MRI - Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

MRI uses a magnetic field and pulses of radio wave energy to make pictures of organs, soft tissues, bone and virtually all other internal body structures. In many cases, MRI gives different information about structures in the body than can be seen with X-ray, ultrasound or a computed tomography (CT) scan. MRI may also be used to show problems that cannot be seen with other imaging methods.

MRI is performed to evaluate:

• Organs of the chest, abdomen and pelvis including the heart, liver, biliary tract, kidney, spleen, pancreas and adrenal glands
• Pelvic organs including the reproductive organs in the male (prostate and testicles) and the female (uterus, cervix and ovaries)
• Pelvic and hip bones
• Blood vessels (magnetic resonance angiography, or MRA)
• Breast cancer and implants
• Heart problems including the aorta and other blood vessels — or more information, visit our magnetic resonance angiography (MRA) and cardiac CT services

Adventist Health Portland’s MRI department and Gresham Imaging Center are accredited by the American College of Radiology (ACR).

Preparing for your MRI

Our staff may request you not eat or drink anything prior to your exam if a media will be administered. If you think you may be allergic to media, please contact your physician for pre-medication instructions.

Nothing metallic may be worn. Please leave all watches and jewelry at home. We recommend you do not wear eye makeup because some brands contain metallic substances that can cause swelling or discomfort. Please make sure the staff performing your MRI is aware of any metal fragments you may have in your body, including those from old injuries or wounds (such as shrapnel, slivers from grinding or welding).

If you feel apprehensive in tight places or about the MRI procedure itself, let your provider know. Your provider may prescribe a mild sedative to help you relax.

What to expect when having an MRI at Adventist Health Portland:

• If there are metal zippers, snaps or buttons on your clothes, you will be asked to change into a hospital gown
• An IV may be inserted for gadolinium (contrast material) administration
• Earplugs will be provided, as the MRI scanner makes a loud "knocking" sound
• You will be taken into the MRI room and asked to lie on the table, which slides out from the scanner
• Once you are comfortable, the technologist will leave the room but your provider will be available over the intercom if you have any questions or concerns during your exam
• The technologist will tell you how long each sequence will last — each sequence generally lasts from 30 seconds to three minutes
• The scanner makes a loud banging or clanging sound for the duration of the sequence, so you may experience some vibration
• A little over half way through the procedure, the gadolinium (if being used) will be injected, either with a syringe or into the IV that has been installed for this purpose —it usually feels a little cold
• The duration of the entire test depends on what is being scanned and whether the scan will be done with contrast material
• Generally, tests are completed within 30 to 60 minutes

Claustrophobia & anxiety during an MRI

Claustrophobia is defined as a fear of enclosed spaces. To most people, this translates to a feeling of anxiety or panic (from a level of "just a little anxiety" to severe panic) when in a small or confined area. In MRI, the enclosed space is the inside of the magnet machine. The magnet is open on both ends. Many individuals who suffer from claustrophobia may require medication to relieve or reduce their anxiety in order to have the MRI successfully performed.

Breast MRI

Breast MRI is rapidly becoming an essential tool in the diagnosis and management of breast cancer. While mammography is still the best and only screening tool for detecting early breast cancer in the general population, MRI is increasingly being utilized to evaluate ambiguous findings on mammography, ultrasound and adjunctive screening examinations for the smaller population of "high-risk" women.

Breast MRI indications:

• Evaluating newly diagnosed breast cancer cases for extent of disease as well as for multicentric and contralateral disease
• Aiding in the biopsy of lesions occult on mammography and ultrasound
• Managing findings on mammography and ultrasound, which are indeterminate, specifically to aid in the decision as to whether biopsy or short term follow-up is recommended
• Evaluating breast implants for possible rupture or leakage
• Distinguishing post-lumpectomy scarring from local recurrence
• Screening high-risk patients

Pelvic MRI

For women, pelvic MRI provides a detailed look at the ovaries and uterus and is often used to follow up on an abnormality seen on ultrasound. Pelvic MRI is also used to look at the bones and muscles of the pelvis and to evaluate the spread of cancer to the uterus.

Pelvic floor dysfunction (PFD) is a hidden women's health epidemic in the United States, with more than 10 percent of women having a lifetime risk for undergoing a surgical repair for this problem.

Pelvic floor dysfunction is an umbrella term for a heterogeneous (unassociated) group of disorders affecting up to 50 percent of middle-aged and older women presenting with:

• Pelvic pain
• Pressure
• Dyspareunia (pain during intercourse)
• Incontinence
• Incomplete emptying

The development of MRI — which allows noninvasive, radiation-free, rapid, high-resolution evaluation of the entire pelvis in one examination — now plays a major role in the clinical management of the two main components of PFD: pelvic floor relaxation and pelvic organ prolapse.

Magnetic Resonance Angiography

Magnetic resonance angiography (MRA) is a noninvasive way for providers to evaluate the various blood vessels in the body. MRA can reveal blood vessel narrowing (stenosis), blockage (occlusion), aneurysm (weak ballooning area on the vessel) and other abnormalities. MRA is frequently used for evaluating the blood vessels in the brain, neck (carotid and vertebral arteries), kidneys and legs, but also can be used elsewhere in the body.

Neuroradiology MRI

MRI can also be used for neurological diagnostic purposes:

• Spine: Spine MRI is most commonly used to look for a herniated disk or narrowing of the spinal canal (spinal stenosis) in people with neck, arm, back and/or leg pain. It is also the best test to use to look for a recurrent disk herniation in a person with a history of prior back surgery.
• Brain: An MRI of the brain produces very detailed pictures of the brain and is commonly used to study people with such problems as headaches, seizures, weakness, hearing loss and blurry vision. It can also be used to further evaluate an abnormality seen on a CT scan.
• Stroke assessment: MRI and MRA can be a powerful combination for thorough assessment for stroke or potential stroke patients. MRI of the brain that includes "diffusion" weighted imaging provides early detection of strokes in the brain. MRA of the brain and neck shows narrowing that could lead to stroke. It can also show areas where the blood supply has been interrupted in a patient who has had a stroke.

Musculoskeletal MRI

The wrist, elbow, shoulder, ankle, knee and hips can all be evaluated in great detail using MRI. In addition to assessing the bony structures, MRI provides valuable information concerning the cartilage, ligament, tendons and muscles, known as "soft tissue" structures. Abnormalities such as tears, strains and inflammation can all be assessed effectively with MRI.