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Bone, Joint's open MRI eliminates ‘the tube’

by Michael Baker
Public Relations
Participating in a typical magnetic resonance imaging (MRI) scan can make the toughest person feel self-conscious. Patients often dread the experience of sliding into the claustrophobic space within the machine, where they lie silently until the imaging is complete. 

It seems unfair that diagnosing a musculoskeletal condition sometimes causes more discomfort than the infirmity. 

Now, many patients won’t have to deal with those concerns. MUSC’s Bone and Joint Center recently acquired the university’s first open MRI equipment, which drastically improves the ease and comfort of analyzing musculoskeletal injuries in the body’s extremities.

Langdon Hartsock, M.D., chair of the Department of Orthopaedic Surgery, explained the advantages of the new equipment.

“The open MRI is more compact and less intimidating,” he said. “The aspect of MRI scans that people generally dislike—going into ‘the tube,’ as they call it—is non-existent. Instead, the equipment obtains images from the injured body part while the patient lies on a comfortable, cushioned table.”

During an open MRI scan, a patient with a torn knee ligament lies on the table with the injured knee cradled in a small coil. The table rotates, placing the coil underneath a circular panel approximately three feet wide. The panel hangs about 12 inches above the patient and only covers the injured leg from mid-thigh to slightly below the knee. 

Hartsock said the less intrusive process reduces fear in many younger patients.

“Because imaging on the extremities requires a relatively low-powered magnetic field, parents can sit with their children during the scan without disrupting the imaging process,” he said.

William Conway, M.D., Ph.D., head of musculoskeletal radiology, added that an open MRI scan helps uncomfortable adults as well.

“About 10 percent of our patients feel claustrophobic when undergoing a typical MRI. Some either refuse or need sedation to proceed,” he said. “An open MRI alleviates the problem.”

The process begins when the equipment generates a fixed magnetic field.

“When the patient lies on the table, the magnetic field automatically aligns molecules within the patient’s body tissue,” Conway explained. “Then, we use a radio frequency pulse to disturb those molecules, drawing them out of position.”

The equipment produces images of the body’s various tissues—bones, ligaments, tendons, larger veins and arteries—based on the speed at which each tissue’s molecules return from their disturbed state to their original positions.

“Each tissue has different characteristics that determine how quickly the molecules return to their alignment within the magnetic field,” he said. “The realignment times differ only by microseconds, but the equipment helps us differentiate.”

The magnets used in an open MRI scan have a low field strength and cost less than the more powerful magnets used for typical scans. Despite its lower price, the equipment produces images of equal quality to the larger machines. It also requires less lab space and less stringent safeguards. 

“There are no harmful effects of placing yourself within a magnetic field of this strength,” Hartsock asserted. “Unlike X-rays and CT scans, there’s no radiation involved. We only use barriers between us and the machine to prevent the magnet from demagnetizing credit cards and stopping our watches.”

The addition of open MRI scanning improved MUSC’s ability to treat a large volume of patients as well. Rather than using the larger MRI equipment for every scan, physicians now can refer patients with extremity injuries to the Bone and Joint Center. The referrals liberate the more powerful MRI equipment for use during more complicated scans of the brain and abdomen.

Although the new technique has been available at MUSC for only two weeks, patients have responded favorably.

“Many people have requested the open MRIs,” Hartsock said. “We get patients into the office and onto the machine more quickly, and they feel more comfortable with the entire process.”

Both men agreed that the benefits to patients and to MUSC made the acquisition a necessity.

“We wanted to get an open MRI for many reasons,” they concluded, “but the bottom line is that it matches the right machine with the right job.”
 

Friday, July 23, 2004
Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.