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Why musculoskeletal MRI is better at 3T
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3T-MRI (3 Tesla magnetic resonance imaging) is MRI done with a stronger magnet. Using a stronger magnet results in better images. Tesla is a unit of “magnetic field.” Using 3T-MRI, we can get better and sharper pictures in less time than is possible with a weaker magnet. 3T-MRI is the best way to do MRI. Musculoskeletal MRI is improved at 3T for at least four reasons. 3T has higher signal to noise and this makes MR imaging of the joints faster, more detailed (for trabecular detail) and higher in resolution. And it is twice as sensitive to contrast enhancement. Fat saturation of the joints is also improved at 3T. So when you combine fat saturation plus contrast you get more sensitive studies to areas of inflammation, tumors and healing. All of these will have increased blood flow and enhancement which is easier to detect when you use fat sat. We also scan most areas contiguous (And with thinner sections) and this means we scan up to 30% more of the body than other scanners. Other scanners will scan with a skip but since we are faster we can take the time to scan everything in the area of question. The images we scan in the extremities are often 512x512 matrix and 2mm thin. This is quite a bit more resolution than any other scanner and this takes only 3 minutes. Higher signal to noise (which is doubled at 3T) theoretically means the scan can scan up to four times as fast. In real practice it is better to say we only scan twice as fast. But twice as fast is a true improvement. The patients are getting more restless and if you can produce a higher quality scan in half the time this is a true advance in technology. Bring more sensitive to trabecular detail makes our bony imaging very detailed and our sensitivity to bone marrow tumors and subtle stress fractures much higher. This is important since the most common cause of bone pain is a subtle fracture. We are extremely fortunate to have such good bony detail and where other scanners say there is a bone bruise we can actually see the fracture line in most cases. Whenever we see radiating linear edema in the bone this is definitely from a subtle fracture. If you have lower resolution and less trabecular detail it is understandable why you might miss a fracture. I have included a image in this article of a significant foot fracture missed on an OPEN MRI scanner. Our ability to scan with thinner sections and higher resolution also directly impacts our ability to see abnormalities. If the images are of lower resolution and detail they basically are less sensitive for finding an abnormality. Being able to scan faster, thinner and with higher spatial resolution has given us the ability to see very subtle things, like small areas of arteriovenous shunting, or subtle areas of inflammation or microtrauma. We can see the individual fibers of the anterior cruciate ligament of the knee or the subtle fibers of the calcaneofibular ligament in the ankle. We see more and can diagnose more abnormalities. When you combine the higher resolution images with dynamic contrast enhanced imaging you can see details of tumors or diseases that we simply could not see before. When we look at muscle trauma or even polymyositis we simply see the abnormalities of the muscles that you cannot see without MRI. And we see much more extensive changes than the doctors think are present. It’s amazing how well we can see without any xrays or high energy particles. Using ionizing radiation is problematic for our current society. It has not been explained to most patients that the risk of getting cancer is 1/500 for children per CT scan and 1/100 in adults. What is worse is that a CTA (computer tomography angiographic) study is 3 times more radiation dose. And a CT colonoscopy can be up to 4 times the radiation dose. The combination of fat saturation and contrast is truly amazing. We see areas of subtle inflammation which we could not see previously. With 3T MRI of the foot and hand also allows us to scan with very small fields of view which basically is like being able to enlarge the area we are studying and see it with higher detail. When you combine these capabilities you end up seeing details of the bones and joints and wrist that were previously never seen except in pathological or autopsy specimens. Using 3T we can non-invasively see details of the response to treatment to rheumatoid arthritis medication. We can see the effects of neoadjuvant chemotherapy for breast cancer. Some patient drive to us from Lewes because we are the closest 3T-MRI machine. Educated doctors insist on 3T-MRI quality. I hope you will think the same in the future. My point? If you need an MRI, have it done on the very best machine available. The first time. Having an MRI done on a less powerful, inferior, machine—which can miss things—will result in your needing a second one on a better, more powerful, machine to confirm the results. If your test is positive on the poor test you may repeat it at 3T-MRI because you can see more. If your test is negative, you will repeat it to make sure there is nothing there. So, why waste your time and money? Why not be sure from the beginning? 3T-MRI is better than CT and OPEN MRI, both of which give inconclusive results. If you need imaging, get the very best available. Use 3T-MRI. (www.3t-mri.net) Be certain, don’t get your scan done on an inferior machine. 3T is generally better for imaging in every part of the body because it has twice the signal to noise and therefore much better capabilities for imaging each area. The images are so clear and crisp at 3T and obtained in the fastest possible times.
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