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NUCLEAR MAGNETIC RESONANACIA
TECHNICAL DEFINITION PREPARATION PROBLEMS TYPES INDICATIONS ACHIEVEMENT PREPARATION ADVANTAGES TO SEE TO CONSULT

DEFINITION

The Nuclear Magnetic Resonance (RMN), or Nuclear Magnetic Resonance (NMR) in English, is a radiological exploration that is born to beginning of the 80s and is a skill that allows to obtain images of the organism of bloodless form (not invasive) without expressing radiation ionizante and in any plane of the space.

It possesses the aptitude to differentiate better than any other radiology test the different anatomical structures. Contrasts can be added paramagnéticos like the gadolinio to delimit even more structures and parts of the body.

The securing of the images is obtained by means of the stimulation of the organism to the action of an electromagnetic field with a magnet of 1,5 Tesla (equivalent to 15 thousand times the magnetic field of the ground). This magnet attracts to the protons that are contained in the atoms of the textiles, which will line up with the magnetic field.

When the pulse is interrupted, the protons return to his original relaxation position, liberating energy and expressing signs of radio that are received by a recipient and analyzed by a computer that will transform them into images (every textile produces a different sign).

In the Magnetic Resonance the images are realized by means of courts in three planes: axial, frontal and sagital, without need that the patient changes his position. The magnetic resonances cross the bones for it the soft textiles can be seen very well.

HOW IS A RMN REALIZED

The RMN device will be in a place that is isolated of all kinds of exterior magnetic fields.

The patient remains knocked down in a stretcher, and this one slides inside the pipe that generates the magnetic fields. The device generates magnetic fields about the patient and expresses waves of radio that they go to the textiles to study. But it is bloodless and not invasive for the patient.

Every "court" will be necessary from 2 until 15 minutes, for it it is possible to be late in this exploration between 30 and 60 minutes.

PREPARATION OF THE PATIENT FOR THE STUDY

  • A diet of 6 hours is indicated usually before the exploration.

  • There must be signed a written assent of acceptance of risks
  • It has not to of taking metallic objects (rings, necklaces, earrings, etc...) in any part of the body, inclusive mobile braces.
  • It must remain calm during the exploration.

PROBLEMS DURING THE RMN

It does not produce pain. The magnetic waves do not produce damages.

The principal problem is the claustrophobia (feeling of being shut up), so much for being in a closed pipe as why the machine produces a lot of noise.

The stretcher can be cold, and lasts, a small pillow can be necessary.

It is necessary to realize RMN neither in pregnant women, nor in persons who have a well-established pacemaker.

EXPLORATIONS OF MORE FREQUENT RMN

  • Thorax RMN
  • Abdominal RMN
  • Heart RMN
  • Cranial RMN
  • RMN lumbosacra
  • Spine RMN

INDICATIONS

His indications are very varied, considering the big wealth of images that it produces. If it gets together with the skill of the TAC (scanner), any organ can be studied practically. In general his indications are:

  • Affectation of the SNC: it provides major resolution than the TAC, especially in affectation of the white substance, later pit and trunk of the brain. It is used for the study of these structures affected by tumors, venous thromboses, you tackle of desmielinización (multiple sclerosis), cerebral infarctions, etc...
  • Spinal cord affectation.
  • Tumor: tumor alterations of any type and in any organ Cardiovascular: it is possible to study the heart as well as his circulation, the arteries, including the aorta and the different veins.
  • Otolaryngology: illnesses of ears, bosoms, mouth and gullet System musculoesquelético: It is very useful for the diagnosis of muscular injuries, you will articulate and ligamentosas.

HOW IS THE EXPLORATION REALIZED

One usually undresses the patient and a robe is placed for the exploration. It will have to get rid of any metallic object that it wears.

The patient will be knocked down in a stretcher that moves ahead and backwards. The pipe of the RMN has a cylindrical opening in his center that is where the patient will remain introduced. Some models are opened to avoid the claustrophobia.

According to the potency of the device the exploration will last from a few minutes up to approximately 30-45 mn.

During the same one, an intense noise is heard in the shape of pulses, which are produced by the magnetic field. This noise weakens by means of a few protective helmets.

The principal problems that can take place are the claustrophobia and that the noise turns out to be intolerable.

It is important that the patient is completely calm to obtain good images.

In some explorations it will be necessary to inject a contrast into a vein during the exploration.

In small children, it can be necessary to use sedation so that it is calm during the exploration. This sedation can be administered by mouth or by means of injection.

In the cases in which there should be necessary the use of endovenoso contrast or sedation one will ask him to sign a sheet of informed assent.

As soon as the exploration was finished a normal life can be done, without side effects existing.

WHAT PREPARATION IS NECESSARY?

In general it is not a necessary any preparation, being able to take his habitual mediation before to the RMN. If it is necessary that it is on an empty stomach they will communicate it to themselves on having given him the subpoena.

It is convenient that, before realizing it, it realizes his physiological needs not to want during the test.

If the patient has history previous to allergic reactions or serious illnesses, or bearer of someone prosthesis or another metallic object must communicate it previously to the test.

ADVANTAGES AND DISADVANTAGES

ADVANTAGES:

  • It is very sure since it does not produce radiation ionizante.
  • It is not invasive for the patient.
  • There is neither pain nor need for punctures.
  • It has a big resolution capacity, generating very good images of the different organs and textiles that with other diagnostic skills were not so finished.

DISADVANTAGES:

  • It can produce claustrophobia.
  • The intense noise can become very annoying.
  • It is relatively expensive with regard to other radiodiagnóstico skills.
  • In some cases it can be necessary to inject contrast.

Who cannot realize this skill?

At present the carrying patients of cardiac pacemaker are the only absolute contraindication.

If you are a bearer of some type of metallic implant or prosthesis in some textile or organ (for example, paper clips in cerebral glasses, stent coronary, prosthesis in knee or hip, cardiac metallic valves, etc...) must consult it previously to the test if it was not possible to realize, but almost all these implants are of materials not imantables that they allow to realize it.

A special case is the pregnancy. One usually tries to defer the resonance until it finishes, but if it is necessary it will make break of the first trimester.

During the first trimester it is not realized, unless it is definitely necessary to preserve the health of the mother, without it having been demonstrated that there exists a developing risk of malformations or of abortions.

TO SEE ALSO

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Writing: Medical equipment   Update: June, 2009


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