MRI of the skull
definition
The Magnetic resonance imaging (MRI) is a non-invasive imaging procedure in which the structures of the body are shown in the form of sectional images with the help of a strong magnetic field and radio waves.
This form of imaging is often used to depict the central nervous system and des Skull used.
Many different diseases in the area of the skull or head can be diagnosed and differentiated from one another with MRT imaging.
In some cases this involves administration of Contrast media necessary in order to better display the blood flow in individual structures and to be able to differentiate them from their surroundings.
Indications
The Magnetic resonance imaging (MRI) has many uses in the area of the skull. With good contrast and high resolution in the area of the Brain tissue MRI imaging is widely used in the diagnosis of diseases of the brain.
In addition to the clarification of possible Tumors is the MRI agent of choice for diagnosing Inflammation in the area of the meninges or brain matter, from Cerebral hemorrhage and from Vascular disease (Stenoses, Aneurysms).
In addition, it is partly also in the Stroke diagnostics used by looking at the circulation and distribution of blood in the brain. Also for the investigation of Dementia and Parkinson's the MRI scan can be used.
In addition to being used for Brain diagnostics A skull MRI can also be performed to diagnose other diseases. It is often used to clarify the causes of a Migraine disease, to investigate the Petrous bone after sudden hearing loss and tinnitus or for the presentation of the Sinuses if suspected Inflammation, Foreign bodies or tumors.
Also in the Orthodontics In individual cases, the MRI is used to image the Temporomandibular joint (Misalignments, cartilage damage) and the teeth including the tooth support apparatus.
MRI in multiple sclerosis
The MRI is often used in the diagnosis and follow-up of a patient Multiple sclerosis. In comparison to other diagnostic examinations (neurological examinations, cerebrospinal fluid puncture), MRI is a safe method for Diagnosis.
In the case of multiple sclerosis, individual round-oval spots in the brain substance can be shown in MRI imaging. These are often located at the edge of those filled with liquor (brain water) Cerebral ventricle in the area of the brain marrow.
These are foci of inflammation in the area of the myelin sheaths of the individual nerve fibers. By administering a contrast medium, the foci of inflammation with a strong blood supply can be better separated from their surroundings.
In addition, the injection of contrast medium enables the distinction between fresh and old lesions of the inflammation.
MRI for tumors
In addition, MRI imaging is a standard method for diagnosing and monitoring the progress of Brain tumors.
The tumors of the brain are usually ulcers that originate from the cells of the supporting and connective tissue of the brain and not from the nerve cells.
There are many different tumors in the brain area - a better demarcation is made with the MRI examination.
By administering Contrast centerl During the MRI imaging, a statement can be made about the size, location and type of the tumor.
The individual brain tumors enrich the contrast agent in different ways and can thus be distinguished from one another.
A biopsy is usually required to confirm a suspected diagnosis.
MRI for migraines
At migraine is a form of chronic headache. These typically occur on one side and are often accompanied by nausea, vomiting, and sensitivity to light and noise. A cause and the development of this severe headache is often unclear.
MRT imaging represents an additional form of diagnosis, which is used primarily for patients with conspicuous clinical and neurological symptoms.
It serves to rule out life-threatening causes of long-lasting headaches (e.g. with a Subarachnoid hemorrhage or with brain tumors).
MRI of the sinuses
Both Sinuses are bony cavities of the facial skull that branch off from the nose and are filled with air.They are primarily used to humidify, clean and warm the air.
MRI imaging of the paranasal sinuses is often used to examine soft tissue structures due to its good representation Inflammatory processes and space requirementsn (benign or malignant tumors) used in the area of the nasal mucosa.
Possible injuries and breaks in the area of the thin bony borders of the paranasal sinuses (fractures) can also be diagnosed.
Most often, MRI imaging is used to clarify the cause of a chronic sinus infection (Sinusitis) is used. With the help of the imaging, a possible flow obstruction of the nasal mucus can be shown, which means that the inflammation cannot heal.
MRI of the temporal bone
At the Temporal bone it is a section of the skull bone in the area of the temporal bone (Temporal bone).
It surrounds the inner ear, as well as important nerves of the brain that, among other things, control the Facial motor skills, hearing and balance involved.
The MRT imaging is used to examine the Inner ear, of Auditory nerve and the investigation of Tumors and Injuries.
Often patients become noticeable by sudden hearing loss, tinnitus or imbalance.
With the help of the MRI scan, the soft tissue structures including the nerves in this area can be displayed, while computed tomography (CT) primarily serves to display the bony structures (e.g. in the context of injuries).
preparation
Before the MRI scan, the patient should have all metallic objects and clothing lay down. Information about possible risk factors such as items of clothing and jewelry that may not be worn during the examination is usually provided by a questionnaire or by a doctor or a doctor's assistant.
There are rooms available for storing all items and items of clothing, in which (valuables) items can be safely stored.
About further (not to be removed) metallic objects (e.g. Implants, Piercings, Tattoos) the attending physician must be informed prior to the examination.
Depending on Implant, its size and location may not allow MRI imaging to be performed.
Procedure of the MRI
The MRI examination of the skull is usually comparable to other MRI examinations. To examine the head, however, it is converted into a Kitchen sink (a kind of grid) to receive the radio waves required for imaging.
In addition, the head is stabilized with pillows and special supports.
The patient is pushed head first into the MRI tube. The head and upper body are in the tube during the examination, while the legs are usually outside.
During the imaging, the patient should be try not to movein order to be able to guarantee a high quality of the pictures. The patient usually receives headphone (partly with music), as the examination is very loud (loud knocking).
Depending on the question, the administration of Contrast media become necessary. After an initial imaging without contrast agent, there is a short pause during which the contrast agent is administered to the patient. The MRI examination is then carried out again.
Finding
The images are often examined and analyzed by a radiologist during the examination. Of the Finding can be communicated to the patient in a conversation after the examination. The patient is often given a CD with the recorded images.
For some questions, however, it may be necessary to discuss the findings with the doctor who commissioned the imaging (e.g. family doctor, orthopedic surgeon). In this case, the images with the report are usually sent to the referring doctor within a day.
MRI of the skull - when do I need contrast media?
An MRI examination of the skull always takes place without the administration of contrast medium.
Depending on the question and the illness, the examining radiologist decides during the examination whether a Injection of contrast medium via an access in the crook of your arm is necessary or helpful.
A second pass of imaging is then performed. The administration of Contrast media is mainly used for the better representation of strongly perfused, metabolically active structures (e.g. Inflammation ) suitable.
The comparison between the images with and without contrast agent allows a distinction to be made between fresh and old lesions, for example in multiple sclerosis.
In addition, the enrichment of contrast media is characteristic of each individual Brain tumors and metastases. This makes it easier to differentiate between them.
At a MR angiography it is a separate representation of the vessels in the area of the head with the aid of contrast media. It is used to identify Vascular changes (e.g. stenoses, aneurysms).
When can I do without contrast media?
The MRI imaging of the skull initially always takes place without the administration of contrast medium. In some cases, depending on the question, these recordings are already meaningful, which is why there is no need to administer contrast agent and re-imaging.
In patients who have a Intolerance to the contrast media or where the contrast agent cannot be excreted via the kidneys, such as in Kidney dysfunction, administration of contrast media is not permitted.
Risks
After removing all metallic objects and clothing, insist usually no risks for the patient through the magnetic field and radio waves. In studies carried out so far, none could Side effects can be proven for humans.
An examination can therefore be repeated as often as required and can also be performed on children and in exceptional cases during pregnancy be applied.
If the patient cannot take off all metallic objects and items of clothing (e.g. implants or Tattoos), the attending physician must weigh up the risks and benefits of the examination. There is a risk that the effect of the implants will be extinguished by the magnetic field or that the tattoos will cause it Warming of the skin up to burns.
Other side effects that occur are due to the administration of a Contrast agent justified.
Although side effects from the contrast agent are rare, temperature sensation disorders, tingling of the skin, headaches, nausea and general malaise are possible.
However, these symptoms usually do not last longer than a few hours, as the contrast medium is quickly eliminated through the kidneys.
Duration of a skull MRI
The examination of the skull in the MRI takes approximately between, depending on the question 20 and 30 minutes. During this period, the patient must not move around a good image quality to be able to guarantee.
The imaging initially takes place without a contrast agent. In some cases, the patient is reimaged after a brief interruption in which the patient is given contrast agent through a vein.
Cost of a skull MRI
The Cost of an MRI examination of the skull in the closed MRI are covered by the health insurance companies if there are clinically necessary questions.
For investigation in one open MRI (e.g. at Claustrophobia) an application should be made to the health insurance companies beforehand to cover the costs. This must justify the need to perform an open MRI and provide a cost estimate.
The price of an MRI examination of the skull for self-paying or private patients depends on the scope of the examination. It is roughly between 500 and 1000 €.
The administration of contrast media during the examination incurs additional costs of up to € 100.
MRI for claustrophobia
When examining the skull on an MRI, there is a risk of Claustrophobia (claustrophobia).
The patient is with his head as well as his upper body in the approximately 60 to 70 cm wide tube.
In addition, the head is enclosed by a coil, which is why the tube appears even narrower.
The doctor performing the examination should be informed about the patient's claustrophobia prior to the examination. At the request of the patient, a Sedatives administered.
During the examination, the patient receives a button with which he can stop the examination at any time if he or she becomes increasingly unwell.
Alternatively, an examination of the skull can also be carried out in one open MRI occur. This is a C-shaped magnet, which gives the patient a 320 ° all-round view.
However, by using a weaker magnetic field, the examination is in an open MRI not for all clinical questions suitable.
