NSI FAQ

By NeuroSkeletal Imaging // May 21, 2012

Frequent Asked Questions About:

• MRI , please click here

• CT , please click here

• Ultrasounds , please click here

• X-Ray , please click here

The MRI examination

You will be asked to lie on your back on a comfortable scanning table. Some examinations require an intravenous injection of a small amount of Gadolinium – a substance that improves the visualization of some structures and is necessary to demonstrate some diseases or conditions (especially for some brain and abdominal exams, and for MRA). This substance almost never causes side effects, and is quickly excreted by the kidneys. A “surface coil” may be placed on or around the part of your body to be imaged, such as the head, knee or shoulder. Since the large magnet and rapidly changing magnetic field produces a loud noise at times during the exam, you will also be offered ear plugs. Most exams take anywhere from 15 to 45 minutes to complete.

Prior to your going in to the exam room, a staff member will interview you and will explain what will happen during your test. A technologist will stay in constant contact with you throughout the exam.

What is MRI?

MRI is “magnetic resonance imaging.” MRI uses a large magnet, radio waves and a powerful computer to produce cross-sectional images of the body. No X-rays or other ionizing radiation is employed.

What forms can I fill out prior to my examination?

– MRI Safety Checklist

– HIPAA/Authorization to Release or Obtain Information

– Patient Questionnaire

– Patient Breast History

– Arthrogram Consent

How does MRI work?

To understand how an MRI works, let’s start by focusing on the “magnetic” in an MRI. The major and most important component in an MRI system is the magnet. The magnet in an MRI system is rated using a unit of measure known as a tesla. MRI provides an magnificent view inside the human body.

A large magnet surrounding the body causes the hydrogen nuclei (protons) in water molecules to align in a particular direction, and then radio waves strike the protons, causing them to spin out of alignment. When the radio signal is turned off, the protons return to their previous alignment, giving off new radio waves at the same time. The returning radio signals are received and analyzed by a computer, which then creates cross-sectional images of the body.

When is MRI used?

Like CT, MRI can be used to image almost any part of the body, although MRI produces pictures containing information that may not be seen on a CT scan. For some things, MRI is more useful than CT, and for some things CT is more useful. Sometimes, both are necessary, since the information gained from one may complement or clarify information gained from the other. MRI is often used for the following:

Brain and nervous system: MRI is the most accurate tool for evaluating most diseases of the brain and spinal cord, including strokes, tumors, and multiple sclerosis.

Musculoskeletal system: MRI is the most accurate way to non-invasively image most joints (knees, shoulders, wrists, etc) for problems involving cartilage, ligaments, tendons and muscles.

Breast: with our new EXCITE technology upgrade come H.D. VIBRANT (Volume Imaging for Breast AssessmeNT). We can now simultaneously examine both breasts in high resolution in a single patient visit.

Other: MRI can also be useful for evaluating the neck, liver, kidneys, pelvic organs, blood vessels, and lymph nodes.

What is MRA?

MRA is “magnetic resonance angiography”. Using special techniques, MRI can be employed to produce highly detailed images of many arteries and veins, without the need to insert catheters into the body or inject iodinated contrast agents. The pictures obtained look much like a conventional angiogram, but are obtained non-invasively.

Preparing for an MRI

Not everyone can be safely exposed to a magnetic field, so if any of the following apply to you, you should let us know before making an appointment:

Cardiac pacemaker
History or possibility of a metal fragment in your eye, even if it has been removed
Aneurysm clip in the brain
Ear or eye implant
Nerve stimulator
Drug infusapump
Recent surgery (less than 8 weeks ago)
Any other procedure where medical personnel might have left a stent, coil, filter, wire, or any other implantable device inside your body.

When can my physician expect a copy of my report?

In most cases, reports are provided within 24 hours.

CT SCAN OR CAT SCAN

The CT scan procedure

With the latest multidetector CT scanners, most examinations take less than 10-15 minutes. You will be asked to lie on a comfortable table, which will slide into the opening of the machine, and you will move through the opening as your body is being scanned. If intravenous contrast material is required for your exam, a temporary IV will be started in your arm by a technologist. For abdominal scans you will also be asked to drink a dilute barium solution, beginning approximately two hours before the procedure.

What is CT or CAT scan?

CT stands for “computed tomography,” taken from the Greek word “tomos” meaning “to cut” or “to slice”. CT uses ordinary X-rays coupled with special detectors and a powerful computer, to create images which appear as sections or slices of the body.

What forms can I fill out prior to my examination?

– CT Scanning Patient History

– Contrast Consent Form

– HIPAA/Authorization to Release or Obtain Information

– Patient Questionnaire

– CT Guided Aspiration

– Arthrogram Consent

Are there different kinds of CT scanners?

The earliest CT scanners required as long as two minutes to produce a single, very blurry section of the body. The very newest ones can produce multiple, highly-detailed sections in less than one second. Early CT scanners were able to “slice” the body in only one direction, while newer ones, called “helical” CT scanners, can “slice” the body in many different ways, and can even produce three dimensional images. In CT technology, “multidetector” scanners can produce even more detailed 2-D and 3-D images than were ever before possible, and in much less time. The increased speed of these newer machines often allows for a significant reduction in the amount of intravenous contrast material required for an exam (see below for more about contrast material).

When is CT used?

CT scanners can be used to evaluate almost any part of the body for a variety of different problems. Some examples are:

Head & Neck: CT can be used to evaluate the brain for strokes, headaches, or injury. It can also be used to evaluate the sinuses, facial bones and structures of the neck.

Chest: CT is excellent for evaluating the lungs for infection, emphysema, tumors and other conditions.

Abdomen & Pelvis: CT is extremely useful for visualizing all organs of the abdomen and pelvis, and is often performed to evaluate the possibility of appendicitis, diverticulitis, kidney disease, liver or gall bladder disease, etc.

Spine: CT is very helpful in evaluation of spinal fractures, and can also be used to evaluate disc herniations and other causes of neck and back pain.

Blood vessels: A type of CT scan can be performed for visualization of arteries or veins; it is called CT Angiography (CTA). The latest multidetector CT scanners produce the most accurate CTA examinations.

What is contrast material?

Intravenous contrast material is an organic compound containing Iodine, which greatly improves the visualization of blood vessels and many organs on a CT scan. IV contrast material is not usually required for spinal exams, but is often necessary for proper evaluation of the head, chest, abdomen and pelvis. (If you are diabetic and taking Glucophage (metformin), Glucovance, Riomet, Metaglip or Advandamet and have been scheduled for a CT scan, please phone for special; instructions.) Orally administered contrast material (a dilute barium solution) is usually necessary for CT scans of the abdomen and pelvis, where it aids in visualization of the gastrointestinal tract.

How do I prepare for a CT scan?

If your examination requires intravenous contrast material, you will be asked to drink 4-6 cups of clear liquid (fruit juice, soda, coffee, water) beginning 4 hours before your exam. You may take regular medications, but eat no solid food during that time. For examinations of the abdomen and pelvis, you will also need to drink a dilute barium solution (oral contrast material) beginning 3 hours prior to your exam. (You can stop by our office anytime before your appointment, to pick up this solution.)

Is CT scanning a safe procedure?

CT scanning uses X-rays, and the amount of radiation exposure is similar to that of many ordinary X-ray examinations. The risk from this amount of radiation is minimal for most people, but can be more for a fetus. CT scanning is therefore not usually performed on pregnant women, unless absolutely necessary. Intravenous contrast material can cause allergic reactions in some people. These reactions are usually minor (such as a temporary skin rash or hives) and require little or no treatment; more serious reactions are very rare.

When can my physician expect a copy of my report ?

In most cases, reports are provided within 24 hours.

ULTRASOUND

The Ultrasound examination

The procedure is painless. You will lie on a comfortable exam table, while the sonographer moves a transducer over your skin. A gel-like substance is applied to the skin, to allow the sound waves to pass through more easily. For some exams of the female pelvis it may be necessary to place a transducer into the vagina, but this is not uncomfortable for most women.

What is Ultrasound?

Diagnostic Ultrasound is the use of high-frequency sound waves to study the anatomy and function of the body. The sound waves can be used to produce images of various organs, to observe motion within organs, or to measure the flow of blood using a specialized method called Doppler Ultrasound.

What forms can I fill out prior to my examination?

– HIPAA/Authorization to Release or Obtain Information

– Patient Questionnaire

How does Ultrasound work?

A small, hand-held device, called a transducer, is used to send sound waves into the body, and to receive returning signals. The information returning to the transducer is sent to a computer, which reconstructs cross-sectional images of the body – similar in concept to sonar or radar.

When is Ultrasound used?

Because Ultrasound is non-invasive, painless, and does not use ionizing radiation, it is an extremely valuable way to evaluate many parts of the body – including the pregnant uterus, pelvic organs, kidneys, gallbladder, liver, thyroid, breasts and testicles. Doppler Ultrasound is used to evaluate the heart, as well as blood vessels such as the carotid arteries and veins of the legs.

Preparing for an Ultrasound exam

There are different preparations for different kinds of exams.

Pregnancy, pelvic, and bladder sonogram: Start drinking five (5) 8oz.glasses of non-carbonated water or clear liquid 1 ½ hours before your appointment. (Finish drinking within one hour.) Do not empty your bladder until the exam is completed.

Abdomen, gallbladder, liver and kidney sonograms: No solid foods for eight (8) hours prior to your exam. You may have clear, non-carbonated liquids (including jello) and you may take your usual medications.

Why do some exams require me to have a full bladder?

A full bladder acts as a “window” in an otherwise solid “wall,” the abdomen/pelvis. This enables us to look through the window to what lies behind it, including the uterus and ovaries

When can my physician expect a copy of my report?

In most cases, reports are provided within 24 hours.

X-RAY

What is X-Ray?

A beam of X-rays can be produced by bombarding a tungsten target with a stream of electrons, inside an X-ray tube. The X-ray beam can penetrate through the body, exposing a sheet of photographic film which records the image cast upon the film by the differing absorption of portions of the beam, by tissues of varying density within the body. For example, the lungs are easily seen because they contain air, allow most of the X-ray beam to pass through, and appear dark on the film. Bones are clearly seen for the opposite reason: they absorb most of the X-ray beam that strikes them, and appear white on X-ray films.

What forms can I fill out prior to my examination?

– HIPAA/Authorization to Release or Obtain Information

– Patient Questionnaire

Are X-rays dangerous?

Exposure to any radiation is potentially hazardous, although the amount used for diagnostic examinations is extremely small – similar to the amount of radiation we receive each month or year from natural sources. Diagnostic X-rays are requested by your physician and performed by us, only when the potential benefit to you far outweighs any potential harm.

How are X-Rays used?

X-ray films are very useful for examining the lungs and bones (including the spine) and can also be used for evaluation of the skull, sinuses, abdomen, and all other bones throughout the body.

What happens during an X-ray examination?

Because X-rays are a form of ionizing radiation, women will be asked for a menstrual history, to determine if there is any possibility of pregnancy. For X-rays of the chest or abdomen you will be asked to put on a gown that has no metal snaps or zippers. The examination may be performed while you are standing (chest X-ray), sitting (hand), or lying on an examination table (abdomen).

When can my physician expect a copy of my report

In most cases, reports are provided within 24 hours.