MRI of the spine: what happens, how to choose a tomograph, when you need a CT scan, etc.

Various reasons lead us to undergo an MRI examination. Signing up for an MRI of the spine is already a victory over laziness, the usual schedule of life, a victory in favor of your health. But how can you make a visit to the MRI Center as useful as possible, what should you pay attention to so as not to be disappointed in the capabilities of modern diagnostics? How to save money, but not lose the accuracy of your pictures? The MIBS-Moscow website answers. Read and... sign up!

Back pain - what to do? This common complaint can be a symptom of a wide range of diseases, from quite harmless to deadly ones, such as spinal tumors. MRI of the spine is the most universal way to identify the cause of back pain. The examinations are carried out without radiation exposure (magnetic resonance imaging is not an x-ray), without anesthesia, quickly and comfortably.

Which tomograph should I choose for MRI of the spine?

It becomes more and more difficult to make a mistake when choosing an MRI Center in Moscow every year. For the most part, diagnostic centers are already equipped with modern high-field closed (tunnel) tomographs with a field strength of 1.5 Tesla.

PHOTO: Magnetic resonance imaging at MIBS Centers in Moscow is performed on high-field Siemens tomographs

Such devices combine high resolution images, suitable for identifying possible pathologies and injuries of the spine, with the optimal cost of MRI examination. Accordingly, the price of MRI diagnostics is optimal.

But there are also several “traps”. Despite progress, low-field tomographs (magnetic field strength less than 1.5 Tesla), both open and closed, are still represented on the capital market. And, in relation to MRI of the spine, they remain the lot of aggregator companies offering the lowest prices for MRI examinations in Moscow.

Illustration: Low-field tomography can be useful for visualizing large structures, but MRI of the spine using such a machine does not provide sufficient information

The resolution of MRI images of the spine using such equipment is usually insufficient to make an informed medical decision, and instead of saving, patients often have to pay more by undergoing repeated examinations at other MRI centers. But thanks to massive advertising and attractive prices (more precisely, declared impressive discounts - up to 40-60% of the average market cost of a high-quality examination), aggregator companies still receive a significant number of requests from patients. Moreover, MRI of the spine will only be possible for the first time under compulsory medical insurance.

Formatting QUOTE: Be careful not to pay twice!

As for the capabilities of ultra-high-field tomographs (3 Tesla and higher), world practice in the treatment of spinal diseases has shown the redundancy of this parameter. Accordingly, for the treatment of most pathologies and injuries, MRI of the spine performed on 1.5 Tesla tomographs is sufficient, and more expensive studies on an ultra-high-field tomograph are extremely rarely indicated.

Preparation for the procedure

No special preparation is required for MRI of the sacrovertebral region. But before a contrast study, you need to adhere to a rational diet on the day of the procedure. During contrast, a special substance, gadolinium, is injected intravenously into the patient, which improves the visualization of various structures in the MRI image.

When performing tomography with contrast on breastfeeding women, there is a ban on breastfeeding until the substance is removed from the body naturally. This usually takes about 2 days; drinking plenty of liquid helps speed up the process. During this period, it is necessary to express milk to feed the baby.

Some patients have intolerance to the components of the contrast agent. You should inform your doctor about this in advance. The study will be conducted without contrast.

In other cases, it is enough to arrive at the clinic on time and bring with you pictures taken during previous studies, if any. This will help the doctor assess the dynamics of the processes occurring in the lumbar and sacrum areas. In addition, you will have to remove all metal jewelry and clothing with metal elements, such as buttons.

High-quality MRI of the spine is not only a modern tomograph

But technical support is only one component of the accuracy of an MRI examination. The second key link is the preparation of a conclusion describing the identified deviations from the normal state of the spinal structures. The qualifications of a doctor, his experience, the possibility of consultation with colleagues - these are the elements that save health and lives. And they are the focus of the entire international network of MIBS diagnostic centers, two of which operate in Moscow. Even in cases where complaints lead the patient to an MRI of the spine earlier than to an initial consultation with a doctor, the identified changes can suggest a diagnosis and save time on sorting through doctors of different specialties, determining whose jurisdiction the problem is.

How is tomography performed?

The patient lies down on a horizontal platform, which slides into the tomograph tube. During the examination, the device emits a monotonous humming sound, which should be taken calmly. To reduce discomfort, the patient is offered earplugs.

Sometimes the area being examined is fixed with special soft belts or rollers. This is due to the fact that high-quality images can only be obtained if the patient remains motionless.

Throughout the procedure, the doctor remains in the adjacent room. He maintains vocal contact with the patient and observes him through a transparent partition. If pain or serious discomfort occurs, you can inform your doctor at any time.

MRI of the lumbar and sacral regions usually lasts about 20 minutes, with contrast - 35-40 minutes. After completing the procedure, the doctor draws up a conclusion in which he describes in detail the results obtained, the condition of organs and tissues, and the pathologies identified. Along with this document, the patient receives printed images and data on electronic media, for example, on a disk.

What is the difference between CT and MRI of the spine?

The main misconception among patients is related to another type of medical imaging—radiography. Indeed, not so long ago, X-rays were almost the only source of information about the condition of not only bone elements, but also cartilage, nerves, muscles, ligaments, and connective tissue. With the development of medical imaging technologies and their penetration into widespread clinical practice, it has become possible to visualize nerves, ligaments, and cartilage without exposure to harmful ionizing radiation - MRI of the spine.

And the use of X-ray radiation appeared in the form of computed tomography (CT), the task of which is to accurately visualize the dense structures of the spine - bone and cartilage tissue.

Given the serious impact that X-ray radiation has on the body, especially in children, the appointment of a CT scan should be for good reasons. Whereas MRI of the spine can even be the first stage of seeking medical help, with virtually no contraindications due to the patient’s age and condition.

In modern practice, the capabilities of CT and MRI complement each other so much that in high-tech treatment, for example, proton therapy and radiosurgery of spinal tumors, performed in medical centers that are part of the Sergey Berezin Medical Institute (MIBS), fusion of image arrays is used - “fusion” ”, which significantly increases the information content for the attending physician and is the basis for planning non-contact robotic treatment.

Does it make sense to examine all parts of the spine?

There is no clear answer to this question. But there are often cases when the doctor needs to diagnose two or more parts of the spine within which the symptoms are localized (for example, MRI of the lumbosacral spine and MRI of the coccyx), or parts of the spinal column and the adjacent area (MRI of the craniovertebral junction, MRI of the sacroiliac joints). A complete examination of the spine (cervical, thoracic, lumbar, sacral, coccyx) lasts more than an hour.

What is examined using MRI of the lumbosacral region?

The lumbar region is inferior in mobility to the cervical region, so it takes on a greater load. In this regard, patients more often present with pain in the lower back than in any other part of the spine.

MRI of the sacrolumbar region is used to examine:

birth defects or developmental disorders;
causes of chronic pain;
condition of the vertebrae for the presence of bends, hernias, degenerative changes;
injuries and their consequences for bones, ligaments, circulatory system, blood vessels, nerve endings;
infectious lesions of the intervertebral discs and spinal cord in the lower back;
tumors;
abscesses;
changes in the shape and structure of bones, muscles and ligaments.

MRI is used for accurate diagnosis of diseases such as:

multiple sclerosis;
Bekhterev's disease;
osteoporosis;
malignant tumors of the spine;
intervertebral hernia;
kyphosis;
scoliosis;
radiculitis;
Scheuermann-Mau disease;
sciatica;
lumbodynia;
stenosis

Which doctors will need MRI images of the spine?

Considering the impact of the condition of the spine on the functioning of the entire body, MRI examinations are prescribed by doctors of different specialties: a neurologist, neurosurgeon, oncologist, cardiologist, rehabilitation specialist and even a therapist in many cases will rely on data from magnetic resonance imaging of the spine. Are you worried about headaches, dizziness, limbs that “don’t obey” or go numb, or the functioning of the heart and other internal organs is disrupted? Perhaps MRI of the spine will provide an answer about the cause of the disorders and possible directions for their elimination.

What determines the cost of an MRI of the spine?

Definitely, the price of MRI of the spine on a low-field tomograph is lower due to differences in technology, which explains the higher acquisition cost and maintenance cost of high-field tomographs (from 1.5 Tesla). But such savings are savings on the accuracy of the survey. In addition, an MRI of the spine on a low-field tomograph lasts about half an hour, which is twice as long as a tomography of the same volume on a high-quality 1.5 Tesla tomograph. Accordingly, the risk of patient movements causing blur in some images is twice as high.

With comparable technological support and qualifications of specialists (for example, MIBS radiologists who prepare reports for images regularly undergo full-time and distance learning and advanced training, including specific studies and features of “narrow” pathologies, such as identifying neurological pathologies or tumors), there are differences The cost of MRI of the spine may be determined by the following factors:

scope of the survey (number of departments studied);
justified need for administering a contrast agent (to identify inflammatory processes and tumors of the spine)

Saving on the administration of a contrast agent or the number of spine sections studied is the most “slippery issue” in the practice of MRI centers in Moscow. In particular, focusing on the rich experience and constantly improving system in the network of MIBS diagnostic centers for the quality of examinations, a significant part of patients choose us to undergo magnetic resonance imaging under compulsory medical insurance. However, insurance only covers MRIs of the spine without contrast within one anatomical area (compartment). But, for example, a suspicion of a tumor located at the border of two parts of the spine requires an MRI of two zones with contrast.

Illustration: Visual difference in the information content of MRI of the spine without contrast (left) and with contrast (right). The introduction of a contrast agent made it possible to determine the presence of XXX and promptly begin treatment

Regardless of the patient’s choice, doctors at MIBS centers in Moscow will provide the most informative conclusion available in the selected examination mode.

Indications for MRI of the lumbosacral region

An MRI of the lumbar spine can be ordered by a doctor or done independently.

Indications for the procedure will be:

pain in the lumbar region;
numbness of the lower extremities;
numbness in the groin area.

The main task of diagnosis is to determine the presence of:

hernia;
degenerative-dystrophic diseases of the spine and intervertebral disc;
complications after injuries;
inflammation;
structural anomalies;
malignant and benign neoplasms.

Diagnostics can be recommended by a radiologist if pathologies of the thoracic region, abdominal organs and pelvis are suspected.

How to save on MRI of the spine without losing the information content of the examination?

But, as promised in the title of the page, there are some “secrets”, knowledge of which will allow you to significantly reduce the cost of MRI of the spine and any other parts of the body without reducing the accuracy of the examination.

First of all, these are special price offers with the help of which diagnostic center managers optimize equipment utilization. It should be emphasized that when we mention discounts on MRI, we are not talking about “virtual” discounts, with which less technological examinations are offered on low-field tomographs, and not about discounts from “MRI factories”, where tomography is carried out, although with good equipment, but with an increased step ( distance between slices) and preparing a conclusion within 10-15 minutes, during which it is difficult to even briefly view the entire array of images.

We are talking about discounts on professional studies that allow you to attract patients during a decrease in activity on weekends, holidays and at night. For example, at the MIBS-Moscow MRI Centers there are regularly discounts from 5 to 15%, which subscribers of our account on Instagram and other social networks will find out about (icons at the bottom of the page). In addition, we provide special conditions for certain social groups.

Therefore, if you, like many thousands of patients, are already ready to choose the quality of diagnostics at MIBS centers in Moscow, but prefer to wait for a special price offer, subscribe to our groups. Or simply call us to find out how to undergo a high-quality MRI of the spine with maximum comfort for your own budget.

Analysis of contraindications

MRI is not performed on patients if:

pacemaker;
Ilizarov apparatus (made of ferromagnetic metal);
insulin pump;
metal hemostatic clips;
middle ear prostheses, etc.

Relative restrictions are those that require correction of the power of the device or rescheduling of the procedure. Their presence does not mean inevitable potential harm to the body. MRI is performed for health reasons and with some special features in the following cases:

During pregnancy. It is not advisable to undergo the procedure in the first trimester due to the lack of evidence of its safety for the fetus. If we are not talking about acute life-threatening conditions, the study is postponed to a later date. MRI with contrast is not performed on pregnant women.
Childhood. MRI scanning is difficult in the case of babies. The quality of the images depends on the patient’s ability to remain completely still throughout the procedure, which takes 15-40 minutes. The child will not be able to remain calm during this time. According to vital indications, MRI in childhood is performed under anesthesia. Our Magnit center is licensed to provide diagnostic assistance to young patients, including contrast contrast, but we only accept children from 5 years of age (from 12, if an MRI with an indicator is required).
Metal implants. If there are structures made of ferromagnetic alloys outside the study area, scanning admission is determined individually. If an implant (plate or pin) is installed in the skull, it is necessary to determine the type of metal. The Magnit diagnostic clinic will need to provide a document confirming that the product is made of titanium. The certificate can be obtained from the institution where the operation was performed.
Claustrophobia. In the confined space of a tomograph, some people may experience panic, which will negatively affect both the patient’s condition and the results of the study. If other diagnostic procedures are uninformative, MRI of the brain is performed using open-type devices or under anesthesia.
Inability to remain still during the study. This problem is observed in people with hyperkinesis and other neurological disorders. MRI in such cases can be performed under sedation in a hospital setting.
Excess body weight. If the patient's weight exceeds that allowed for the transporter of conventional machines, MRI can be performed on an open-type structure.

MRI of blood vessels and brain