Medical Imagining Department
MEDICAL IMAGING DEPARTMENT
Academica Medical Centre owns a complete mdical imaging department, provided with premium devices manufactured by General Electric Healthcare; the medical x-ray and imaging laboratory within this department is provided with a magnetic resonance imaging (MRI) equipment, a computer tomography (CT) device and a conventional X-ray device – state-of-the-art platforms which provide the opportunity of performing exceptional non-invasive investigations.
MAGNETIC RESONANCE (MRI)
Unique by its investigation software which alows highly reliable examinations of all anatomical regions of the body, the nuclear magnetic resonance equipment of Academica Medical Centre provides images of excellent quality (neurovascular, cardiovascular, abdominal, orthopedic, prostate, breast and other organs), including spectroscopic techniques which facilitate the diagnosis.
MRI is an imaging method of high performance, non-invasive and without radiations, which uses a powerful magnetic field in order to obtain section images of the human body. Because the method of obtaining the images is very sensitive, even minor lesions with millimeter-like dimensions can be shown.
By MRI all organs can be investigated and this is an election method for disorders of the nervous system, genital and musculoskeletal disorders
In certain cases (except for patients with advanced kidney failure), the patients receive a paramagnetic contrast substance in order to describe and mark the lesion and to be able to differentiate it from other pathologies. Allergic reactions to the paramagnetic contrast substance are exceptional.
Depending on the studied region, a standard investigation of an anatomical region can last between 20 and 60 minutes.
The investigation does not require a special preparation of the patient (previous examinations, diets or medications).
The advantages of the method include:
- the differentiation of two neighbor tissues;
- investigation method without radiation;
- multiplanar representation;
- provides clear and detailed images of different soft tissues (internal organs, tumors, vessels);
- spots very small lesions (especially when performing cerebral investigations);
- contrast substances which are administered (only if needed) have a minimal risk for the patient;
- proved efficacy in the diagnosis of nervous system disorders.
The contraindications of the method do not pertain to the risks it has, but to the conditions of the patient or existence of implants:
- patients with a pacemaker or metal implants, metal cardiac valves, recently implanted hip prostheses. The existence of a pacemaker (heart stimulator) or cerebral vascular postoperative metal clips is an absolute contraindication for this investigation!!!
- In case of patients with metal prostheses, stents, etc., is is important that the doctor who requests the investigation mention that the materials out of which the prostheses are made will be MRI compatible.
Particular situations which require precaution in MRI:
- patients who suffer from claustrophobia. Claustrophobia (fear of small closed spaces) is a relative contraindication. To prevent it, a previous preparation is recommended, which can be performed by the imaging specialist – a sedation can be ensured in order to perform the examination. The sedation of the patient is a procedure that implies the presence of an anesthesiologist, monitoring of the patient and bearing all risks that it involves. If the referring doctor did not recommend the sedation and the examination cannot be performed because the patient suffers of claustrophobia or he/she is nervous, then the radiologist can recommend the repetition of the examination with sedation performed by an anesthesiologist.
- In patients with unstable vital functions, requiring monitoring, the examination can be performed only in the presence of an emergency medical team accompanying the patient.
- Another particular situation is that of maternal pathology during pregnancy. Even though up to this moment the adverse reactions of this investigation were not shown, MRI should be avoided during the first three months of pregnancy – it can be performed only if the benefits exceed the risks for the fetus. However, if the investigation is necessary, the attending physician together with the imaging doctor will evaluate the benefit/risk ratio and will decide the suitability of the examination.
- • As for pediatric examinations, the referring doctor is the one that has the expertise to evaluate whether the examination must be performed under sedation or not. Sedation is generally mandatory for an age between 6 months and 6 years; outside these limits an examination without sedation can be tried; if this is not possible, the examination under sedation will be rescheduled and will be monitored by an anesthesiologist. The administration of the contrast substance is to be avoided as much as possible for an age under 1 year.
The MRI investigations which can be performed at Academica Medical Centre, as well as their prices, are found in Services and prices.
COMPUTED TOMOGRAPHY (CT)
Computed tomography (CT) is an imaging investigation technique which uses X rays in order to sutdy anatomical regions, such as the head, chest, abdomen, pelvis and arms and legs, providing detailed images of the structures of the entire body. The information obtained after the CT scanning is processed by a computer and transformed in images which are afterwards interpreted by a specialist in medical imaging.
Modern CT devices are so fast that they perform the scanning of a significant part of the body in just a few seconds. This great acquisition speed is beneficial for all patients and especially for children, elderly persons and critical patients.
Certain CT examinations require the administration of a contrast substance, used to improve the visibility of the structures within the interest area, to optimally describe the lesions with or without the appartenance to an organ. The contrast medium is a iodine substance which is administered either intravenously (by approaching a peripheral vein) or orally, by fistula or in articular spaces. In some situations it is enough to obtain a negative contrast within the digestive tract by water ingestion. The contrast substance, orally administered, is used just to make the digestive lumen opaque, while the contrast substance, i.v. administered, is used to highlighgt the circulatory system and to show, mark and describe different pathological lesions.
Using a special equipment, the computed tomography investigation generally lasts between 5 and 30 minutes, including the preparation of the patient for the examination.
Depending on the studied region, the patients can be recommended to follow a special diet and medication. In case this diet was not observed, irrespective of the reasons, the patient must notify the doctor and the investigation will be postponed.
Advantages of the method:
- The method is non-invasive and pain-free;
- Rapid and simple examination, impossible to replace in medical emergency and in critical patients, rapidly spotting bleeding or internal organs trauma
- The representation of the organs, blood vessels and skeletal elements are all in the same time highly accurate;
- It provides detailed images of various types of tissues (lungs, heart, parenchyma organs, blood vessels, bones)
- It allows the exploration of patients with medical devices that cannot benefit from a diagnosis by means of NMR examination and is less likely to be sensitive to movement compared to NMR examination;
- X rays used for CT scanning with advanced and fast equipments do not usually have side effects;
- It is the diagnosis solution for a very wide range of medical problems and it has an excellent cost-efficacy ratio.
Risks and factors which can influence the results of the test:
- Irradiation risk which in case of sole investigation is minimal, but is increasingly high in case of repeated examinations; the doctor will have to be informed about the number of exposures to radiation before the investigation is being performed.
- Pregnancy is an absolute contraindication for CT examination, as for any other type of investigations that use X rays. In case the patient suspects she might be pregnant, the investigation is postponed until a pregnancy test is being performed.
- Patients with allergic history are recommended to avoid the administration of the contrast substance because it is iodine-based and can trigger relatively important allergic effects. Persons allergic to iodine or with multiple allergies can perform the examination only if they undergo desensibilization under medical control 24 hours before the procedure. The patients must state all allergies. Kidney samples must be within normal ranges (the patient must have his/her creatinine previously measured). If renal function is impaired, the patient can go into kidney failure. The patient should not eat 3 – 4 hours before the procedure.
- The procedure must be avoided in patients with decompensated advanced kidney diseases or severe diabetes mellitus because the contrast substance, which is mainly released through the kidneys, can worsen their dysfunction; in patients with liver or kidney conditions, the contrast substance will be administered under close monitoring and only after some tests were previously run.
- In case the patient has diabetes mellitus and he/she is under metformin treatment, the contrast substance can lead to the occurrence of some problems; in this situation, the doctor will recommend when to stop the administration of metformin and when to restart it.
- The method is not recommended in children unless the study is absolutely necessary and cannot be performed by means of other diagnosis method.
- An abdominal computed tomography must be performed before any barium-based tests, because barium generates artifacts which make the image more difficult to interpret.
- If the patient cannot stay still during the test, the acquired images do not have the best quality.
- • The presence of metal objects, as well as surgical clips or joint prostheses can determine artifacts.
The imaging department of Academica Medical Centre is provided with a 16-slice computed tomography installation (16 rows of detectors, so upon a complete rotation of the tube – which lasts just one second – 16 images are acquired). This equipment provides computed tomography facilities with a maximal confort and a reduced dose of exposure to ionizing radiations. The acquisition speed and resolution of images allow non-invasive, accurate diagnosis from colon cancer to vascular conditions and ensure highly reliable 3-D examinations, including virtual image reconstitutions (virtual colonoscopies, virtual bronchoscopies). The equipment is flexible, it has an ergonomic design and it offers maximum confort for the patient and the assessor.
It is a device with multiple advantages, out of which we mention:
- fast examination;
- low dose of irradiation;
- provides very clear images;
- CT can also be performed in patients with a more severe state, with unstable vital functions, that require monitoring (patients connected to special devices – X rays do not interfere with these equipments);
- in case of traumas, CT provides fast data about internal bleeding or other severe lesions;
- recommended to investigate the patients with severe cardiorespiratory conditions because of the short time necessary to acquire the images, which reduces the apnea (period of time during wich the patient should not breathe) to just a few seconds;
- investigation method useful to guide biopsies, collection release, abscess drainage, etc.;
- can be used in radiation therapy for a “treatment schedule” – accurate identification of the area that must be radiated;
- by processing the obtained images, 3-D images can be created of the studied region (reconstructions) or only certain structures can be highlighted;
The types of CT investigations that can be performed at Academica Medical Centre, as well as their prices are found in Services and prices.
The service is provided with a fixed installation for Roentgen diagnosis with a radiographic post. This allows the visualization of anatomical structures inside the human body by means of X radiation. The principle is based on the absorbtion difference of the rays depending on the density of the anatomical structures they cross and it provides the opportunity to perform the X-ray examination.
The conventional radiology system used at Academica Medical Centre is an equipment conceived to provide a variety of radiologic requirements: chest, abdomen, spinal cord, skeleton, cranium. It is a flexible system, easy to install and use, which provides an impeccable quality. A special advantage is the minimal radiation (by reducing the necessary exposure time and the automatic control system of exposures).
The advantages of this system are undisputed:
- The high frequency and power generator ensure a minimal exposure.
- The Automatic Control System of Exposures (ACSE) leads to the performance of qualitative exposures, with no failures, thus reducing the radiation of the patient.
- Previous Automatic Settings of Parameters (PASP), depending on the desired investigation, supports the medical personnel. It is ergonomic and very easy to use.
For X-ray highly reliable AGFA films are used which allows the decrease of the dose of radiations. The system of film developing is automatic and determines a very good quality of the radiologic image, standardizing the entire process and reducing potential errors to a minimal level.
The only contraindication of radiologic examination is PREGNANCY.
The types of radiologic investigations that can be performed at Academica Medical Centre, as well as their prices are found in Services and prices.