72147 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)

Name of the Procedure:

Magnetic resonance imaging (MRI) of the spinal canal and its contents, thoracic region, with contrast material

Common name(s) and any technical or medical terms used:

Thoracic spine MRI with contrast, MRI of thoracic spine with gadolinium

Summary

Magnetic resonance imaging (MRI) of the thoracic spine with contrast is a diagnostic procedure that creates detailed images of the thoracic section of the spinal canal and its contents. This is achieved by using a powerful magnet and radio waves, with a contrast agent injected to enhance the visibility of certain structures.

Purpose

• Medical Condition/Problem Addressed: Abnormalities and conditions affecting the thoracic spine, such as herniated discs, spinal tumors, and inflammation.
• Goals/Expected Outcomes: To provide a clear and detailed image of the thoracic spine to help diagnose and plan treatment for spinal conditions.

Indications

• Symptoms/Conditions:
  • Persistent back pain
  • Numbness or weakness in the lower extremities
  • Suspected spinal tumors or infections
  • Trauma to the thoracic spine
• Patient Criteria: Patients with unexplained thoracic spinal pain or neurological symptoms, or those needing further evaluation of known spinal abnormalities.

Preparation

• Pre-procedure Instructions:
  • Patients may need to fast for a few hours prior to the procedure.
  • Remove all metallic objects (jewelry, eyewear, etc.).
  • Inform the healthcare provider of any allergies, especially to contrast material.
  • Discuss any current medications and medical history, particularly concerning kidney function.
• Diagnostic Tests/Assessments: Blood tests may be needed to assess kidney function due to the use of contrast material.

Procedure Description

• Step-by-Step Explanation:
  1. The patient is asked to lie down on the MRI table.
  2. An intravenous (IV) line is inserted to administer the contrast agent.
  3. The patient is positioned within the MRI machine.
  4. The MRI machine generates detailed images through radio waves and a magnetic field.
  5. The contrast material is injected to enhance the images, and additional scans are taken.
     • Tools/Equipment: MRI machine, IV line, contrast agent (gadolinium).
     • Anesthesia/Sedation: Usually not required, though sedation may be used for patients with claustrophobia or anxiety.

Duration

The entire procedure typically takes about 45-60 minutes.

Setting

MRI is usually performed in a hospital or specialized outpatient imaging center.

Personnel

• Radiologist (to interpret images)
• MRI technologist (to operate the MRI machine)
• Nurse or technician (to assist with contrast injection and patient care)

Risks and Complications

• Common Risks:
  • Mild discomfort from IV insertion
  • Claustrophobia during the scan
• Rare Risks/Complications:
  • Allergic reaction to contrast material
  • Kidney issues in patients with pre-existing kidney conditions

Benefits

• Expected Benefits: Accurate diagnosis of spinal conditions, leading to appropriate treatment.
• Timeline: Results are typically reviewed within a few days, enabling quick initiation of a treatment plan.

Recovery

• Post-procedure Care: Patients can resume normal activities immediately unless sedatives were used.
• Recovery Time: No recovery time needed for the imaging itself.
• Follow-up: Review results with a healthcare provider; additional follow-up may be necessary based on findings.

Alternatives

• Other Treatment Options:
  • CT Scan (less detailed for soft tissues)
  • X-rays (less detailed, especially for soft tissues)
• Pros and Cons: MRI provides more detailed images of soft tissues without radiation exposure, but it is more expensive and time-consuming than other imaging methods.

Patient Experience

• During Procedure: Mild discomfort from lying still, noise from the MRI machine (earplugs or headphones can be provided), possible sensation of warmth when contrast is injected.
• After Procedure: Minimal to no discomfort; patients can typically return to normal activities right away. Pain management is generally not needed.