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One of
virtues of MRI pictures is that they are based on physical principles totally different from those responsible for creating CT pictures. Thus,
MRI is good (or not so good) at showing different things than CTs. Another virtue is that MRIs can slice and dice
brain at different angles, while CTs slices are limited to just
horizontal plane. Yet another virtue of MRIs is that they are much better than CTs at imaging most diseases of
spine. Finally, MRIs are much more flexible than CTs: new bells, whistles and capabilities are being added all
time.
To
patient,
experiences of having a CT and of having an MRI greatly resemble each other. In both cases
patient lies horizontally on a flat table that moves into and out of an opening in
scanner that resembles a giant doughnut-hole. The doughnut-hole in
MRI machine is narrower, so claustrophobic patients need to inform their doctors if this might be a problem. The MRI machine is also noisier: a loud sound is created each time its radio-frequency coils turn on and off. For each kind of scan
technologist might stick a needle in
patient's vein to administer contrast-material.
Both tests are otherwise painless and are very safe with certain exceptions. Pregnant women who need a scan might have to do without one for fear of exposing
fetus to excessive x-rays in
case of
CT scan or to an excessive magnetic field in
case of
MRI. If push comes to shove,
woman is more likely to receive a CT scan because her abdomen can be draped with a lead shield that blocks passage of most x-rays, while there is no good method for blocking
magnetic field produced by an MRI machine.
A circumstance in which MRIs are simply not done is when
patient has a cardiac pacemaker. This is because
MRI machine's magnet might disrupt
pacemaker and stop
heart. No image is so necessary and valuable that this risk would be worth taking. Another circumstance in which an MRI is avoided is when
patient is critically ill. An unstable patient can be adequately monitored and supported while receiving a CT scan, but not while receiving an MRI.
Depending on
nature of
patient's problem,
doctor will usually order just one of
two types of scans and not
other, but in selected cases
magic of both kinds of scan might be needed.
(C) 2005 by Gary Cordingley

Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher who works in Athens, Ohio. For more health-related articles see his website at: http://www.cordingleyneurology.com