MRI scan

• Cardiac MRI (CMR)
• Foetal MR
• MR Mammography
• MR enteroclysis
• Functional imaging of the central nervous system (fMRI)
• Magnetic Resonance Spectroscopy (MRS) examinations
• Diffusion tensor imaging (with tractography)

• Head MRI
• MRI of the pituitary gland
• MR of the cerebellopontine angles
• MRI of the eye sockets
• MRI of the craniofacial region/paranasal sinuses
• MR of the nasopharynx
• MRI of the neck
• MRI of the brachial plexus
• MRI of the mediastinum/chest
• Cardiac MRI
• MRI of the spinal canal and spinal cord in the cervical (C) region
• MRI of the spinal canal and spinal cord in the thoracic (Th) region
• MRI of the spinal canal and spinal cord in the lumbosacral (L-S) region
• Bone MRI
• MRI of the joints: knee, shoulder, ankle, elbow, wrist and others
• MRI of the lower pelvis
• MRI of the abdominal organs and retroperitoneal space
• MR cholangiography
• MR cerebral angiography
• Angiography of the carotid arteries
• Aortic arch angiography (with contrast)
• Abdominal aortic angiography (with contrast)
• Pelvic and limb angiography (with contrast)
• Brain MR diffusion (in early ischaemic stroke)

It is used to rule out, investigate further or monitor: brain or meninges tumours, the skull base and orbits, acoustic neuroma, pituitary tumours, encephalitis or meningoencephalitis, encephalopathies, leukodystrophies, intracranial complications of ENT disorders, demyelinating diseases, congenital malformations of the brain or meninges, venous sinus thrombosis, and the detection of intracranial vascular malformations.

W uzupełnieniu do badania TK, MR wykonuje się do pogłębienia diagnostyki lub monitorowania: urazów głowy, padaczki, udarów i zmian pooperacyjnych. MR pozwala na bardzo wczesne diagnozowanie udarów niedokrwiennych mózgu, co ma decydujące znaczenie o podjęciu decyzji o sposobie leczenia. Na podstawie badania dyfuzyjnego można diagnozować wczesny udar niedokrwienny, różnicować guzy mózgu i oceniać ich stopień złośliwości, a także oceniać aktywność ognisk demielinizacyjnych. Badanie perfuzyjne dostarcza wiadomości o regionalnym przepływie krwi, co ma zastosowanie w diagnostyce wczesnego udaru, przed podjęciem decyzji dotyczącej leczenia trombolitycznego, pozwala zróżnicować zmiany ogniskowe mózgu (łagodne/złośliwe) pozwala odróżnić guza pierwotnego mózgu od przerzutu oraz pozwala określić optymalne miejsce biopsji guza. Badania perfuzyjne pozwalają także na ocenę wznowy nowotworowej po radioterapii. W spektroskopii MR ocenia się metabolizm tkanek, co pozwala m.in. na lepsze scharakteryzowanie zmiany ogniskowej mózgu.

Functional magnetic resonance imaging (fMRI) enables, amongst other things, the creation of so-called cortical maps, which are of great importance in planning neurosurgical treatment. Diffusion tensor imaging allows the direction of water molecule diffusion to be assessed, enabling the course of major nerve pathways to be visualised when planning surgical treatment.

Orbital MRI – This is used to further investigate conditions affecting the orbit, the eyeball and/or the visual pathways, as well as thyroid disorders or double vision.

MRI is routinely used to rule out, investigate further or monitor: tumours of the nervous tissue or meninges, myelitis or meningitis, demyelinating diseases, spinal cord compression, congenital disorders of the spinal cord, cauda equina or meninges, myelopathy, cervical, thoracic or lumbar radiculopathy, spinal stenosis, trauma, and for the investigation of any spinal condition in pregnant women. In urgent situations, an MRI of the spine is performed to diagnose compression of the spinal cord caused by secondary or primary malignant tumours.

It is used to rule out, investigate further or monitor: tumours originating in bone or other connective tissue; inflammation; necrosis; and inflammatory, degenerative and post-traumatic changes in the bones, tendons and cartilage of the hip, knee, elbow, shoulder, ankle, tarsus and wrist joints; and in the diagnosis of ankylosing spondylitis, particularly in patients with inconclusive X-ray findings of the sacroiliac joints (who are HLA-B27 positive).

MRI is used in the diagnosis of aortic dissection, aortic aneurysm, ruptured aortic aneurysm, Marfan syndrome, other congenital aortic defects, and to rule out aortic origin of peripheral embolisms. The scan can also be used to monitor the effects of treatment for aortic dissection or anomalies of the aortic arch and coarctation, as well as to diagnose a periaortic infection or abscess. MRI is also performed for the post-operative assessment of an aortic graft. MRI enables the assessment of acquired and congenital defects of the superior vena cava, inferior vena cava and portal venous system, including the diagnosis of Budd-Chiari syndrome. MRI can be used to identify abnormalities in the pulmonary arteries, including central thrombosis, aneurysms, stenosis and dissection. MRI can also be used to assess vascular invasion in the context of cancer or systemic diseases, and to differentiate between a tumour and thrombosis.

When we carry out magnetic resonance imaging (MRI) scans of the heart:

• In patients with heart failure or cardiac dysfunction – to differentiate between the causes (ischaemic, post-inflammatory, of unknown aetiology) and to visualise any scar tissue
• Assessment of myocardial function, morphology and anatomy.
• In patients eligible for revascularisation (angioplasty, coronary bypass surgery) to assess long-term survival.
• Assessment of myocardial damage following a heart attack.
• In people with valvular heart disease.
• If a tumour or blood clot is suspected in the heart chambers.
• Prior to ablation procedures – assessment of the anatomy of the left atrium and pulmonary veins.
• In cases of hypertrophic cardiomyopathy (including athletes) – assessment of fibrosis in the heart muscle.
• Pericardial diseases. On the day of the examination, you should avoid any activities that might increase your heart rate: drinking coffee, smoking, and vigorous exercise.

Contraindications to the test:

• Absolute contraindications include the following conditions following implantation: – cardiac pacemakers not certified for use in a magnetic field – implants that stimulate the central nervous system and cranial nerves (e.g. cochlear implants).
• Relative contraindications: – claustrophobia – the presence in the body of metallic structures that may heat up during the examination (ferromagnetic materials), such as metal filings, clips, stents and joint prostheses.
• You must declare any metal implants at the time of booking your scan.

An MRI scan enables the differentiation of focal liver lesions, primarily metastases and primary tumours. MRI can also be used to diagnose diffuse diseases of the liver parenchyma, such as haemochromatosis, haemosiderosis, cirrhosis and steatosis. MRI enables the assessment and better characterisation of certain tumours of the pancreas, kidneys, adrenal glands and ovaries. MRI is the method of choice for the diagnosis of fistulas and abscesses in patients with Crohn’s disease, perianal abscesses and fistulas, and inferior vena cava involvement in patients with a diagnosed solid renal tumour. In patients with an allergy to radiological contrast agents or in pregnant women, MR urography may be performed instead of a conventional radiological examination. In pregnant women, MRI allows for the assessment of the placenta and the normality or abnormalities of the foetus. MRI is also used to assess the uterus in patients prior to planned fibroid embolisation. In men, MRI is used in the diagnosis and staging of prostate and testicular cancer. MRI is also the method of choice for staging rectal cancer.

Used to further investigate conditions affecting the bile ducts and pancreas in cases where the results of other tests are inconclusive.

It is used to rule out or further investigate stroke, carotid artery disease and vertebrobasilar insufficiency, carotid or vertebral artery dissection, intracranial aneurysms, intracranial arteriovenous , venous sinus thrombosis, vascular abnormalities in patients allergic to radiological contrast agents, occlusions of the superior and inferior vena cava and the large pelvic veins, and the assessment of peripheral arteries in the upper and lower limbs. Furthermore, MR angiography is used to assess stenosis of the transplanted renal artery and to determine the degree of renal artery stenosis prior to angioplasty or stenting.

In addition to ultrasound or CT scans, magnetic resonance imaging (MRI) enables a more detailed diagnosis or monitoring of malignant and benign soft-tissue tumours (e.g. in the limbs or the chest wall).

It is performed in cases where breast cancer is clinically suspected but is not visible or is inconclusive on mammography, and in patients at high risk of developing cancer (those with the BRCA1 and BRCA2 genes) in whom other diagnostic methods have not revealed any abnormalities. Breast MRI is important in the pre-operative and post-operative assessment of both lobular and ductal cancer, as well as multifocal or multicentric cancer, particularly in young women. Another important indication for breast MRI is the need to assess the breast following reconstruction or augmentation surgery, as well as to evaluate breast implants. 

Currently, screening is based on a digital rectal examination and measurement of PSA levels in patients at increased risk. PSA levels may be elevated in BPH (benign prostatic hyperplasia), prostatitis or other benign conditions. Conversely, low PSA levels do not rule out malignant prostate cancer. Multiparametric magnetic resonance imaging (mpMRI) of the prostate has proved to be an effective tool for investigating suspicious areas of the prostate that require special attention during subsequent biopsy or when determining eligibility for further treatment (surgical or conservative).

When we carry out an MRI scan of the prostate:

• Determining the stage of prostate cancer – assessment of regional lymph nodes and potential invasion of neighbouring structures
• The appropriate type of treatment is selected on the basis of the MRI scan.
• Monitoring of patients in the low-, medium- and high-risk groups.
• Assessment of the prostate in patients who have undergone treatment and in whom a rise in serum PSA levels has been observed
• In patients with suspected glandular cancer where the biopsy result is negative.