An examination in which brain tissue is imaged at high resolution. It is the preferred method for conditions such as tumors, stroke, multiple sclerosis and headache.
Indication
- Investigation of the cause of persistent or atypical headaches
- Suspicion and follow-up of stroke (assessment of acute ischemic area with DWI sequence)
- Diagnosis of multiple sclerosis (MS) and follow-up of plaques (FLAIR and T2 sequences)
- Suspected brain tumor, mass or cyst
- Structural investigation of the cause of epilepsy
- Evaluation of dementia and cognitive decline
- Suspicious findings after head trauma
- Evaluation of pituitary gland and cranial nerve pathologies
Preparation
- Fasting is generally not required (for non-contrast scans)
- If contrast is to be administered, fasting for 4 hours beforehand and a kidney function test are required
- All metal items (hairpins, watches, credit cards) are removed
- Implants such as pacemakers, cochlear implants and brain aneurysm clips must be reported
- The sedation option is evaluated in advance for patients with claustrophobia
How it's performed
- The patient is positioned supine; a head coil is placed around the head
- The scan takes 15-30 minutes; remaining motionless during this time is critical for image quality
- There is significant noise while the device is operating; headphones or earplugs are provided
- In suspected MS, FLAIR, T2, DWI and often post-contrast T1 sequences are obtained
- In acute stroke, the DWI (diffusion weighted) sequence is prioritized; it can show acute ischemia within minutes
- When needed, post-contrast images are obtained by intravenous administration of gadolinium contrast
Post-procedure
- There are no special restrictions after the scan; daily life can be resumed immediately
- If contrast was given, drinking plenty of water is recommended
- Results are reported by the radiologist and interpreted by the referring physician
- If sedation was administered, driving on the same day is not appropriate
Risks
- Rare allergic reaction to gadolinium contrast
- Risk of nephrogenic systemic fibrosis in advanced kidney failure (very rare)
- Inability to complete the scan due to claustrophobia
- Heating or displacement of MR-incompatible metallic implants (compatibility is checked beforehand)
FAQ
What is the difference between brain MRI and brain CT?
Brain MRI is far superior in soft tissue detail and does not involve radiation. CT, on the other hand, provides quicker information in acute hemorrhage and head trauma; the two methods complement each other.
Why is MRI performed frequently in MS?
MS plaques appear as bright areas on FLAIR and T2 sequences. Periodic MRI is recommended to monitor whether new plaques have appeared and the activity of existing ones.
I am very afraid of enclosed spaces — what can I do?
Inform your physician about your claustrophobia. Options such as an open MRI device, mild sedation or pre-scan anxiolytic medication can be considered.
I am pregnant — can I have an MRI?
MRI does not involve ionizing radiation; however, during pregnancy — particularly in the first trimester — it is performed only when necessary and usually without contrast. Be sure to inform your physician of your pregnancy.
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