Magnetic Resonance Imaging (MRI) of the Spine

Test Overview

Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to make pictures of the spine. In many cases MRI gives different information about structures in the body than can be seen with an X-ray, ultrasound, or computed tomography (CT) scan. MRI also may show problems that cannot be seen with other imaging methods.

For an MRI test, your body is placed inside a special machine that contains a strong magnet. Pictures from an MRI scan are digital images that can be saved and stored on a computer for further study. The images also can be reviewed remotely, such as in a clinic or an operating room. In some cases, a contrast material may be used during the MRI scan to show certain structures more clearly.

The MRI can find changes from the normal in the spine and in other tissues. It also can find problems such as infection or a tumor. MRI can look at the spine in the neck (cervical spine), upper back (thoracic spine), or lower back (lumbosacral spine). The entire spine can be seen in one series of pictures to find a tumor. More detailed pictures of one area may be taken. See MRI pictures of the lumbar spine .

MRI may be used to check low back problems. For more information, see:

Should I have a magnetic resonance imaging (MRI) scan for low back pain?

See pictures of a standard MRI machine and an open MRI machine .

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	Should I have magnetic resonance imaging (MRI) for low back pain?

Why It Is Done

Magnetic resonance imaging (MRI) of the spine is done to:

• Find problems of the spinal discs, such as a ruptured disc. The test may also show if a disc is pressing on a nerve, causing symptoms such as sciatica.
• Find areas of the spine where the canal is abnormally narrowed (spinal stenosis) and may need surgery.
• Find tumors affecting the bones or nerves of the spine. The tumors that most commonly spread to the spine include those from prostate, breast, or lung cancer.
• Check areas of joint inflammation (arthritis) or bone loss found during an X-ray test or a bone scan.
• Find areas of the spine that do not have good blood supply.
• Find an infection.
• Find nerve damage caused by injury or disease, such as multiple sclerosis.
• Check problems of the spine that have been present since birth (congenital).

An MRI may be done using contrast material to see abnormal tissue more clearly. The contrast material also may help distinguish between old surgical scars and a new disease or injury.

How To Prepare

Before the MRI test, tell your health professional and the MRI technologist if you:

• Are allergic to any medicines. The contrast material used for MRI does not contain iodine. If you have a known allergy to the contrast material used for MRI, tell your health professional before having the test. Sometimes the benefits of having this test may outweigh the risks.
• Are or might be pregnant.
• Have a pacemaker, artificial limb, any metal pins or metal parts in your body (especially in the eyes), metal heart valves, metal clips in your brain, metal implants in your ear, tattooed eyeliner, or any other implanted or prosthetic medical device (such as a medicine infusion pump).
• Have had an accident or work around metal. This increases the possibility that you have metal fragments in your head, eyes, skin, or spine. An X-ray may be taken first, to see if you can have the MRI test.
• Had recent surgery on a blood vessel. In some cases, you may not be able to have the MRI test.
• Have an intrauterine device (IUD) in place. An IUD may prevent you from having the MRI test done.
• Become very nervous in confined spaces. You need to lie very still inside the MRI magnet, so you may need to have the test done with open MRI equipment. It is not as confining as standard MRI machines. You may need medicine to help you relax.
• Have any other health conditions, such as kidney problems or sickle cell anemia, that may prevent you from having an MRI using contrast material.
• Wear any medication patches. The MRI may cause a burn at the patch site.

You may need to sign a consent form that says you understand the risks of an MRI and agree to have the test done. Talk to your health professional about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will indicate. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?) .

You may need to arrange for someone to drive you home after the test, if you are given a medicine (sedative) to help you relax.

How It Is Done

A magnetic resonance imaging (MRI) test is usually done by an MRI technologist. The pictures are usually interpreted by a radiologist. But some other types of doctors can also interpret an MRI scan.

You will need to remove all metal objects (such as hearing aids, dentures, jewelry, watches, and bobby pins) from your body, because these objects may be attracted to the powerful magnet used for the test.

You will need to take off all or most of your clothes, depending on which area is examined (you may be allowed to keep on your underwear if it is not in the way). You will be given a gown to use during the test. If you are allowed to keep some of your clothes on, you should empty your pockets of any coins and cards (such as credit cards or ATM cards) with scanner strips on them, because the MRI magnet may erase the information on the cards.

During the test you will lie on your back on a table that is part of the MRI scanner. Your head, chest, and arms may be held with straps to help you remain still. The table will slide into the space that contains the magnet. A device called a coil may be placed over or wrapped around the area to be scanned. A special belt strap may be used to sense your breathing or heartbeat. This triggers the machine to take the scan at the right time.

You may wear cloth straps (harness) that can be pulled during the test to see how your spine moves in response to tension or weight.

Some people feel nervous (claustrophobic) inside the MRI magnet. If this keeps you from lying still, you can be given a medicine (sedative) to help you relax. Some MRI machines (called open MRI) are now made so that the magnet does not enclose your entire body. Open MRI machines may be helpful if you are claustrophobic, but are not available everywhere. The pictures from an open MRI may not be as good as those from a standard MRI machine. See pictures of a standard MRI machine and an open MRI machine .

Inside the scanner you will hear a fan and feel air moving. You may also hear tapping or snapping noises as the MRI scans are taken. You may be given earplugs or headphones with music to reduce the noise. It is very important to hold completely still while the scan is being done. You may be asked to hold your breath for short periods of time.

During the test, you may be alone in the scanner room. But the technologist will watch you through a window. You will be able to talk with the technologist through a two-way intercom.

If contrast material is needed, the technologist will inject it, usually through an intravenous (IV) line in your arm. The material may be given over 1 to 2 minutes. Then more MRI scans are done.

An MRI test usually takes 30 to 60 minutes but can take as long as 2 hours.

How It Feels

You won't have pain from the magnetic field or radio waves used for the MRI test. The table you lie on may feel hard, and the room may be cool. You may be tired or sore from lying in one position for a long time.

If contrast material is used, you may feel some coolness and flushing as it is injected into your IV.

In rare cases, you may feel:

• A tingling feeling in the mouth if you have metal dental fillings.
• Warmth in the area being examined. This is normal. Tell the technologist if you have nausea, vomiting, headache, dizziness, pain, burning, or breathing problems.

Risks

There are no known harmful effects from the strong magnetic field used for MRI. But the magnet is very powerful. The magnet may affect pacemakers, artificial limbs, and other medical devices that contain iron. The magnet will stop a watch that is close to the magnet. Any loose metal object has the risk of causing damage or injury if it gets pulled toward the strong magnet.

Metal parts in the eyes can damage the retina. If you may have metal fragments in the eye, an X-ray of the eyes may be done before the MRI. If metal is found, the MRI will not be done.

Iron pigments in tattoos or tattooed eyeliner can cause skin or eye irritation.

There is a slight risk of an allergic reaction if contrast material is used during the MRI. But most reactions are mild and can be treated using medicine. There also is a slight risk of an infection at the IV site.

Results

Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to make pictures of the spine.

The radiologist may discuss initial results of the MRI with you right after the test. Complete results are usually ready for your health professional in 1 to 2 days.

An MRI scan can sometimes find a problem in a tissue or organ, even when the size and shape of the tissue or organ looks normal.

What Affects the Test

Factors that can interfere with your test or the accuracy of the results include:

• Pregnancy. An MRI test usually is not done during pregnancy.
• Medical devices that use electronics, such as a pacemaker or medication infusion pump. The MRI magnet may cause problems with these devices, and that may keep you from having an MRI.
• Medical devices that have metal in them. The metal might make some of the detailed MRI pictures blurry. This may prevent your doctor from seeing the organ that is being looked at. For example, any metal in your spine may prevent your doctor from seeing it clearly.
• Inability to remain still during the test.
• Obesity. A person who is very overweight may not fit into standard MRI machines.

Many modern medical devices that do not use electronics-such as heart valves, stents, or clips-can be safely placed in most MRI machines. But some newer MRI machines have stronger magnets. The safety of MRI scans with these stronger MRI magnets in people with medical devices is not known.

What To Think About

• Sometimes your MRI test results may be different from the results of CT, ultrasound, or X-ray tests, because the MRI scan shows tissue differently.
• Magnetic resonance imaging (MRI) of the spine can often be used instead of other tests that use X-rays, such as a computed tomography (CT) scan or myelography.
• MRI is a safe test for looking at structures and organs inside the body. It costs more than other methods and may not be available in your area.
• Open MRI machines are now made so that the magnet does not completely surround you. But these machines may not be available in all medical centers. Open MRI is useful for people who are claustrophobic or obese.
• Contrast material that contains gadolinium may cause a serious skin problem (called nephrogenic fibrosing dermopathy) in people with kidney failure. Before having an MRI scan, tell your doctor if you have serious kidney disease.

References

Other Works Consulted

• Chernecky CC, Berger BJ, eds. (2004). Laboratory Tests and Diagnostic Procedures, 4th ed. Philadelphia: Saunders.

• Fischbach FT, Dunning MB III, eds. (2004). Manual of Laboratory and Diagnostic Tests, 7th ed. Philadelphia: Lippincott Williams and Wilkins.

• Pagana KD, Pagana TJ (2006). Mosby's Manual of Diagnostic and Laboratory Tests, 3rd ed. St. Louis: Mosby.

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