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One of the most effective, popular and rapidly developing research methods today is magnetic resonance imaging (MRI). MRI of the lumbosacral spine is the best way to carefully examine degenerative-dystrophic changes and other pathologies in this area.
With the help of MRI, you can make the correct diagnosis and begin timely treatment of detected ailments and abnormal changes. A neurologist prescribes a diagnosis of the lumbar region and, according to the results, analyzes the complete clinical picture of the disease. Having collected together the patient’s complaints and his medical history, the doctor makes a diagnosis and the course of therapy begins.
Why MRI of the lower back, sacrum?
Magnetic resonance imaging is performed in three planes: transverse (axial), longitudinal (coronal) and lateral (sagittal). The tomograph scans the areas of examination, and the data is immediately displayed on a computer monitor. The resulting scans have a slice thickness of no more than 3-4 millimeters. A transverse or axial projection is made with the smallest possible slice thickness.
Sometimes magnetic resonance imaging of the sacrum is prescribed with the use of a contrast agent, thanks to which the images are more detailed and informative.
Most often, this procedure is recommended if a tumor is suspected, as well as to clarify the diagnosis in case of a dubious picture on a native study. For example, to differentiate between a sequestered (torn off) disc herniation and a tumor.
MRI of the spine, namely the lumbosacral region, is a universal examination in which the zones of the lower part of the spine are scanned by a tomograph at different angles. The procedure results in images of the joints, muscles, blood vessels, cartilage, nerve roots, spinal cord and vertebrae. Tomography of the lumbosacral zone helps to identify violations in these structures.
When should you get an MRI scan?
Magnetic resonance imaging of this area of the spine is recommended for osteochondrosis of the spine (a chronic disease of the spine and its departments, it affects the intervertebral discs and cartilage, most often people suffer from osteochondrosis after 35-40 years of age), with injuries, pains of unknown origin to clarify their nature.
Patients with anomalies in the development of the lumbar region, with metastases of tumor cells in this area, instability or dysfunction of the spine, injuries of the lumbar spine, as well as with hernias and protrusions of the lumbosacral spine, need to be diagnosed.
Diagnosis of the lumbosacral region allows you to identify diseases that cannot be determined by conducting other examinations.
Indications and contraindications
The indications of the examination by magnetic resonance imaging include: pain in the lower back and lower extremities, sensory disturbances in the lower extremities, the presence of metastatic changes in other parts of the spine; as well as with hernias, osteochondrosis, circulatory disorders in the lumbosacral spine. Before surgery on the lower back, it may be necessary to conduct this study, as well as after the operation.
Contraindications for MRI include:
- pregnancy in the first trimester;
- fear of closed spaces (claustrophobia is a serious ailment in which it is quite difficult to do an MRI, so the procedure can be performed with an open circuit or when a person is under anesthesia);
- weight exceeding 120 kg;
- the presence of a pacemaker, installed heart valve prostheses, ferromagnetic devices and implants, wires, fragments, hemostatic clips of cerebral vessels, the presence of an inner ear prosthesis.
The bracket system, implants, titanium prostheses do not interfere with the work of the tomograph and make it possible to conduct a study. This is due to the fact that these designs are made of materials that do not affect the smooth operation of the machine.
Advantages of MRI of the lumbosacral spine
The advantages of MRI diagnostics include: modern equipment that does not irradiate the body with x-rays; obtaining images in different planes; image accuracy is 95%; the ability to enlarge images tenfold; the possibility of simultaneous diagnostics of the spine and spinal cord.
The procedure itself lasts from 15 to 30 minutes, depending on whether contrast will be injected. It takes up to 15 minutes for an MRI without the addition of a contrast agent, and from 15 to 30 minutes for a procedure with intravenous contrast.
A staining substance is introduced to clarify the diagnosis. The contrast passes through the vessels and accumulates in the tissues. Because of this accumulation, the visualization of the spine becomes clearer and more detailed. The contrast is completely eliminated from the body within a day.
Contraindications to the introduction of a contrast agent are:
- individual intolerance to the active substance (gadolinium sulfate);
- hepatic and renal insufficiency;
- severe heart disease;
- lactation period (or, if there is an urgent need for contrast, the woman stops feeding for 2 days after the introduction of the contrast, expresses milk and pours it out).
Preparing for the procedure
Preparation for the study is not difficult. Eating, drinking and taking medications before diagnosis is possible.
If the patient has previously experienced bouts of claustrophobia, this should be reported to the specialist conducting the diagnosis. The health worker may give you sedatives or a bulb that can be squeezed during the exam if you feel discomfort or fear. When you press the pear, the examination will be immediately stopped.
Before the MRI itself, it is necessary to remove metal jewelry, a wig, a hearing aid, and a denture. Smartphones and credit cards do not need to be taken to the procedure. It is advisable to wear clothes that can be easily removed. Sometimes private clinics provide disposable sterile clothing.
Stages of the study and interpretation of images
MRI of the lumbosacral spine is performed in several stages. The first stage – the person lies down on the table, which moves inside the tomograph to such a distance that the area under study is under the scanner built into the tunnel of the tomograph.
Previously, the X-ray laboratory technician can fix the patient’s arms, torso and head so that he does not move during the examination. Then the X-ray technician goes to the next room, where he controls the operation of the apparatus on the computer, and starts the tomograph. Unlike CT, where the tomograph ring rotates around the area of the body being examined, no rotation occurs on MRI, but the device makes various sounds and noises, so it is better for the patient to wear earplugs or headphones so that these sounds do not cause discomfort. The procedure lasts from 15 to 30 minutes, and after it is over, you can get up and dress.
If the patient is afraid of diagnosis, then you can come to the procedure with a loved one who will be nearby and support. The examination itself does not cause pain or discomfort.
MRI can be prescribed even for children, the main thing is to fix the child and calm him down before starting the procedure. There are no contraindications for magnetic resonance imaging in children. If the child has certain symptoms and the doctor wants to confirm his diagnosis, then an MRI should be done.
The doctor deciphers the pictures within 15-30 minutes and writes a conclusion. The patient with the obtained images and the conclusion is sent to the attending physician. It can be a vertebrologist, therapist, neurologist or traumatologist.