Procedure

Prior to an MRI examination of the cervical spine, every patient must be informed about the procedure by having the doctor or trained personnel explain the information sheet and finally sign the consent form. Otherwise, from the patient’s point of view, no further preparations need to be made. Clothing must be removed for the examination.

It is very important that all metallic objects such as jewelry, piercings, hearing aids or credit cards are removed. These are attracted by the applied magnetic field and can injure the patient due to their acceleration. The patient should lie in the most comfortable position on the examination table and is then moved into the MRI tube.

When examining the cervical spine, it must be fixed in place, as any movement may render the sectional images useless. For this purpose, the head and shoulders are usually fixed by a kind of grid. For certain problems, so-called functional images of the cervical spine are taken.

During the examination, rearrangements are made, which allows the representation of functional changes. For example, narrowing of the spinal canal, which only occurs in certain positions, can be detected. Since the magnetic fields that are switched on and off produce relatively loud knocking noises, the patient is offered ear protection in the form of earplugs before the examination.

Duration of the MRI ́s of the cervical spine

An MRT examination of the cervical spine takes about 20 minutes. The higher the desired resolution of the sectional images, the longer it generally takes to produce the images.

Contrast medium

Most MRI examinations do not require the administration of contrast medium.For example, a herniated disc of the cervical spine can be depicted with sufficient accuracy even without a contrast medium, since the tissue of the intervertebral discs can be sharply delineated from the surroundings. If the issue at hand does not require the administration of contrast medium for the MRI, it is not administered, as this represents a further (albeit small) intervention on the patient. If MRI with contrast medium is indicated, gadolinium DTPA is usually used, which improves the tissue representation of an MRI image.

Gadolinium-DTPA is used, for example, in the diagnosis of multiple sclerosis (MS) to detect active foci. Gadolinium-DTPA is also of great importance in tumor diagnostics and in the imaging of inflammation. In general, gadolinium-DTPA is very well tolerated, with only 0.1-0.01% of applications resulting in allergic reactions.

The contrast medium is injected into the arm vein via a cannula and is then distributed throughout the entire body circulation. Immediately after the injection, a feeling of warmth or cold, discomfort or headaches may occasionally occur. However, these symptoms usually subside quickly.

If unusual symptoms still occur after the examination, patients should not hesitate to ask their doctor for advice. The contrast medium is excreted completely via the kidneys after just a few hours. For this reason, gadolinium DTPA is not suitable for patients with kidney disease.

In case of doubt, the creatinine (kidney) values of the patient to be examined should be determined before the administration of contrast medium. During the examination, the patient usually lies on his back on an examination table, head, neck and shoulders are fixed with a grid, as the imaging becomes useless at the slightest movement. The patient is then moved head first into the “tube” on the table.

Since only images of the cervical spine are taken, the table does not have to be moved completely into the device, so that a large part of the body does not disappear into the MRI machine. How large the diameter of the device is, depends on the design of the respective device. Also, whether the head end of the MRI “tube” is open and the patient can look out the front varies from model to model.

In the meantime, there are so-called open MRIs that are not even tubular and can make the examination much more comfortable for patients with claustrophobia. Most patients have a more or less pronounced fear of the MRI examination. If you suffer from claustrophobia, you should not be ashamed at all and discuss this with your doctor before the examination.

There is always the option of being given a medication to calm you down. The only important thing to remember is that due to the effects of the medication, you are usually not allowed to drive immediately after the examination and you should arrange for an accompanying person to accompany you. As a rule, drugs from the benzodiazepine group, e.g. Dormicum®, are used.

The patient is given earplugs or radio headphones to counter the noise caused by the magnetic fields switching on and off. In the event that the patient has to stop the examination because of a panic attack, an alarm button is pressed in his hand beforehand. The entire examination is monitored by the treating physician (the radiologist), so that the patient is not alone during the entire process and can intervene immediately in case of an emergency (e.g. a panic attack). You will find extensive information on the procedure for claustrophobia under our topic: MRI for claustrophobia