What is an MRI?

MRI stands for Magnetic Resonance Imaging – a technique used to create images of body tissue and organs in greta detail. It makes use of magnetic fields and radio waves to do so. You may be familiar with what it looks like – a large tube-like device into which a patient passes lying down. The device is magnetic and the field is used to realign hydrogen atoms in the body. This allows the machine to create images of the cross section of the body. It can even be used to create 3D images of various organs, allowing for detailed study by doctors. An MRI scan can be used to examine almost any part of the body, including:

• Brain and spinal cord
• Bones and joints
• Breasts
• Heart and blood vessels
• Internal organs, such as the liver, womb or prostate gland

The results of an MRI scan can be used to help diagnose conditions, plan treatments and assess how effective previous treatment has been.

What happens during an MRI scan?

During an MRI scan, you lie on a flat bed which is moved into the scanner. Depending on the part of your body being scanned, you will be moved into the scanner either head first or feet first.

The MRI scanner is operated by a radiographer. They control the scanner using a computer, which is in a different room from the scanner to keep it away from the magnetic field generated by the scanner.

You will be able to talk to the radiographer through an intercom and they will be able to see you on a television monitor throughout the scan. During the scan the scanner will make loud tapping noises. This is the electric current in the scanner coils being turned on and off. You will be given earplugs or headphones to wear.

It is very important that you keep as still as possible during your MRI scan. The scan will last between 15 and 90 minutes, depending on the size of the area being scanned and how many images are taken.

Safety?

An MRI scan is a painless and safe procedure. You may find it uncomfortable if you have claustrophobia (fear of enclosed spaces), but with support from the radiographer, most people find this manageable. Sometimes going into the scanner feet first may be easier, although this is not always possible.

MRI scans do not involve exposing the body to X-rayradiation. This means people who may be particularly vulnerable to the effects of radiation, such as pregnant women and babies, can use them if necessary.

However, not everyone can have an MRI scan. For example, they are not always possible for people who have certain types of implants fitted, such as a pacemaker(a battery operated device that helps control an irregular heartbeat).

Extensive research has been carried out into whether the magnetic fields and radio waves used during MRI scans could pose a risk to the human body. No evidence to suggest that there is a risk has been found, which means that MRI is one of the safest medical procedures currently available.

Can paediatric patients receive an MRI?

Yes children can receive an MRI. Parentes can accompany their children into the scan room with the child during the MRI exam. Some children may need sedation and the radiologists works closely with the anaesthetists for meeting this unique need.

Should I take medications on the day of my MRI?

Yes, patients can continue taking all medications as prescribed by their physicians before their MRI. Patients should let their technologists know what medications they have taken prior to their MRI scan.

Can I eat before my MRI?

Patients will receive individual instructions about eating from a member of the MRI department prior to their scan.

How should I dress for my MRI?

Patients should dress in loose – fitting, comfortable clothing without metal snaps or zippers. All valuables should be left at home. Jewellery, glasses, hearing aids, dentures, hairpins, credit cards, coins, keys and other metal objects need to be removed.

Will I receive an intravenous contrast during my MRI?

Depending on the type of exam, patients may receive a contrast agent intravenously (IV). Contrast mediums or contrast agents are safe injections used to highlight organs and blood vessels to produce a better image for the radiologist. If your physician or radiologist has determined that an IV contrast will improve your MRI scans result you will receive an IV contrast through a vein in the arm or hand.

What equipment do you use?

Here at Sri Ramakrishna Hospital, we make use of a state-of-the-art Siemens MRI MAGNETOM Avanto machine. Rated at 1.5 Tesla, its a top-notch MRI scanner with a host of diagnostic applications.

The MAGNETOM Avanto gives total flexibility, with innovative applications for each part of the body such as the following:

• Evaluation of pathology from disc herniation to acute stroke. With high-quality morphological and functional techniques
• Examination of ligament tears to cartilage degeneration. With high-resolution imaging
• Clinical questions can easily be answered. From cardiomyopathies to ischemic heart disease. And from valvular to congenital heart diseases
• Excellent contrast and resolution with multiple protocols. Using ultrafast and motion correction techniques
• Depiction of vessel diseases with a wide range of contrast and non-contrast enhanced techniques
• State-of-the-art oncology services for tumor detection. And staging of prostate, liver cancers, and more
• Streamlined workflow in clinical cases. Including lobular cancer, breast implant assessment, and therapy monitoring.

Its major advantages are:

• Ultra-fast image acquisition
• Dramatic reduction in acoustic noise without compromising performance
• The most comprehensive application range available today
• Phasellus auctor augue
• Shorter-than-ever exam times
• Up to 97% acoustic noise reduction
• Feet-first examinations
• No patient repositioning
• ultra-lightweight coils

What is a CT scan?

CT is short for ‘computerised tomography’ scan. The scan in very simple terms is essentially a computerised composite of a number of X-rays which have been taken from various angles. This generates a three-dimensional picture of the inside of the scanned patient. It is an excellent diagnostic tool.

Should I do anything special to prepare for a CT scan?

How you prepare for a CT scan depends on which part of your body is being scanned. You may be asked to remove your clothing and wear a hospital gown. You’ll need to remove any metal objects, such as jewelry, that might interfere with image results. Some CT scans require you to drink a contrast liquid before the scan or have contrast injected into a vein in your arm during the scan. A contrast medium blocks X-rays and appears white on images, which can help emphasize blood vessels, bowel or other structures. If your test involves a contrast medium, your doctor may ask you to fast for a few hours before the test.

Can I take my medicine before a CT scan?

Yes, please take medicines before the CT scan, with the exception of diabetic medicines. Consult your physician before the test for instructions.

How long will it take to do a CT scan?

The scan itself may take less than a minute on the newest machines. Most scans take just a few minutes to complete. For a few studies depending on the preparation needed the exam may last longer than an hour.

Will the radiation that I receive from the CT scan hurt me?

CT scans are similar to those of conventional X-rays. During the CT scan, you’re briefly exposed to radiation. Our studies, protocols and our newly acquired machine makes sure our patients receive the lowest dose of radiation. Having the very latest equipment allows for studies to be done quicker which also lowers radiation exposure.

What will I experience during and after the procedure?

During the CT scan, you lie on a narrow table that slides through the opening of the gantry. You may lie on your back, side or stomach, depending on the area to be scanned. The table can be raised or lowered. Straps and pillows may help you stay in position. During a CT scan of the head, the table may be fitted with a special cradle that holds your head still. CT scans are painless. If your exam involves use of an intravenous contrast medium, you may feel a brief sensation of heat or experience a metallic taste in your mouth.

If you receive the contrast medium through an enema — to help highlight your lower gastrointestinal region — you may feel a sense of fullness or cramping. After the exam you can return to your normal routine. If you were given a contrast medium, your doctor, a nurse or the CT technologist performing the scan may give you special instructions. You may be asked to wait for a short time in the radiology department to ensure that you feel well after the exam. After the scan, you’ll likely be told to drink lots of fluids to help your kidneys remove the medium from your body.

Will I have to take a CT contrast or dye, and can I be allergic to it?

It depends on which part of your body is being scanned. Although rare, the contrast medium used in a CT scan poses a slight risk of allergic reaction. Most reactions are mild and result in hives or itchiness. For people with asthma who become allergic to the contrast medium, the reaction can be an asthma attack. In rare instances, an allergic reaction can be serious and potentially life-threatening — including swelling in your throat or other areas of your body. If you experience hives, itchiness or swelling in your throat during or after your CT exam, immediately tell your technologist or doctor.

If you’ve had a reaction to a contrast medium in the past, and you need a diagnostic test that may require a contrast medium again, inform your doctor. Be sure to let your doctor know if you have kidney problems, since contrast material that’s injected into a vein is removed from your body by your kidneys and could potentially cause further damage to your kidneys. If you have had a prior reaction to contrast media or have asthma or allergies, there’s an increased risk of a reaction to the contrast medium. Diabetes, asthma, heart disease, kidney problems or certain thyroid conditions may increase your risk of a reaction to contrast media.

Will I need someone to drive for me after the CT scan?

No, the CT scan is a safe test that will not affect your ability to drive.

What equipment do you use?

Here at Sri Ramakrishna Hospital we make use of the more advanced Siemens ‘dual source CT’ which allows doctors to examine the subject in far greater detail than with the normal type of CT scanner.

What is a mammogram?

With breast cancer becoming among the most common forms of cancer, and incidents on the rise, mammograms are increasingly becoming important. New screening tests, performed in a timely manner, are saving thousands of lives. Mammograms are essentially x rays of the breasts. In it, the breast is flattened between two plates before imaging. The digital mammography does away with the need for film and records the scans digitally. This allows analysis by both physicians as well as computers. In addition, it reduces the patient’s exposure to radiation by as much as 25%.

Mammograms allow radiologists to look for breast lumps and changes in breast tissue. They can show small lumps or growths that may not be felt during a clinical breast exam.

How do I get ready for my mammogram?

Some general guidelines include:

• Before your mammogram, discuss any new findings or problems in your breasts with clinician or Ob/Gyn clinician. In addition,inform your clinician of any prior surgeries, hormone use, and family or personal history of breast cancer
• Make your appointment for one week after your period, when your breasts are less likely to be tender
• Bring previous mammograms, breast sonograms, and reports to your appointment so that they are available to the radiologist, who needs the prior information in order to make comparisons to your current mammogram
• Describe any breast symptoms or problems to the technologist performing the exam. Inform the technologist of your previous breast history
• Don’t wear deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your appointment, as these can cause shadows on the mammogram
• If you have breast implants, be sure to tell your mammography facility when you make your appointment

Is the mammogram going to hurt?

Adequate compression is necessary for the radiologist to see the breast tissue better. Compression of the breast also lowers the radiation dose. Women who have tender breasts may experience discomfort. If you are afraid or nervous about feeling pain during your mammogram please discuss this with the technologist before the examination. The technologist will work with you to make you as comfortable as possible while still taking good-quality images.

How is a mammogram done?

The radiological technician places one breast at a time between two plastic plates, which press the breast to flatten it. You will feel pressure and possibly some discomfort for a few seconds. The flatter your breast is, the better the picture. Usually, two pictures are taken of each breast, one from the side and one from above. A screening mammogram appointment takes about 30 minutes from start to finish.

How often should I get a mammogram?

General guidelines:

• Women 40 years and older: every one to two years
• Women 50 years and older: every year
• Women who have had breast cancer or other breast problems or who have a family history of breast cancer might need to start getting mammograms before age 40, or they might need them more often

Several reputable organizations such as the American Cancer Society, US Preventive Health Task Force, and the American College of Obstetricians and Gynecologists make similar recommendations about the frequency of mammography.

What is an ultrasound?

You’ve probably heard of the term ultrasound and seen some fuzzy looking images but you may not be sure what it really is. Ultrasounds are basically sound waves of frequencies which are higher than what is audible to humans. It is used in a host of fields to for identifying objects and even measuring distances. In medicine, ultrasound imaging or sonography is used to create images of the internals of the body. They are most commonly used to monitor pregnancy. Since it uses sound waves, there is no radiation at all. Typical ultrasounds produce flat images while new technology allows for even 3D images. They are taken in real time and are a huge boon to diagnostics.

How is it performed?

The individual being examined is either seated comfortably, or lies on a cot depending on the area to be examined. It may be necessary for you to assume a particular position, to allow access to the area of concern. A gel is applied to the skin and a transducer (or probe) is placed on it. It emits high frequency sounds which are transmitted to the gel and then the inside of the body. As the sounds bounce back, the probe ‘collects’ them and the computer uses the information to create an image.

What are the risks?

Ultrasound uses non-ionizing radiation and is extremely safe.

Why does the bladder need to be full for a pelvic exam?

A full bladder moves the intestines out of the way so that we can adequately visualize the pelvic structures especially the uterus and ovaries.

Why do I have to fast for my abdominal ultrasound?

This decreases the amount of gas in the abdomen and allows the gallbladder to be adequately visualized. The gallbladder contracts when you eat or drink.

Why is it better to schedule my abdominal or RUQ ultrasound in the morning?

Your abdomen has the least amount of gas in the morning.

Is ultrasound better than other modalities?

Not necessarily. Each modality images differently. Sometimes it is necessary to image with different modalities for the best diagnosis. An ultrasound is what your doctor’s office has ordered at this time.

Can I have a transvaginal exam while I am still on my period?

Yes, but if you are uncomfortable in any way we would be happy to reschedule your appointment.

I am under age 25, why am I having an ultrasound of my breast instead of a mammogram?

It is best to start with an ultrasound (no radiation) first. Women under the age of 30 also have very dense breasts, which makes mammography very difficult to interpret. If the radiologist feels that a mammogram is necessary, we will then proceed with mammography.

What equipment do you use?

At Sri Ramakrishna Hospital we use top-of-the-line ultrasound machines from GE and Phillips.

A positron emission tomography or PET scan is a nuclear medicine imaging technique. Nuclear medicine is the field of medicine where patients are given tiny amounts of radioactive medication, known as a radiopharmaceutical, to makes the body a little radioactive for a short period of time. A specialised camera for nuclear medicine, which can detect radiation emissions from the body, can then take ‘pictures’ of it (The Radiation) thereby creating an image of the inside of the body as it works. In a PET scan, a tracer (made of a radioactive substance) is injected into the body.

The tracer moves through the body and collects in regions where there are increased levels of chemical activity. These are usually areas with disease. During the scan, they are highlighted as bright spots. Here at Sri Ramakrishna Medical hospital we use cutting-edge GE equipment to do a number of PET scans such as whole-body FDG, brain, heart and bone.

Digital radiography is the modern equivalent of x ray imaging. In it, the images which are ordinarily captured on an x ray film, are captured digitally instead. The report is generated within minutes and the film can be shared with physicians from remote locations instantly.

Digital radiography uses sensors instead of film and the cassette used in computed radiography. It also makes use of a lower dose of radiation than Computed Radiography (CR). At Sri Ramakrishna Hospital, we use the very latest technology to give our patients the best possible care and it is no different in this department.

We use a GE digital radiograph to ensure fast and seamless x ray imaging.