Description of magnetic resonace scans

MRI of the head and neck - This is applied in order to exclude or expand diagnostics or monitor tumours of the brain or meninges, in the diagnostics of the skull base and eye sockets, acoustic nerve neuroma, tumours of the pituitary gland, encephalitis or meningitis, encephalopathy, leucodystrophy, intracranial complications of laryngological diseases, demyelinating diseases, congenital malformations of the brain or meninges, thrombosis of venous sinuses, and detection of intracranial vascular malformations.

To supplement the CT scan, MRI is performed to expand diagnostics and to monitor head injuries, epilepsy, strokes and postsurgical lesions. MRI enables the very early diagnosis of ischaemic brain strokes, which is significant in deciding on the correct treatment. The latest MRI techniques applied in the diagnostics of diseases within the head are diffusion, perfusion, MRI spectroscopy, functional magnetic resonance (fMRI) and the examination of diffusion tensor (tractography). Diffusion examinations make it possible to assess water diffusion in tissue. On the basis of the diffusion examination, early ischaemic strokes can be diagnosed, brain tumours can be differentiated and the degree of their malignancy as well as the activity of demyelination foci can be assessed. The perfusion examination provides information on regional blood flow, which is useful in early stroke diagnostics, before deciding on the thrombolytic treatment, which makes it possible to differentiate focal lesions of the brain (benign/malignant), to distinguish primary tumours of the brain from secondary ones and to determine the optimal site for the biopsy. In addition, the perfusion examinations enable the precise location of the contours of tumours and an assessment of neoplastic recurrence after radiotherapy. In MRI spectroscopy, the metabolism of tissues is assessed, which enables early detection of an ischaemic focus, determination of the nature of the focal lesion, very early assessment of the effectiveness of chemotherapeutic treatment, and diagnostics of some neurodegenerative diseases e.g. Alzheimer’s disease.

Functional magnetic resonance imaging (fMRI) is used in the diagnostics of epileptic foci and dementia. fMRI makes it possible to create so-called maps of cortical centres, which are significant in the planning of neurosurgical treatment, to save important cortical centres. The examination of a diffusion tensor is based on an assessment of the direction of diffusion of water particles. 3D pictures obtained in this manner (called tractography) are used to visualise the major neural pathways, which is significant in the planning of surgical treatment, enabling the surgeon to perform the surgery in a minimally invasive manner.

 

MRI in ophthalmology - This is used to expand the diagnostics of pathology of the orbits, eyeballs and/or optic pathways, thyroid thyreopathy or double vision.

 

MRI of the spine - A routine MRI is used for excluding, expanding or monitoring: tumours of the nervous tissue or meninges, inflammation of the cord or meninges, demyelination disease, pressure on the spinal cord, congenital disorders of the spinal cord, cauda equina or meninges, myelopathy, cervical, thoracic or lumbar radiculopathy, a narrowing of the spinal canal, injuries, and for the examination of any spinal diseases in pregnant women. In emergencies an MRI of the spine is performed in the diagnostics of spinal cord pressure due to secondary and primary cancerous tumours.

 

MRI of the bones and/or joints - This is used for excluding, expanding the diagnostics or monitoring tumours deriving from bones or connective tissue, inflammations, necrosis, inflammatory, degenerative and post-trauma bone lesions, ligaments and cartilages of the hip, knee, elbow, shoulder, ankle and wrist joints, in the diagnostics of ankylosing spondylitis, especially in patients with unequivocal X-ray pictures of the sacroiliac joints, who are HLA B27 positive. MRI enables the diagnostics and monitoring of post-trauma problems e.g. slipped proximal femoral epiphysis, post-inflammatory or post-traumatic fusion of the metaphysis in patients below 16 years of age. Thanks to the MRI examination, it is possible to make an assessment of the viability of the transplanted cartilage.

 

MRI of the thoracic aorta and other large vessels of the thorax - MRI can be applied in the diagnostics of aortic dissection, aortic aneurysm, ruptured aortic aneurysm, Marfan syndrome, other congenital defects of the aorta, and exclusion of the peripheral embolism of the aortic origin. With the help of this examination, it is possible to control the effects of the treatment of aortic dissection or anomalies of the aortic arch, coarctation, and to identify periaortic infections or abscesses. MRI is also performed in order to make a post-surgical assessment of the aortic graft. MRI enables the assessment of acquired and congenital defects of the upper vena cava, lower vena cava and the portal vein system e.g. the diagnostics of Budd-Chiari syndrome. The application of an MRI makes it possible to find pathologies in the pulmonary arteries, including the central thrombosis, aneurysms, stenosis or dissection. Thanks to the MRI, vascular invasion can be assessed in neoplastic or systemic diseases, and differentiation between tumours and thrombosis can be made.

 

MRI of the heart and pericardium - This examination is used for the diagnostics of heart morphology, haemodynamic function, perfusion of the heart muscle with an assessment of its viability, metabolism of the heart, morphology and function of the valves, and complications of heart infarction e.g. the formation of an aneurysm. The MRI enables an assessment of the ventricular dysplasia, congenital heart defects, anomalies of the pulmonary veins, and the monitoring of the results of surgical procedures on congenital heart defects. In terms of the diagnostics of the pericardium, the MRI enables an assessment of the thickness of the pericardium and detection of metastases, diagnosis of pericarditis and exudate and/or tamponade.

 

MRI of the abdomen and pelvis - This type of MRI enables the differentiation of focal lesions of the liver, mainly primary and secondary tumours. The most common indications of this type are e.g. the differentiation of the angioma from other focal lesions. Thanks to the MRI it is possible to diagnose infiltrative diseases of the hepatic parenchyma, such as hemochromatosis, haemosyderosis, cirrhosis and steatosis. The MRI makes it possible to assess and better characterise some cancers of the pancreas, kidneys, adrenals and solid and cystic ovarian tumours. The MRI is the method of choice in the diagnostics of fistulas/abscesses in patients with Crohn’s disease, perirectal abscesses and fistulas of the inferior vena cava in patients with diagnosed solid renal tumours. In patients with an allergy to radiological contrast media or in pregnant women, MRI urography can be done instead of a radiological examination. In pregnant women the MRI offers the possibility of assessing the placenta, as well as to detect or exclude foetal defects. The MRI also has an application in the assessment of the uterus in patients with elective embolization of myomas. In men, the MRI is applied in the diagnostics and assessment of progression of the cancer of the prostate and testicles. The MRI is also a method of choice in an assessment of the progression of rectal cancer.

 

MRI of the bile ducts (MRCP) - Applied to broaden the diagnostics of diseases of the bile ducts and pancreas when the results of other tests are unequivocal.

 

Magnetic Resonance Angiography (angio MRI) - Applied to rule out or expand the diagnostics of strokes, diseases of the cervical arteries or vertebrobasilar insufficiency, dissection of cervical or vertebral arteries, intracranial angiomas, intracranial arterial and venous malformations, thrombosis of venous sinuses, abnormalities of vessels in patients allergic to radiological contrast media, occlusion of the upper or lower vena cava and large veins of the pelvis, and assessment of the peripheral arteries in lower and upper limbs. Moreover, the angio MRI is used for the assessment of any narrowing of the artery of transplanted kidneys, as well as an assessment of any narrowing of the renal artery before angioplasty or stenting. The application of MRI for an examination of the aorta and other large vessels of the thorax has been described above.

 

MRI of the soft tissues - As a supplement to the USG or CT, magnetic resonance imaging enables the expansion of the diagnostics or monitoring of malignant and benign soft tissue tumours.

 

MRI of the breasts - In general an MRI of the breasts is performed especially in cases when suspected breast cancer is clinically or mammographically hidden, or in patients with a high risk of developing cancer (patients with BRCA1 and BRCA2 genes), in whom other diagnostic methods have not revealed pathologies. In diagnostics of the breasts, this MRI enables an assessment of the size of the cancer and its relationship to the fascia. The MRI is significant in the preoperative and postoperative assessment of cancer, both lobulous and ductal, multifocal and multicentre - especially in young women. An important indication for the breast MRI is also the necessity of assessing breasts after reconstructive surgery or enlargement, as well as to assess breast implants. MRI Spectroscopy is applied in the early assessment of the effectiveness of chemotherapy.