MRI - examination of the spine
introduction
Magnetic resonance tomography is an imaging examination method in medicine in which - in this case of the back or the spine - sectional images can be generated in longitudinal and / or cross-sectional views.
A very strong magnetic field is used for this and not, as with X-ray or computer tomography, stressful X-rays.
The images are based on the fact that certain atomic nuclei in the body (preferably hydrogen or protons) are excited by the magnetic field, so that the MRT receiver device registers an electrical signal and converts it into an image.
indication
The MRI examination of the back is always indicated when the doctor's attention is particularly focused on the soft tissue in the context of spinal problems, such as the Back muscles, the Spinal cord and the Spinal nerves as well as the Band washers.
Accordingly, MRI imaging is preferred for questions about Herniated discs or bulges, inflammatory processes in the intervertebral discs / back muscles / spinal cord nerves / vertebral bodies or the spinal cord, injuries to the spinal cord / spinal cord nerves, constrictions in the spinal canal (Spinal stenosis), Circulatory disorders or after Tumors or metastases to the spinal cord / spine.
Also Scar tissue (for example after operations) can be shown particularly well with the help of an MRT examination.
Fractures in the spine or the Vertebral bodies can also be recognized in the MRI, but due to the better representation in the context of this question, it is more likely that CT preferred as an imaging method.
Procedure and implementation
Due to the strong magnetic force field that is generated during an MRI examination, it is important before starting the procedure to put down all metallic objects (Jewelry, watches, hair clips, piercings, belts, etc.), as these could otherwise be attracted by the magnetic field and therefore indicate the potential for injury and / or damage.
Also implanted in the body Pacemaker can be damaged in the course of an MRI examination and lead to a possibly life-threatening failure, which is why it is all the more important to mention this before the procedure (it may not be possible to perform an MRI).
The patient to be examined initially lies supine on a mobile or movable couch in front of the MRT tube.
If the patient suffers from severe pain, so that it will be difficult for him to lie still during the entire examination period, a Painkiller administered.
In case of a necessary Administration of contrast medium During the examination, an indwelling cannula is also placed in the arm vein in the crook of the elbow, through which this can be administered later.
Before the examination begins, the patient also receives one Bell in handwith which he himself during the investigation in the MRI tube in case of problems or complaints to make noticable can.
Once all the preparations have been made, the patient is pushed into the MRI tube on the movable couch, in which he or she is taking pictures of the back usually around 20 minutes, breathing as motionlessly and calmly as possible must linger in order to be able to achieve good image quality.
Because the MRI tube is very narrow, it can in some cases lead to discomfort Claustrophobia come, which is why it may be necessary to additionally give a sedative beforehand.
In addition, loud knocking noises are generated during the examination, which are generated by the MRI machine, so that usually Earplugs or headphones (possibly with music) as noise protection or as a distraction.
Undress / clothes
The affected patients do not have to completely undress during an MRI scan.
It is important that all items of clothing that (could) have metallic components are removed. This usually includes the bra (underwire) and pants, but also all other items of clothing that are provided with buttons and / or zippers.
Contrast media
A Contrast media During an MRI scan of the back is always necessary when similarly dense body tissues are to be more clearly delimited from one another and better distinguished from one another in the imaging (e.g. Blood vessels and muscles).
Contrast media that are used in an MRT examination usually have an indirect effect, as they change (usually amplify) the signals in the MRT image.
Thus, among other things, they can be used to better represent pathological processes that often behave differently than the surrounding, healthy tissue.
In addition, they can also be used as part of the control be useful for the course of a disease or therapy.
The contrast media are usually administered via the vein During the MRT examination, so that the agent is distributed over the body's blood system and, as a result, processes or tissue with particularly good blood flow are shown more clearly (with more signal).
Contrast media are primarily used for an MRI scan of the back Gadovist® (Gadobuterol) for the Spine illustration and Dotarem® (gadoteric acid) for the Spinal cord imaging are used, both based on the chemical element gadolinium. The areas that are reached by the gadolinium-containing contrast media appear lighter in the imaging.
The contrast media are excreted via the kidney or the urine.
The contrast media used in the MRI examination are usually well tolerated, so that hardly any side effects are known. Occasionally skin irritation at the injection site, a tingling sensation, a headache and feeling uncomfortable or feeling warm or cold during contrast administration.
However, gadolinium-containing contrast media are used in patients who have severely impaired Renal dysfunction suffer from the rare disease called "Nephrogenic systemic fibrosis“(NSF). This is a potentially life-threatening, systemic disease in which there is a pathological increase in connective tissue in the skin, the Musculature and in internal organs, like lung, heart, liver and diaphragm comes.
Risks
In contrast to other imaging procedures with the use of X-rays - no risks. Since only magnetic fields are used to generate images of the interior of the body, no radiation damage occurs.
The contrast agent that may be used also does not contain iodine, so that there are no serious side effects, such as one thyrotoxic crisis in patients with a Hyperthyroidism are to be feared. Also one allergic reaction the contrast agent used is rarely known.
Occasionally, mild symptoms such as skin irritation at the injection site, a tingling sensation, a headache and feeling unwell or feeling warm or cold during contrast administration.
Furthermore, no harmful consequences of an MRI examination in unborn babies are known, so that it is an important, possible imaging during pregnancy. Nevertheless, the indication should always be carefully made beforehand.
The only danger posed by a magnetic resonance tomography machine are metallic objects (e.g. coins, keys, hair clips, implants in the body, etc.), which can be attracted by the magnetic field generated and thus lead to injuries or damage to the patient and the device (Warning: the magnetic field can lead to implanted, vital cardiac pacemakers being rendered inoperable by patients).
costs
What a cost MRI examination of the back depends primarily on what and how much of the back or the spine is to be represented: the Spine and thus also the imaging in the MRI in the Cervical spine-, Thoracic spine- and Lumbar spine area (Cervical spine, ESPE, Lumbar spine), in some cases the representation of the shoulder area can also be counted as part of a back imaging.
Depending on the question and the symptoms of the patient concerned, individual sections can be displayed by means of an MRI examination.
If imaging of the entire back (i.e. all parts of the spine) is necessary, individual examinations of the various parts of the spine are usually carried out in order to achieve better image quality (a general overview of the spine is still possible with a lower detail resolution).
Accordingly, the costs are set for Back MRI from the costs for the individual examination of the cervical spine, thoracic spine, lumbar spine and possibly the shoulder area together.
In general, the costs differ between private patients / self-payers and those with statutory health insurance.
Additional costs, on top of the pure MRI costs, can possibly through a consultation prior to the examination, through necessary Contrast agent was givene or additional images are created in special layers / special layers.
Overview of the pure MRI costs
- Cervical spine / thoracic spine / lumbar spine each: private patients at least € 244.81, max. € 612.02
- Statutory health insurance patients € 124.60
- Shoulder: private patients at least € 139.89, max. € 349.72
- Statutory health insurance patients € 124.60
(Remuneration of private patients according to the GOÄ; the statutory health insurance patients according to the EBM). Additional costs arise from the creation of additional layers, computer-technical reconstructions, contrast media, the use of materials and diagnosis by the radiologist.
Costs for an MRT examination, which the patient requests himself and which is not considered necessary and requested by a doctor, is not covered by the health insurance.
You can also find extensive information under our topic: Cost of the MRI examination.
