A lumbosacral spine MRI uses powerful magnets and radio waves to create pictures of the structures that make up the spine, the spinal cord, and the spaces between the vertebrae, through which the nerves travel.

Conventional radiography and computed tomographic (CT) imaging use potentially harmful radiation (x-rays) that passes through a patient to generate images. Magnetic resonance imaging (MRI) is based on the magnetic properties of atoms, and there is no exposure to the same type of radiation used in x-rays and CT scans.

A powerful magnet generates a magnetic field roughly 10,000 times stronger than the Earth's. A very small percentage of hydrogen atoms within the body will align with this field. Radio wave pulses are broadcast towards the aligned hydrogen atoms in tissues of interest, returning a signal of their own. The slight differences of those signals from different tissues enables MRI to tell the difference between various organs, and potentially, provide contrast between benign and malignant tissue.

Any imaging angle, or "slice", can be projected, and then stored in a computer or printed on film. MRI can easily be performed through clothing and bones. However, certain types of metal in or around the area of interest can cause significant errors in the reconstructed images.

Since MRI makes use of radio waves very close in frequency to those of ordinary FM radio stations, the scanner must be located within a specially shielded room to avoid outside interference. The patient will be asked to lie on a narrow table that slides into a large, tunnel-like tube within the scanner.

If contrast dye is used, it will be injected into a small vein of the hand or forearm. A technologist will operate the machine and observe you during the entire study from an adjacent room.

Several sets of images are usually required, each taking from 2 to 15 minutes. Depending on the sequences performed and the possibility of the need for a contrast dye, a complete scan may take up to a hour or more. Newer scanners with more powerful magnets, updated software, and advanced sequences may complete the process in less time.

Because of the strong magnets, certain metallic objects are not allowed into the room. Items such as jewelry, watches, credit cards, and hearing aids can be damaged. Pins, hairpins, metal zippers, and similar metallic items can distort the images. Removable dental work should be taken out just prior to the scan. Pens, pocketknives, and eyeglasses can become dangerous projectiles when magnet is activated and should not accompany the patient into the scanner area.

Because the strong magnetic fields can displace or disrupt the action of implanted metallic objects, people with cardiac pacemakers cannot be scanned and should not enter the MRI area. MRI also should not be used for people with metallic objects in their bodies such as inner ear (cochlear) implants, brain aneurysm clips, some artificial heart valves, older vascular stents, and recently placed artificial joints. The technologist will usually provide you with a questionnaire which lists the potentially dangerous items.

Sheet metal workers, or persons with similar potential exposure to small metal fragments, will first be screened for metal shards within the eyes with x-rays of the skull. The patient will be asked to sign a consent form confirming that none of the above issues apply before the study will be performed.

A hospital gown may be recommended, or the patient may be allowed to wear a sweatsuit or similar clothing without metal fasteners.

Infants and children:

The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:

• infant test or procedure preparation (birth to 1 year)
• toddler test or procedure preparation (1 to 3 years)
• preschooler test or procedure preparation (3 to 6 years)
• schoolage test or procedure preparation (6 to 12 years)
• adolescent test or procedure preparation (12 to 18 years)

There is no pain. The magnetic field and radio waves are not felt. Some people experience a claustrophobic feeling from being inside the scanner. The table may be hard or cold, but you can request a blanket or pillow.

The machine produces loud thumping and humming noises during normal operation. Ear plugs are usually given to the patient to reduce the noise. A technologist observes the patient during the entire procedure and may be spoken to through an intercom in the scanner. Some MRI scanners are equipped with televisions and special headphones to help the examination time pass.

Too much movement can blur MRI images and cause errors in the image. If the patient has difficulty lying still or is very anxious, they may be given medicine to relax them (a sedative), by mouth or through a vein. There is no recovery, unless sedation was necessary. After an MRI scan, you can continue normal diet, activity, and medications.

After plain x-rays of the lower spine, MRI is usually the next noninvasive imaging test a doctor will use to look into back pain and spreading leg pain. MRI is excellent at showing degenerative changes, such as from arthritis, which may be narrowing the spaces through which the spinal nerves travel.

In addition, MRI can show disease of the lumbar discs that may be bulging and compressing the spinal cord.

An MRI may be done after traumatic injury to rule out acute compression of the spinal cord, if weakness or paralysis exist. MRI is also better than CT scans in the evaluation of abscesses, tumors, or other masses near the spinal cord. While CT is better at detecting fractures of the vertebrae, MRI can detect slight changes in the bone which may be due to infection or tumor.

There is no ionizing radiation involved in MRI. To date, there have been no documented significant side effects of the magnetic fields and radio waves used on the human body during an MRI scan.

The most common MR intravenous contrast agent, gadolinium, is very safe, and although there have been documented allergic reactions to it, it is an extremely rare occurrence. However, gadolinium should not be given if you are pregnant because of potential harm to the fetus.

If sedation is used, there are associated risks of over-sedation. The technologist monitors the patient's vital signs, including heart rate and breathing as needed.

People have been harmed in MRI machines when they did not remove metal objects from their clothes or when metal objects were left in the room by others.

MRI is more accurate than CT scan or other tests for certain conditions, but less accurate for others. The disadvantages include the high cost, long duration of the scan, and sensitivity to movement. People with claustrophobia (fear of enclosed spaces), or people who are confused or anxious, may have difficulty lying still for the relatively long scan times.

MRI is not portable and is incompatible with some metallic implants, life support-devices, traction apparatus, and similar equipment.

MRI is a superior technique in most cases where telling differences in soft tissues is necessary. It can show organs without blockage by bone and foreign bodies. It can show the tissues from multiple viewpoints and is a noninvasive way to evaluate blood flow.