MRI is a superior diagnostic test for assessing almost all soft tissue disease processes. MRI allows for the detection of increased water molecules in pathologic disease processes which are secondary to inflammation, infection or neoplasia. Disease processes often diagnosed include (but are not limited to):
• Spinal disease – disc disease, lumbosacral instability, neoplasia, fibrocartilaginous emboli, myelitis, meningitis, congenital anomalies, syringohydromyelia
• Brain – neoplasia, hydrocephaly, infarcts, intracranial trauma, meningoencephalitis, congential disease (caudal occipital malformation syndrome, cysts), metabolic disease processes, neuritis
• Head- external, middle and inner ear disease, retrobulbar masses, neoplasia
• Nasal cavity – rhinitis, neoplasia, sinus disease, extension of nasal tumors into the brain
• Oral cavity - neoplasia (tumor extent), some dental disease processes
• Thorax and abdomen – occasionally performed to assess tumor extent/site of origination of a tumor (may need a special study to eliminate breathing and cardiac motion artifact)
• Musculoskeletal – tendinitis, neoplasia (primary and metastatic disease), neuritis
• Vascular – angiography (MRA) to diagnose portosystemic shunts and AV malformations
Considerations:
It is essential that all patients are under general anesthesia, which is well monitored. Lack of motion artifact is essential for obtaining high resolution and diagnostic. Most MRI examinations will take approximately 1-1.5 hours. For proper monitoring of the patient, an MRI safe anesthesia machine, MRI safe ECG machine and a technician/doctor to monitor anesthesia is not only ideal but is essential in many high risk patients (ex: a patient with a brain tumor and secondary increased CSF pressure). General anesthesia also allows for the assessment of early/impending cerebellar herniation prior to a high risk procedures such as a CSF tap at the cisterna magna. Additionally, as with all cross-sectional imaging tests, it is absolutely essential that the patient is perfectly straight. This will allow for assessment of asymmetry in aiding in the diagnosis of many disease processes, especially those which are subtle, focal or small in size (such as neuritis).
How to refer to a case for MRI:
• Please call our office to schedule an MRI; discussion of the case with Dr. Sage is required prior to scheduling the MRI to ensure the best possible study, call to discuss any questions with Dr. Sage!
• MRIs are performed in the evening and all patients board overnight at SOVSC. The owner should drop the fasted patient off by 2pm the day of the MRI. The patient can be picked up the follow morning. Weekend appointments may be available, as well.
• MRI studies will be performed by Dr. Sage and a report will be faxed to your office the following morning. Dr. Sage can call you immediately after the procedure with preliminary results, if requested.
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