Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine.
David Tabriz, MD University of Florida – Gainesville College of Medicine, Gainesville, FL
Of the primary imaging modalities (radiography, ultrasound, computed tomography, nuclear medicine, magnetic resonance), magnetic resonance imaging (MRI) is the most novel of the five used today. Despite the longer time and higher costs, which limit its use, the lack of ionizing radiation makes MRI attractive. For this reason, many research initiatives are aimed at expanding the role MRI has in modern medicine.
MRI has found success in replacing at least some fluoroscopic diagnostic studies. Although it is unlikely that MRI will soon replace fluoroscopic guidance for most invasive procedures, recent work is highlighted below.
Most diagnostic procedures performed using fluoroscopic imaging are unlikely to be replaced by MRI, but MRI is beginning to replace certain procedures (e.g., conventional angiograms, defocography). Other procedures are primarily in the research phase (e.g., swallowing studies, cystourethrogram), although human studies offer promise for their utilization in the not-too-distant future.
Just as computed tomography (CT) angiography has supplanted purely diagnostic fluoroscopic angiography, both contrast- and non-contrast-enhanced MR angiography (MRA) now play an active role in assessment of vasculature patency and pathologies. MRA is seeing use throughout the body, with modern day use and research spanning neurologic, cardiac, thoracoabdominal and extremity vascular evaluation. Furthermore, novel processing algorithms are being refined to provide additional clinically relevant metrics (e.g., perfusion time, flow turbulence, etc.).
Primarily in the research stages, both non-vascular and vascular interventions using MRI exist.