Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) is a medical imaging technique used primarily in medical diagnostics to visualize internal structure, the function of tissues and body organs.

MRI uses electric and magnetic fields. The high-frequency pulses (radio waves) stimulate atoms with an odd mass number (dipoles) in the human body, so that they vibrate. Different types of tissues of the body are determined by different so-called relaxation times. In this way, the contrasts between organs and tissues are made visible.

Images showing the body on each possible level depict all organs in detail, thus meaning that potential pathological changes can be recognized.

The process is performed completely without x-rays. However, in Germany it may only be used by radiologists.

MR Angiography

This method makes it possible to examine your blood vessels without surgical intervention. With the help of the magnetic field technique, we create a three-dimensional model of your vessels so we can see if everything is running “smoothly” there. It helps to recognize narrowing and tissue weaknesses (aneurysms) that may cause circulation problems, stroke or bleeding. The MR Angiography is so advanced that its image quality is the same as that of conventional angiography. In case of specific problems beyond vasoconstriction, e.g. in an upper or lower limb artery, MR Angiography provides more precise information than conventional angiography does. 

Advantages of MR Angiography compared with X-ray Angiography (DSA)

The standard method of examination used to be X-ray Angiography. For this purpose, a thin tube (catheter) was inserted from the groin into the artery. While x-ray contrast media was injected through the catheter under high pressure, we would create x-ray images which depicted the blood vessel filled with contrast agent.

MR Angiography no longer requires inserting a thin tube (catheter) from the groin into the artery. This saves approximately four hours of semi-hospitalization. In MR Angiography a contrast agent is injected into the vein. In addition to that, no x-rays are used in MRAngiography, but the vessels are visualized with the help of a strong magnetic field.

Advantages of MR Vessel examination

• In MR Angiography, no catheter is inserted into the femoral artery. The contrast material is injected only into the arm vein.
• In the case of specific problems, MR Angiography provides more detailed information than the regular x-ray angiography.
• The examination is done quickly and without semi-hospitalization.
• There are no problems such as bleeding or clotting disorders.
• MR Angiography does not use x-rays. The vessels are shown with the help of a strong magnetic field.
• The contrast agent used in MR Angiography does not contain iodine and can therefore be used for patients suffering from hyperthyroidism.

The procedure is completed without x-rays. However, in Germany it may only be performed by radiologists.

MR Mammography

Sometimes, the MRI examination of the breast can be used not only complementarily, but also as an alternative to x-ray mammography. It can help to clarify certain issues that may have possibly been left open after mammography and other examination procedures of the breast. As no x-rays are used during magnetic resonance imaging (MRI), this method is considered to be especially gentle.

The breast MRI is performed, for example, in order to precisely examine patients with breast cancer before surgery. In the after-care of patients who have already undergone breast surgery or have breast implants, MR Mammography is also used. This method complements the conventional x-ray mammography procedure, especially for women with dense tissue structures. 

MR Mammography indisputably has the highest sensitivity and preciseness for the detection of breast tumours that are already growing invasively.

Who are the examinations intended for?

• For women with diagnosed changes in the breast tissue (such as a digital rectal examination, or abnormalities in the x-ray or ultrasound examination): Magnetic Resonance Imaging of the breast may clarify whether the changes in the breast are benign or malignant, in the cases when the usual screening tests such as mammography (x-ray) and ultrasound do not provide reliable information.

• For patients with breast cancer, as a test before surgery to exclude other focuses of cancer and to plan the operative procedure. Should chemotherapy be required before surgery, its efficiency and progress can be checked. 
• For breast cancer patients in after-care to exclude a scar recurrence (tumour formation on the scar) with greater safety.
• For women with breast implants (e.g. silicone): The implants can interfere with the conventional diagnostic mammography (the implant covers large parts of the glandular tissue as a ‘shadow’). In addition, the position and integrity of the implants can be checked. 
• For patients who may have specific reasons which do not allow them to undergo breast cancer screening or x-ray mammography or they do not wish to do it: For example, young women with frequent breast cancer cases in the family history, who need an early detection of breast cancer as early as after the age of 30.

Advantages and disadvantages of magnetic resonance imaging of the female breast

• The images are created with the help of a strong magnetic field. X-rays are not required.
• The magnetic resonance imaging can be so good that it complements mammography and / or breast ultrasound in case of appropriate indications.

Magnetic resonance imaging alone cannot always distinguish benign tumours from malignant ones or detect breast cancer in its preliminary stages (carcinoma in situ).

The procedure is performed completely without x-rays. However, in Germany it may only be performed by radiologists. 

Sports Medicinal & Musculoskeletal Diagnostic Procedures

The focus of the practice is on musculoskeletal imaging in order to diagnose acute and chronic illnesses of the whole musculoskeletal system in adults and children. Cartilage is of central significance for the integrity of the joints. Using ultra-high-resolution MRT, an unparalleled image can be created of the deterioration of cartilage – even in its early stages. An exact diagnosis forms the basis for early and efficient treatment. Of course, we also offer measurement of bone density for the early recognition or progress and therapy monitoring of osteoporosis.

Computed Tomography (CT)

In Germany, Computed Tomography may only be performed by radiologists.

Unlike a regular x-ray examination, CT creates not only a simple silhouette, but also a cross-sectional image of the corresponding organ or body section. One or two x-ray sources rotate around the affected body part during recording, while the opposite x-ray detectors collect the weakened beams left after having gone through body structures (organs, bones, soft tissue).

Converted into digital data, this information provides a slide by slide picture of an anatomical cross-section that can be reconstructed and viewed on the screen.

Periradicular Therapy (PRT)

Periradicular Therapy (PRT) is a form of therapy that can be used in case of chronic back pains which are caused by changes in the intervertebral discs (e.g. herniated disk). The treating physician inserts a thin needle into the area of the nerve root and/or into the small vertebral joint. When the needle is correctly positioned, which is checked by computed tomography, a mixture of a local anaesthetic, a cortisone preparation and an x-ray contrast agent are administered. The medication is only active in the nerve root. An effect on the whole body is almost excluded. The intervention is carried out under local anaesthesia.

We carry out this procedure with the help of multislice computed tomography (multislice CT). Therefore, we are able to precisely check the position of the tip of a needle and we can treat the area causing pain very precisely. It is also possible to distinguish other structures such as blood vessels, bones and muscle tissue, in order not to damage them.

After four to six sessions, the patient will suffer from much less pain or will be completely pain-free.

Whole Body Imaging (MRI), Early Diagnosis & Prevention

Whole body MRT makes it possible for us to view an image of the whole body – all organs, the skeleton, the spine, the circulatory system and the joints. The examination is principally for the early detection of cancer. Depending on the patient’s age and genetic or other previous conditions, other questions can be answered – such as whether there is a narrowing of the blood vessels. The examination can take place without x-ray and usually without the use of contrast agent.

Low-dose CT of the Lung

Nowadays, lung cancer can be diagnosed reliably and in a very gentle way, using so-called low-dose computed tomography. With the help of modern technology, tumours with a diameter of only a few millimetres can be detected.

The process is very suitable as an early recognition method for patients with an increased risk of lung cancer (e.g. heavy smokers). Initial studies show that many very small (< 20 mm), lung tumours can be diagnosed, which are easily operable and therefore curable.

In addition to its use as an early detection procedure for lung cancer, depending on the question to be answered and the patient’s physique, we also use low dose CT of the lung to clarify illnesses which affect the lungs only (i.e. asbestosis, sarcoidosis), and to look for tumours in high-risk patients.

Advantages and disadvantages of lung cancer early recognition with computed tomography

• The low-dose CT in multilayer technology is considered to be the most sensitive method for early recognition of lung cancer.
• The low-dose CT increases the chances of recovery since lung tumours can be detected in very early stages.
• With the help of low-dose CT, lung cancer tumours that „hide“ behind vessels and diaphragm domes can also be recognized. The conventional methods do not detect these tumours.
• With the help of computer-assisted analysis of the CT data we perform as a standard measure, the size of a tumour can be accurately measured and the smallest changes can be detected. By means of a CT follow-up examination at three to six month intervals, benign tissue changes can be differentiated from malignant ones based on a lack of growth.
• The introduction of new detector systems makes it possible to perform lung examinations with a very low radiation dose. With the multi-slice CT technology, the radiation exposure is approximately 0.2 to 0.6 mSv. By way of comparison: every citizen in Germany is, on average, exposed to a radiation dose of about 2.5 mSv from the environment every year.