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Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)

CPT4 code

Name of the Procedure:

Magnetic Resonance Imaging (MRI), Upper Extremity with Contrast Material(s)
Common name: MRI Upper Extremity with Contrast

Summary

An MRI of the upper extremity with contrast is an imaging procedure that uses a magnetic field and intravenous contrast material to create detailed pictures of the structures in the upper arm, from the shoulder to the hand. The contrast material helps to highlight specific areas, providing clearer images for diagnosis.

Purpose

This procedure is used to diagnose issues in the muscles, bones, nerves, and other tissues of the upper extremity. It can detect tumors, inflammation, or injuries, and assess conditions like rotator cuff tears, nerve compressions, and vascular disorders.

Indications

  • Persistent or unexplained pain in the upper extremity
  • Suspected tumors or masses in the arm
  • Inflammation or infection signs
  • Previous injuries not well-explained by other imaging methods
  • Suspected nerve damage or vascular conditions

Preparation

  • Patients may need to fast for 4-6 hours before the procedure.
  • Removal of all metal objects, including jewelry and piercings.
  • Patients should inform the technician of any allergies, especially to contrast material, and any metal implants like pacemakers.
  • Pre-procedural tests may include renal function tests to ensure the kidneys can handle the contrast material.

Procedure Description

  1. The patient changes into a hospital gown and removes all metal objects.
  2. An IV line is placed in the patient's arm for the contrast material.
  3. The patient lies down on the MRI table, which slides into the MRI machine.
  4. Initial scans are taken without contrast.
  5. Contrast material is injected through the IV, and additional scans are taken.
  6. The patient must remain still during the imaging to ensure clear images.

The MRI machine uses magnetic fields and radio waves to generate images, while the contrast material helps to enhance the visibility of blood vessels, tissues, and any abnormalities.

Duration

The procedure typically takes 45 to 90 minutes, depending on the specifics of the case.

Setting

MRI suite in a hospital, outpatient clinic, or specialized imaging center.

Personnel

  • Radiologist
  • MRI Technician
  • Nursing staff (for IV placement and patient monitoring)

Risks and Complications

  • Allergic reaction to contrast material (rare)
  • Discomfort from lying still for a long period
  • Slight risk of kidney issues in patients with pre-existing renal problems
  • Claustrophobia in some patients

Benefits

  • Detailed and accurate images of the upper extremity
  • Non-invasive with no ionizing radiation exposure
  • Helps in precise diagnosis and treatment planning

Recovery

  • No significant downtime; patients can usually resume normal activities immediately.
  • Hydration is encouraged post-procedure to help flush out the contrast material.
  • Follow-up appointments may be necessary for further consultation based on the MRI results.

Alternatives

  • CT scan: Faster but involves ionizing radiation.
  • Ultrasound: Limited in its ability to visualize deep tissues.
  • X-ray: Best for viewing bones but not soft tissues.

Patient Experience

During the procedure, the patient might feel a cool sensation when the contrast material is injected. The MRI machine makes loud noises, so ear protection or music may be offered. Some may feel a bit anxious in the enclosed space. Most don't experience any pain during or after the procedure. Comfort measures, like blankets, are typically provided to ensure a patient’s comfort.

Medical Policies and Guidelines for Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)

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