The Next Generation: "Open" MRI

A friend's experience... My friend Sharon who lives in Washington, DC called me with a medical problem: She recently started having mild backaches as well as the sensation of "lightening" shooting down her left leg. Her doctor in Washington was concerned she could have a herniated disk in her spine and he recommended an MRI to diagnose the problem. It was explained to her that an MRI is basically a large magnet that images the body. The advantage of the MRI is that unlike some other tests there is no radiation and the detailed images obtained are of excellent quality. The disadvantage is that the test can take up to 45 minutes and one's entire body enters the MRI through a narrow tube surrounded by the machine. The space between a patient's body and the machine can be tight. Unfortunately, Sharon is extremely claustrophobic. 

After arranging for the procedure at a radiology facility near her home in Washington DC, she attempted to have an MRI on an older magnet but couldn't go through with it. She was even given a little valium to relax her but the tight space was too much to bear. Sharon called me wanting to know what she should do. I told her that the MRI is the best test to detect a herniated disks in her spine. She needed the MRI. 

Sharon then asked me about an "open" MRI. Open MRIs became very popular in the 1990s. Instead of being surrounded by the machine while lying in a tube, the machine was in the shape of a clam with the sides of the MRI being open. There were still a few problems with the open MRI. Although the sides were open, the top of the machine was very close to the patient's face. This design still bothered some patients who suffered from claustrophobia. 

The bigger problem with the Open MRIs was the strength of the magnet. Weaker magnet strength means lower image quality. Most standard MRIs have a strength of 1.0 Tesla which gives good images. Most open MRIs have a magnet strength of 0.4 Tesla. This markedly degrades the image quality, compared with standard MRIs. Additionally, many advanced MRI techniques cannot be performed with these weaker magnets. 

Sharon asked what do we do at my office. I told her we have the very latest in "open" MRI technology, which addresses both of these issues. Our brand new MRI has a magnet strength of 1.5 Tesla which is stronger than most standard MRIs. This produces superior images and allows us to perform advanced MRI techniques and sequences. The stronger magnet strength also decreases the scan time allowing the patients to finish their exams faster. 

The opening (also called the bore) in our new MRI is very wide with the machine far from the patient's face. The standard MRI would be several inches from the patient's face; however our wide bore open MRI is one foot from our patient's face. This dramatically decreases the sensation of claustrophobia. This wide bore is approximately 2.3 feet wide, which is ideal for claustrophobic patients and larger patients who need more room. With the older model MRIs, one's entire body has to enter the MRI. Our new MRI is 4 feet long. This is much shorter than most MRI's and is in the shape of a donut (rather than a long coffin-like tube). This means that for a majority of tests, our patient's head is outside of the machine, helping to ease the sensation of claustrophobia. 

I told Sharon that since we placed our new MRI, we practically haven't had any patients complain of claustrophobia. Our referring physicians, especially our surgeons and neurologists, have also been very pleased with the image quality produced by our machine. Sharon came to my office in Toms River and had her examination without any problems. She was so comfortable in our MRI she actually fell asleep! The good news for Sharon is she did not have a herniated disk. She had a small tear in her disk that was causing her symptoms and will heal in several months without surgery. 

If you are claustrophobic but need to undergo an MRI, before you head to the first facility with an "open" MRI, here is my advice: first contact the facility and ask about the strength of their Open MRI. Ideal strength for the MRI is "1 Tesla" or greater. If you are not sure if a facility's MRI is spacious enough for your comfort, visit the facility and ask to see the machine. You may also ask if you can lie down in the machine to get a sense of how the procedure will feel. Remember, not all MRIs are alike, and you will want to make certain that the one you will be using provides adequate strength and maximum comfort for your examination.