Anchor: We Are Austin from Home. It’s a powerful tool for healthcare providers and there is a lot that can be seen from an MRI. From fractured bones to helping with strokes, this painless exam helps doctors diagnose and treat patients. Today we’re talking with Dr. Jeff Wood, a musculoskeletal radiologist at ARA Diagnostic Imaging about the impact of an MRI. It’s nice to be with you.
Dr: Good to see you too, Taylor. How are you?
Anchor: I’m doing well. It’s nice to see you. It’s been a little bit but we’re in our Zoom party today, huh?
Dr: Yeah, my first one.
Anchor: Well, we feel very lucky that you are joining us here on We Are Austin. I know you do a lot of important work. I know even today you’re in the middle of a lot of important work, so thanks for taking this time to share with us what is so significant about MRIs.
Dr: MRI is just one of the many tools we have in radiology. Sort of the most powerful tool for all intents and purposes. That’s why a lot of people don’t necessarily need or get one. Um, but when they are necessary, just like in your garage tools sometimes the power tool’s necessary. The beauty of it is that there’s no radiation unlike a CT which is basically thousands of little X-rays that are then put together. This actually uses a magnet and then we’ll skip all the really hard physics, but somebody very, very smart put that together with a super computer and magnets and that makes these very, very beautiful images…
Dr: …that show very detailed things.
Anchor: It is impressive technology, as you mentioned. So, what exactly are those images used for? Why would one get an MRI?
Dr: Oh, we use it for an incredible array of things. Whether it be, like you said, with stroke, vascular type things we can actually see tissue that’s alive or not alive based on it. We can use it for musculoskeletal injuries, things that I use, sports stuff like the bottom of ESPN. You can use that for finding tumors. You can use it for finding very subtle fractures. It’s very, very good at detail-oriented, small, subtle things that may be missed on X-ray or CT.
Anchor: Mm hm. Can you show us and while we see it, talk about what an MRI looks like?
Dr: Sure. Yeah, I assume most people watching television have seen this kind of giant donut-looking suitcase that lies in the middle of a big room. It is a similar appearance to a CT except if you walk in there with your watch or something metal, bad things will happen. So, we do a very, very good job of making sure that doesn’t ever, ever occur. But, again, just a big bore with a table in the middle. And the bore being a wide hole that you lay in based on what part you’re going to get imaged.
Anchor: Mm hm. And what exactly is that experience like? You’re mentioning CT scans, which I have had a number of times. But MRIs, what does that feel like?
Dr: Yeah, so I think a lot of people have had some sort of medical imaging. The difference would be is the length of time. Uh, that’s actually one of the reasons that not everyone gets MRI is, like most big powerful tools, they cost more or they take more time or there’s some hindrance. These, every slice that you get takes more time to acquire and so an average MRI can be somewhere between thirty minutes and even an hour. Versus a CT where they just acquire the data very quickly. You know, 10, 20 seconds and then can do things with them after that. So, the patient gets screened by our tech or one of our medics. Um, make sure that everything is necessary.
Dr: Some people actually will need intravenous contrast or IV contrast. And that helps us with a multitude of certain exams and if they need that IV contrast, then they get an IV and then they get screened again so that we make sure there’s no metal on their person. But similar to what it would feel like for a CT, except you’ll be there for quite a bit longer.
Dr: I think one surprising thing for people is that it tends to be very noisy. Again, part of the high-level physics and the magic, is what I like to call it, is these very large, large magnets moving from one side to another. And those make these really loud clanging and banging sounds like you’re in your grandma’s basement listening to the radiator.
Anchor: I love all the analogies that you’ve used today because they really do help paint a picture. We’re talking about metal, kind of related to that, I’ve heard that maybe you can’t have an MRI if you have metal in your body or there are certain circumstances that might change your ability to have one. Is that true?
Dr: Um, sometimes, yeah. So, the big fancy word is “contraindication.” Some metal is very important for us to know, some, some is actually okay to have. One of the main ones that I get is, “I have an old joint replacement.” Albeit a hip arthroplasty or a knee, shoulder. Most of those we’ll still check each and every time, but the vast majority of hardware that is put in by an orthopedic surgeon or other surgeons for that matter are MRI-safe. They’ll give us a little bit of artifact and they make the picture a little streaky, for lack of a better term, but they’re okay.
Dr: Another one I get frequently is, “I have a cardiac pacer,” or “I have a pain stimulator for my back.” Some of those sort of things that we call implants or medical devices. Those are varying, every single one’s different. Some actually are completely fine, some we actually turn off and then they’re okay and you turn them back on afterward and some we cannot do, so each one of those are sort of case by case.
Dr: And then another common one I get is you know from my job or an old injury or an old hunting accident I have metal fragments from a gunshot or something like that, is that okay? And for the most part, that’s actually fine. If anything, it’ll heat up. They don’t actually fly out of your skin like you would think they would. If anything, they sort of warm up like a microwave would.
Dr: And in those cases, we’re very careful but usually it’s okay. And sometimes we give people a little tool that they can alert us if things start to warm up and that way we can keep them safe but still get them imaged.
Dr: So, if you do have an implant and it being case by case, most people that have one will have had a card given to them that actually gives the specific details of what they had put in and if it is MRI safe. So, if you can dig that up, find that somehow, some way when you call our schedulers or when you come in for your scan.
Anchor: Yeah. A lot of great information here. It sounds like it’s a really personalized experience based on the individual. We’ve talked a lot about different ways to approach it. Can you show us a few scans?
Dr: I’d love to. That’s the good part, right? Yeah, this is your brain. We actually have cut it like a loaf of bread so you’re looking down at it. And this, unfortunately, is a very bad stroke acutely, or just happened, so this person came in and then their right corpus striatum had a big non-hemorrhagic stroke but kind of the most common one that we would see. This is about as classic as it gets but unfortunate for this person. But, yeah, this is showing us restricted diffusion which is a fancy term for blood flow is not going there.
Anchor: Oh, man. Are we, are both those images from an MRI?
Dr: Yes, ma’am. My apologies, yeah.
Anchor: Interesting. Okay what else?
Dr: We have, this is a Little League pitcher who’s been throwing, uh, quite a bit so this is shoulder MRI. You can see the arm bone here and then this side we actually use again the magic. We can do all kinds of things. This, we’ve taken out the fat just with physics and so here all we see is just edema around. Can you see this line here? This is the growth plate and when you get over to the side of the growth plate on their arm, their humerus bone it’s irregular and partially broken so this kid has what’s actually called Little Leaguer’s shoulder. So, he’s throwing so much that he’s starting to fracture his growth plate.
Anchor: Oh, man!
Dr: Yeah. That’s okay, this is one that luckily with just rest will heal up and do just fine.
Anchor: Oh, good. Well, I’m very glad to hear that. And what are we looking at there?
Dr: And this is one actually from yesterday I thought was a terrible story but a great scan. This person fell down the stairs and landed on some glass at the bottom of the stairs. And this is an ankle here from the side, called sagittal, so we’re looking at the Achilles tendon back here on the heel bone, the calcaneus, and they have a complete laceration or section there and it’s actually rolled up into their leg. So, this much of it is missing because it cut and pulled like a rubber band.
Anchor: Well, you’re right. That is an informative scan. That one’s a little harder to look at. My goodness, I hope that person is okay but it sounds like you can get a lot of information from these MRIs.
Dr: Yeah, an incredible amount.
Anchor: Well, definitely a lot of information conveyed through those scans and you are doing such important work! Thank you for helping us understand all of it. Where can people go for more information or maybe they’d like to make an appointment, this is something they’ve been thinking about.
Dr: Yeah. You can get a hold of us on ausrad.com is probably the easiest and on the screen is our scheduling line.
Anchor: Thank you so much, Jeff. It’s great to be with you.
Dr: Yeah, anytime. It’s good to see you, Taylor. Have a nice day.
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