experience during the CT exam?
Overall, you can expect to be in or near the examining room for 20 to
60 minutes. You may feel warm all over when
contrast material is injected, but you should not feel pain at any
time. Any CT study requires that you remain still during the exam.
Pillows and foam pads may help make it more comfortable. At the same
time, the nurse or
technologist may use pads or Velcro straps to keep an area of your
body from moving. The examination table will move into and out of the
scanner opening, but it is not enclosed, and only a small part of your
body will be inside at any one time. You may be asked to hold your
breath for 10 to 25 seconds to be sure that the images will not be
blurred. During the time that no actual imaging is taking place, you are
free to ask questions or talk to the technologist, but friends or
relatives will not be allowed in the examining room. Once the needed
images have been recorded, you will be free to leave. You can eat
immediately, and it is a good idea to drink plenty of fluids in the
hours after the exam to help flush contrast material out of the system.
Back to CT Top
How long
will the CT scan take?
CTA takes about 10 to 25 minutes from the time the actual examination
begins.
Back to CT Top
What
is "contrast" used for during a CT scan?
Before the actual exam begins, you will have a dose of
contrast material injected into a vein to make the blood vessels
stand out. An automatic injector machine is used that controls the
timing and rate of injection, which may continue during part of the time
images are recorded.
Back to CT Top
When
will I receive the results of the CT scan?
A
radiologist, who is a physician experienced in CTA and other
radiology examinations, will analyze the images and send a report to
your personal physician, who in turn will discuss the findings with you.
Typically the results of CTA are available within 24 hours, although in
complicated cases special computer analysis may take somewhat longer.
Back to CT Top
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