I felt going into this semester I would consider myself an experienced MRI technologist. After just taking one semester of classes, I have realized I have so much to learn! After one semester, I feel I am able to improve on my scans, have a better understanding of cross sectional anatomy and also provide better care for my patients. I have learned so much more about different pathologies and feel I will be able to recognize them and add extra scans to show the radiologist as much information I can provide while still having my patient on the table. I really enjoy spine work and after going through the procedures course I feel clinically I have improved on my scans. I have learned to see certain pathologies on my sagital scans which allows me to make sure when setting up my axial images I cover these particular areas. Learning the anatomy of the brain has also been a great help. When patients have previous head CT's I am able to read the report and am sure to set up my MRI scans with the best images possible depending on the are of interest mentioned in the report. I look forward to next semester and continuing on improving.

St. Vincent Health has decided to go with Eovist contrast for Liver MRI scans. We now have a new protocol where we inject early, run a few scans, but must wait at least 20 minutes before running our post Lava scans. There have been many of times where I would have to bring the patient out and sit in there with them hoping they don't move until the 20 minutes were up! This contrast is only for Liver MRI's and demonstrates the pathologies of the liver more clearly.
Today, I have a patient coming in for a Liver scan and I look forward to using the new contrast and protocol. What I am NOT looking forward to, is starting her IV. I guess she came in on Wednesday before Thanksgiving and no one was able to get her IV started. So, they must have all of the confidence in the world in me, because they re-scheduled her on a Saturday and I am the only one here!!!! I may or may not be doing her test! Luckily for me there is no one else scheduled after her!

I had a very interesting case the other night. I was scanning a 12 yr old girl's complete spine for scoliosis. While I was scanning her not only did she have the most drastic S curved spine I have ever seen, but then I realized she also had a synrinx throughout her entire spine. Each of my sagitals for the thoracic spine had to be done in two parts to stay with the alignment of her spine. My facility requires the technologist to scan each part of the spine in separate sections unless they are looking for metastatic disease. Also, since I discovered the synrinx I also had to inject. It is always a challenge to explain to any child and or parent the importance of the contrast for the exam without causing them to worry. I think even more of a challenge in this situation was trying to convince the young girl to lay still so I could just continuously scan without having to realign each scan up for her extreme curvature. She was watching a movie and didn't move at all during her test and injection. I was very lucky!

Clinical update

Since the school year has started we have had so many pediatrics coming in with sports injuries. We have had quite a few ortho cases including knees, wrists, shoulders, ankles, and feet. All patients were under the age of 17! These patients included football players, swimmers, soccer players, and runners. A lot of the knee scans showed torn meniscus and ACL tears. I have decided if I have children they are playing golf! We are just now starting to learn how to T2 mapping with our upgraded software. This program allows us to post process knee scans and with color determine where patients have good and or bad/damaged cartilage. This is very new and I will post more as we get more involved. What I have seen of it, I have been very impressed!

Just from our first few weeks of classes, I have already learned so much more about MRI! Especially the anatomy on the scans. This past week for me has been a very busy one! We run a 1.5 tesla strength magnet from 8:ooam until 8:30pm monday through saturday. The few days I was there, I averaged at least ten patients a day. One of my cases was a little different. I had to do a Brain MRI on a patient with nasopharangeal cancer. My radiologists have a specific protocol and it takes approximately one hour to do. This patient had his mandible removed due to the cancer and was extremely claustrophobic, so it was a bit of a challenge for me. He was sedated, but he still was having a hard time laying in the scanner. The axial scans start at the hyoid bone and need to cover through the pituitary. The coronals must begin posterior to the brain stem and anteriorly through the face. It was challenging, but also a very educational process.