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Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic

CPT4 code

Name of the Procedure:

Magnetic Resonance Imaging (MRI) of the Thoracic Spine with and without Contrast

Summary

Magnetic Resonance Imaging (MRI) of the thoracic spine involves using a powerful magnet, radio waves, and a computer to create detailed images of the spinal canal and its contents. This procedure is first performed without contrast material and then repeated after a contrast agent has been administered to enhance the images.

Purpose

The MRI of the thoracic spine is used to diagnose conditions affecting the spinal cord, vertebrae, disks, and surrounding tissues. It helps in identifying abnormalities, such as herniated disks, tumors, inflammation, or infections, and to evaluate the anatomy and function of the thoracic spinal region.

Indications

  • Persistent back pain.
  • Suspected spinal cord injuries.
  • Symptoms indicating nerve compression.
  • Evaluation of known spinal conditions.
  • Monitoring treatment of spine-related conditions.

Preparation

  • Inform your doctor of any metal implants or devices.
  • Remove all metal objects (jewelry, watches, eyeglasses).
  • Fasting is generally not required, but follow any specific instructions from your physician.
  • You may be asked to wear a hospital gown.
  • Diagnostic evaluation of kidney function may be necessary if contrast is to be used, particularly if you have a history of kidney issues.

Procedure Description

  1. The patient lies on a motorized table that slides into the MRI machine.
  2. Initial imaging is performed without contrast.
  3. The patient is then given a contrast agent via an intravenous (IV) line.
  4. Additional imaging sequences are conducted post-contrast administration to enhance tissue differentiation.
  5. Throughout the procedure, patients must remain as still as possible to ensure clear images.

Duration

The procedure typically takes 45 to 60 minutes.

Setting

The procedure is performed in a hospital's radiology department or an outpatient imaging center.

Personnel

  • Radiologist
  • Radiologic technologist
  • Nurse (for IV placement and contrast administration)

Risks and Complications

  • Allergic reaction to the contrast agent (rare).
  • Discomfort from lying still for an extended period.
  • Contraindications for patients with certain implants or devices.

Benefits

  • Provides high-resolution images of the thoracic spine and surrounding tissues.
  • Can identify and diagnose conditions that may not be visible on other imaging modalities.
  • Non-invasive and generally safe.

Recovery

  • No significant recovery required; normal activities can usually be resumed immediately.
  • Drink plenty of water to help flush the contrast material from your body.
  • Follow-up appointments might be needed based on the findings.

Alternatives

  • X-rays: Less detailed but useful for initial assessment of bone abnormalities.
  • CT Scan: Faster and can offer greater detail in bony structures but involves radiation.
  • Ultrasound: Limited in spine imaging but helpful in assessing soft tissue problems.

Patient Experience

Patients might hear loud tapping or thumping noises from the MRI machine; earplugs or headphones are often provided. Some may feel claustrophobic due to the confined space of the MRI scanner. Mild discomfort can occur from the injection of the contrast agent and lying still. Pain management and comfort measures like blankets and pillows are available to help minimize discomfort.

Medical Policies and Guidelines for Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic

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