Ok, so I’m really curious. In December, I had surgery on my neck. I’ve continued to have consistent swelling and severe pain, worse that before I had the surgery. I complained so much that just about 6 weeks ago the doc that did the surgery sent me for an MRI to see why I’m worse not better. I get a call from the nurse saying that whatever they did in December didn’t work and now I need a total reconstruction of my neck, well great. Hmmmm, I decided to get a second opioin and I go to the imaging place got a CD of my MRI and I get a written reading or results. In this reading of the MRI, it states that around the incision site that a metal artifact was noted and was not sure what it was or where it came from. So… it wasn’t there before surgery, but its there after??? I requested surgery notes to see if the doctor had implated anything at all, nope nothing. I take the findings to another doctor and he says it’s a mystery. i know they don’t like to go against each other, so i didn’t figure I would get anywhere, but he ordered an XRAY. The new doctor said that an xray would show the metal object better. Well, I do the xray and he doesn’t see it. My question is this, why would something show in an MRI and not in an xray? the object looked triangler in shape, but he noted it to be round, who knows. I’m just so curious cause no one wants to talk to me about it and I"m in so much pain and the swelling is unbelieveable and the muscle spasms are so bad I cry. Anyway, anyone have any ideas or thoughts. I really don’t care if they did or not for any kind of lawsuit, I just want to feel better and be normal again. So, any thoughts?
Thanks for just letting me share. I didn’t edit, so please excuse the grammer errors. It’s not easy keep my neck in one position for to long.
I’ve studied MRI and x-rays, but I’m no expert. But in the absence of other responses:
x-rays measure differences in how radiation is absorbed along a line of sight.
MRI measures differences in how tissue absorbs and reemits magnetic field energy, and is 3D (that is, from a single MRI it’s possible to view any slice of the tissue you like, and only see the properties of the tissue in that slice)
It’s possible that something very high absorbing like metal might nonetheless not be high contrast in an X-ray, just because there might be particularly thick bone in the adjacent area, and it might be a thin slice of metal.
But I think more likely is that it’s not metal.
MRI can produce many different kinds of image based on whatever the doctor / radiologist wants to highlight. For most image types there will be a few kinds of tissue / material that show up super bright or dark because the images are tuned for maximum contrast.
I suspect someone has seen an object with clear edges suggesting it’s artificial, and because it’s bright assumed it’s metal, when there are other materials that may show up bright on that kind of image.
OTOH there are image artefacts (basically “glitches”), that you sometimes get in an MRI if there is any metal. If such artefacts are present that pretty much would be a smoking gun that it’s metal.
Aren’t some metals transparent to the wavelengths of diagnostic X-rays? I remember having read somewhere that X-ray tubes for regular radiography (as opposed to mammography or DEXA) have aluminium filters to remove certain unwanted X-ray wavelengths. Aluminium presumably is transparent to the desired wavelengths. I doubt that OP has an exotic metal foreign body, but was just wondering if there are any metals that might not be opaque to X-ray and might have produced an artefact on the MRI scan.
Did the doctors review the MRI themselves, or rely on the radiologist’s report? My guess would be that it’s a transcription error and it was supposed to say motion artifact.
Metal doesn’t really show up on an MRI. You end up with a “metal artifact” on the scan which really just looks like a blank or distorted spot on the scan. So it’s not that you see something, it’s that you don’t see a proper scan of that area.
Were any metal staples used to close the incision on your neck in the surgery? I would expect a staple to show up on an x-ray though.
Maybe the MRI machine just screwed up?
I’m an electrical engineer not a medical professional. While I know what metal does to an MRI machine, I’m otherwise just taking guesses.
Former ARRT CT/MRI tech here: If it is metal, MRI will produce a variety of artifacts from most any metal(s) on imaging. Period. Different types of frequencies used with MRI will show varying artifacts, but its practically ALWAYS present. There are excepptions, but exceedingly rare. A worthy radiologist can give the appropriate instructions to Tech to rule-out if metal or not, trust me. Go with the radiologist’s suggestion(s) on identifying the object in question - not uncommon to have a chat with rad before exam is done, and if not possible, delay imaging until consult is obtained. Do NOT trust a non-trained physician to say what is needed for imaging for a specific purpose. I have seen way too many over-exposures to radiation due to non-rad physicians thinking they know what is best for specific item to be addressed.
HTH
Also, motion artifacts screw up entire image, not just a single area of an image.
X-ray (ie CT/X-ray), if done with appropriate KV/mAs will show metal easily, but too high of a kV (voltage used to produce X-rays for image) can ‘punch’ through a tiny/thin slice of metal/plstic/etc without it being obvious.
I highly recommend a follow-up with a radioloigist knowing what is being looked for, and that is not a ‘routine’ exam’.
IME, I have found, over 20 years of doing such exams, untold numbers of remnants of surgical stuff left in people, but only when it was told to me that such was a concern. For example, soft tissues (lungs/organs, etc) generally use a higher kV than what would be used for bony fractures, like a finger or foor, per se. Aluminum easily shows up on just about any type of X-ray, and will cause significant artifact on MRI, IME.
For a bit of show and tell, I put some of my own images at Index of /spine that help show how different imaging technologies react to metal.
The cervical X-ray shows my neck with a ProDisc-C artificial disc implant. Everything’s nice and clear. The cervical MRI shows a huge warp and “black hole” at the implant level (C5-C6).
For comparison, the lumbar X-ray shows where I had a two-level fusion (L4-L5-S1) A fusion cage was inserted at L4-L5. Again, the image is clear and it’s pretty easy to tell what’s what. The companion image is a CT scan of the same area. The metal causes a starburst and streaking sort of artifact, but the underlying “geography” is not warped.
Go get a real strong magnet. Apply it to the area of the wound. If it sticks, remove it and then go get a plaintiff attorney who does a lot of medical malpractice.
That won’t work if the metal is non-magnetic, and if it is magnetic, a “real strong” magnet might cause physical harm by dragging the metal through soft tissue like nerves. Do not try at home.
[QUOTE=Really Not All That Bright]
You have a cervical disc replacement and a lumbar fusion? What happened to you? :eek:
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I picked the wrong parents - bad cartilage in general and bad spinal discs and knees in particular run in my family. Going up stairs, we tend to sound like we’re walking on bubble wrap. My father needed a lumbar fusion in his early 40s, so I at least managed to hang on a bit longer, probably only because microdiscectomy wasn’t a thing back when his back went bad.
In the past fifteen or so years, I’ve acquired more knowledge of spines, radiology and neurosurgery than the average person. :dubious:
