Upright Open MRI Centres
Upright Open MRI Centres Weight-bearing and positional imaging for patients in non-claustrophobic scanners Upright Open MRI Centres The Upright Open MRI scanners at the Upright Open MRI Centres in Leeds and London are unique in England. Using the latest technology and designed specifically to scan patients in weight-bearing positions, the scanners also bring enormous benefits to claustrophobic and anxious patients thanks to their open design. Upright Open MRI Centres enable more patients than ever before to benefit from the vital diagnostic imaging that an Upright Open MRI scan brings. Over 1500 Consultants already refer to Upright Open MRI Centres including the Royal National Orthopaedic Hospital (RNOH). Upright Open MRI scans The revolutionary design of the Upright Open MRI scanner allows MR imaging of most parts of the body. It is particularly applicable to the spine, the major joints and the pelvic floor which can be examined under physiological conditions, upright in the weight-bearing position. Patients can be imaged; • in a sitting position • in flexion, extension, rotation and lateral bending • in their position of pain • lying down • standing The choice between MRI scanners; conventional, open or upright open MRI? Conventional tunneli and openii MRI scanners only scan in the supine, non- weight-bearing position and as a result may not detect pathology that becomes visible only when the patient is scanned in an upright position. Upright Open MRI scanners have clear advantages over supine imaging and may be used as first line MRI for the spine or as an adjunct if supine MRI is non-diagnostic. Upright Open MRI scanners can be used in a variety of clinical situations (cervical, lumbar spine and other applications) where conventional or open MRI is unsuitable; • as a problem-solving modality in those who have had a negative or unhelpful conventional scan • in patients with a ‘failed-back’ following previous surgery • in those whose symptoms are posture-specific • other joints of the body that are symptomatic in specific weight-bearing positions • assessment of pelvic floor and bladder prolapse Comfortable MRI diagnostics Patients who might be considered for Upright Open MRI scans include; • patients who are claustrophobic or anxious and unable to tolerate the confines of a conventional scanner • patients who are larger and who find it difficult to fit into the constricted space of a conventional scanner • patients who are unable to lie supine whatever the reason • patients who need to be observed during their scan Neutral / Seated Spondylolisthesis Extension / Seated Lumbar Spine - positional abnnormalities Upright Open MRI scanning and patient management In a paper presented to the European Society of Skeletal Radiology (ESSR) in July 2005, Smith and Siddiquiiii reported twenty-five patients referred for MRI of the lumbar spine for sciatica following at least one prior, “normal” MRI examination within six months of referral. • 14 men and 12 women aged between 38 and 67 years of age were scanned using an upright MRI scanner. Each patient was scanned supine, standing erect and in the seated position. In the seated position, images were made with the back in neutral, flexed and extended. Sagittal T2 and Axial T2 weighted sections were made through the lower five intervertebral discs in each position. • In 12 cases, no significant abnormality was seen in any of the five postures • In 13 cases, abnormalities were demonstrated in one or more of the seated postures that were not evident in the conventional supine examination • In three cases lateral disc herniation was only seen in the seated position • In six cases the presence of a hypermobile disc at one or more levels was demonstrated • In two cases a previously unsuspected grade 1 spondylolisthesis was shown and in two cases significant spinal canal stenosis was seen in the seated extended position • In 50% (13/25) of these cases that had previously been investigated for sciatica, a surgically remediable lesion was found Technology and compliance Further reading The Upright Open MRI scanners have been developed to allow imaging under the influence of gravity. A gap exists between two vertical electromagnets where a tilting table is sited that allows seated, standing and supine imaging. A mid-strength 0.6T horizontal field is generated between magnets. Image quality is excellent and all studies are reported by dedicated musculo-skeletal and neuroradiologists. The results of the MRI scan are typically provided to the healthcare professional within 48 hours. • Alyas F, Connell D and Saifuddin A. Upright positional MRI of the lumbar spine. Clinical Radiology. 2008:63(9);1035-1048 • Badami J P, Baker B A and Scholz F J et al. Outpatient metnizamide myelography; prospective evaluation of safety and cost-effectiveness. Radiology. 1998:(207);391-398 • Beric V, Imaging the spine with upright MRI. RAD Magazine. 36:(422);21-22 • Jinkins J R, Dworkin J S, Damadian R V. Upright, weight bearing, dynamic-kinetic MRI of the spine; initial results. European Radiology. 2005:15(9);1815-1825 • Lee S U, Hargens A R, Fredericson M et al. Lumbar spine disc heights and curvature; upright posture vs supine compression harness. Aviation, Space & Environmental Medicine. 2003:(74);512-516 The Upright Open MRI scanners provide a patient friendly experience. During the scan patients can see the radiographer at all times, are able to watch TV or a DVD and can simply walk out once the scan is complete. Dr. David Grant and Dr. Ben Timmis (Consultant Radiologists) are Joint Medical Directors of the Upright Open MRI Centres and hold substantive NHS appointments Erect Seated Supine Same patient same day imaging Seated Positional imaging erect Left Rotation Rotational imaging 1 Patient referrals The Upright Open MRI Centres (London and Leeds) are approved by all the major private health insurance providers. NHS patients and self-funding patients are also welcomed. All patients require a referral from their healthcare professional. Referrals are welcomed from healthcare professionals including Consultants, Specialists, GPs, Radiology Specialist Managers, Osteopaths, Physiotherapists and Chiropractors. Guidelines published by the Royal College of Radiology and the Royal College of General Practitioners provide a framework for appropriate referral for diagnostic services. Each centre has a dedicated team of specialist reporting Consultant MSK radiologists and neuroradiologists. The importance of maintaining existing referral relationships is recognised and therefore Upright Open MRI Centres offer the facility of remote Patient referrals reporting for a radiologist of your choice. The Upright Open MRI Centres (London and Leeds) are appro patients and self-funding patients are also welcomed. All patien Referrals are welcomed from healthcare professionals including Osteopaths, Physiotherapists and Chiropractors. Contact details Guidelines published by the Royal College of Radiology and th for appropriate referral for diagnostic services. Rd ion Alb Rd r Te Mit st A ve n St Fir Masham s By car:HoMetered parking is available on Newman Street ldfo (the streetrthis Ga one way northbound). NCP car parks are rd en available at 45-47 Berners Street, London, W1T 3NE or s London Sanderson Hotel, Wells Mews London, W1T 3NG or 34-42 Cleveland Street, London, W1T 4JY ll L Pl Ho Bru M n ruc eG rth Gre en ns s By rail: Euston is the dnearest mainline station ldfo C ly de Street (5 minute walk), Oxford Circus or s By tube: Goodge 54 minute walk) Tottenham Court road (both a6110 Ho en L Ave Third Rose Castleton Primary School Eig hth Av e Gre e Rd smer Gra 54 c eL rth s Byfobus: Tottenham Court Road or aw Clo Buses that go through n se Oxford Street (Tottenham Court Road end) are suitable B ns Gd y St Julia House, 44 Newman Street, London W1T 1QD Telephone: +44 (0)20 7637 2888 Fax: +44 (0)207 637 5888 email: [email protected] ld B61 d t nal St Ca ford Ba c k Mitfo Rd rd R d e rrac w Vie Ha t Rd Rd St Perc yR lS The London Upright MRI Centre B www.uprightmri.co.uk Julia House, 44 Newman Street, London, W1T 1QD Telephone: +44 (0)20 7637 2888 Fax: +44 (0)20 7637 5888 email: [email protected] Tower Court, Armley Road, Leeds, LS12 2LY Telephone: +44 (0)113 231 1902 Fax: +44 (0)872 023 3863 email: [email protected] • By bus: Buses that go through Tottenham Court Road or Oxford Street (Tottenham Court Road end) are suitable io t nS gto hin Wa s d lR Abbott este ford HM Prison Leeds n The Leeds Upright MRI Centre By car: Metered parking is available on Newman Street (the street is one way northbound). NCP car parks are available at 45-47 Berners Street, London, W1T 3NE or London Sanderson Hotel, Wells Mews London, W1T 3NG or 34-42 Cleveland Street, London, W1T 4JY St ud l eP Air Rd al na The London Upright MRI Centre • mle Ca ll L New Worley Cemetery Ar 47 Glouc Mit Ave ve Gro Barne 01 A6 View Ha Pl ford e rov nG pso Mit Sim Mount ley t Butts Arm ey S Mickl well Oak Ave rrace oklyn rrace el Te Amberley Rd St our A4 W ay Le dg Ca na Rd lR d n eto stl d tt View Mod ross St Frith ek Gre 54 ew el Vi Mod Back el Rd Mod el Rd Mod Back e el Av Mod e el Av Back Bro el Te Mod Mod B61 yR Abbo Win che ster Elsw orth St Albion Ave Back Terrace n Pl Brookly n St Brookly Ln Brooklyn Chapel ng C t rd Wa St C St St Ca Rd Crescent nt Chari nS St St Old ton p om ton 00 A4 St Dea t kS nd t nS St tle et ho De ette mle Terrace St. Bartholomews CE Primary School and Nursery r a nm Ar Ln Hall Ln 0 ish 5 s Ca re Laurel St nd A6 t r St Ca na este St 7 Nancroft Mou A4 t kS ve gS rin ke Pic Chich t Laurel Pl So Soho Square Man St rwic our Be rd Wa St A4 Ca Ca n w Vie ry Av ia are are u Sq d l St Pola all rsh Ma gly Kin t u Sq ton St tR ur Co eP ers St t yll S B St St Tottenham Court Rd Pl ies isle Carl ell uss at R 00 Ba ick Nancroft Gre on ers Bern Bern t ss Nancroft Pl ay a tem dw roa B St nw Ha St rd re ua Sq ell m t thb nS se A64 Rd tre Mis rw ha es St Armley Court Ley Ln fo ed Mo en Gr Ra ma St mill St en ph Ste ley Arm u Sq tt To ws New Me Oxford Ra Arg A4201 ugh r we Go St Pl St t ers St sley St xS ell ss ing nt red ld eS Bern St lls We Win Holles do Burley Via du ct Rd t Ru rr To ou gm Alf fie hit W 00 A4 ott arl Ch St rcy rcy Pe ws e M Ho ro arlb rd dfo S llen at M Gre Rid St ind W ay dW ar are Be A40 ford St St re Sto Rd Forge Ln ount ry M Avia rove ry G Avia ry St ce Avia ra e ry Pl er ac Avia ry T err Avia T Ely St ey Arks ve ry Gro lisbu Sa St l mil Pe Ox er St 4 20 St ws t St t Pl Hanov St Viaduct Rd Cunliff Wood S let Ma d tR ur eld ers Me Regen Eas Oxford Circus ad Milford Pl hS re fi hit Bern lls We os St St tle tcas Marga M 0 20 A4 leig ll ua Sq Yorkshire Television Studios K irk Contact details st a W t Chand y St Hanover Square ns Gd nt ou gm St Rid ey ntl Hu Co uS St A ret St Marke ala Sc 4 Marga le St St 0 52 r St t nd S ge od Go ret St s St Prince ds St m Pl St t dS e us Ho St Mort Cast m ha lan and s St Pl Goodge Street A5 ssa Portl W ell St Na Great g in Portla ton ing rr To ve le Fo Rid Little En n lto 0 ws Me ies en St Ch ey ntl Hu et e Str ha ss en pre p Ca on rd Go 0 A4 tt To Cy e ott arl Ch tt To Cle n St ld St A4201 Harle Pl t Me 00 St et en t yS Each centre has a dedicated team of specialist reporting Consu of maintaining existing referral relationships is recognised and t reporting for a radiologist of your choice. et ld Hanso Gosfie l St n St nterde k St A4 fie t yS zro Fit d lan ve s Cle ew M et P land sfield Oxford Broo er tre dS lan w Ho St St Great A40 Te Str ple 04 Cavendish Square Gardens tta Pl t ee Ma A52 dish Henrie Un t ee Str ity rs ive o aft Gr ime Caven A5204 Wigm ay nW St Stre Port dish Caven ds En Bodley Terrace fto d lan ve Cle t land ver S St New St t ore S ay nW Gra hit W are u Sq ield St Titchf Bolso Great t Port Grea m Halla one Clipst St Man New dish Caven y F A4201 outh m Wey eet ro itz St n re War t Stree Pl h leig tre rS re E Squa to n Str re War Regent’s Park shire d oa nR Eus Great Portland Street Rd Devon we Go Albany Street Park one eb Maryl Warren Street A4201 S on vit Ta Euston Square i. Conventional MRI scan is designed to scan the patient in the horizontal position in ii. Open MRI scan is less claustrophobic, typically lower in field strength (0.2T – 0.5T iii. F.W. Smith, M.D. et al., University of Aberdeen, Scotland. “Positional Upright Imag Paper presented at the ESSR (2005) Oxford, England. Published in Clinical MRI , • By car: Parking is available including disabled spaces. 1.5 miles from Leeds city centre, 0.75 miles from Armley gyratory, 1.26 miles from Junction 2 of the M61, 0.25 miles from Armley town centre, 6.5 miles from Leeds Bradford airport, 8 miles from Bradford city centre • By bus: Buses 5, 14, 62 and 62A from Leeds train station • By rail: Euston is the nearest mainline station • By tube: Goodge Street (5 minute walk), Oxford Circus or Tottenham Court Road (both a 10 minute walk) www.uprightmri.co.uk i. Conventional MRI scan is designed to scan the patient in the horizontal position in a tunnel environment ii. Open MRI scan is less claustrophobic than conventional, typically lower in field strength (0.2T – 0.5T) and designed to scan the patient in the horizontal environment iii. F.W. Smith, M.D. et al., University of Aberdeen, Scotland. “Positional Upright Imaging of the Lumbar Spine Modifies the Management of Low Back Pain & Sciatica.” Paper presented at the ESSR (2005) Oxford, England. Published in Clinical MRI , Vol. 15, Issue 3 (2006)
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