From: email@example.com(Steven B. Harris)
Subject: Re: Disappointed and confused--don't know what to do
Date: 28 Apr 1999 08:13:38 GMT
In <01be90bc$c28fadc0$666335ce@newmicronpc> "Cindy" <firstname.lastname@example.org>
>Andrew Chung <email@example.com> wrote in article
>Exactly. The fact that a city of 300,000 has 6 MRI machines. Does that
>make sense? Of course, when doctors own testing facilities, you have to
>admit that it makes the situation a little suspect.
In this case, it's technology like John Henry vs. the steel drivin'
machine. Why more MRI machines here? Basically because not all
doctors can replace the findings of an MRI machine often by doing a
long and careful neurologic exam. Those that can, are hard to separate
out, and it's cheaper to pay for the time on the machine than it is to
pay for the long time it takes a neurologist to do that work and
document it by US dictation standards. And that's all she wrote. The
money therefore goes to the machines and those who make them, rather
than the docs.
In Canada they resist a lot of this by having a lot of docs type
into a PC in an office while they are talking to the patient. That all
goes into a big patient manangement database (these are being
connected) and documentation time drops a lot. Which means you keep
more people in the loop for the same money, because now they have the
time to do things which machines do otherwise if they don't. In the UK
most clinics don't even have labs. The system requires that the group
makes housecalls. The documentation system permits the time to be
spent that way.
The new flurocarbon contrast agents allow 3D ultrasound to see
coronary arteries. And the new MRI angiographic machines promise to do
the same. Watch that the same doesn't happen to you, John Henry. <g.>
From: firstname.lastname@example.org (Jonathan R. Fox)
Subject: Re: Head MRI
Date: Sun, 20 Feb 2000 22:02:12 GMT
On 16 Feb 2000 20:39:29 GMT, email@example.com wrote:
>Why is it necessary to inject something called catalinium or
>something likethis into the blood stream in order to perform
Gadolinium. It is a contrast agent that enhances the view of blood
vessels in the brain, thereby greatly increasing the diagnostic yield
of an MRI.
>What if one does not want this injected into one. Can a
>diagnosis for headache be done without injecting anything into
>the blood stream?
It depends on what they are looking for on the MRI, which depends on
the details of your problems and the results of your physical exam.
If you don't want to be injected with gadolinium, talk to your doctors
about the risks and benefits. I would say you probably won't want to
have something missed because you refused the contrast, and, in the
even you need surgery, you definitely don't want to deny your surgeon
the benefit of a gadolinium-enhanced MRI before he opens you up.
>What is the difference between a scan and an MRI?
"Scan" is a generic term for many things. Perhaps you meant CT scan.
A computed tomography (CT) scan uses radiation similar to an X-ray,
but takes pictures from many angles and uses complex mathematics
(computed) to form two-dimensional images of slices (tomos = slice,
graphy = picture, in Greek) of whatever you're imaging. An MRI uses
magnets and no radiation.
Jonathan R. Fox, M.D.