MRI not working for lean dudes??

[Raiders789]

Hey guys -

So for the past few weeks i've been dealing with ulnar tunnel syndrome and have done a ton of imaging for it; ultrasound, x-ray, then ct. My doc ordered me to get a wrist MRI, so a few days ago I went to get the test done. Get loaded into the machine, and they run scans for about 30 mins, take me out, put me in again, run more scans, then take me out. Said the machine was broken, and they have me come back 2 days later. So went back today, and they load me into the machine - same exact deal. Was there for a few hours and did multiple tries. Then they tested one of the techs, and the machine worked no problem. At this point they had assembled the avengers of MRI techs to figure out why it wouldn't scan my wrist, and they scanned my arm + knee as well to make sure it wasn't a problem with my wrist - and still weren't getting readings.

So apparently if you have too low of a ratio of subq fat relative to muscle, the MRI isn't able to pick up the right frequencies to create images. I thought I'd share this here because I'm sure some of you guys have had the same issues?! Given that most of the people in this community are more jacked than me. I'd say I'm a pretty above average dude(6'1 205 10%bf) but I'm not crazy lean or crazy huge by any means. But the techs said they'd never had this issue before. I'm currently in Australia and they only have 1.5T MRIs which are a bit less powerful than the 3T MRIs in the US. They have me booked at their only 3T around Sydney to hopefully get a better image but they say it's 50/50 they'll be able to get anything useful. Just curious if this has happened to anyone else.

 

[sionnach]

Your MRI tech is taking massive doses of retardedtide. This isn't a thing.

 

[Raiders789]

Your MRI tech is taking massive doses of retardedtide. This isn't a thing.

Coil tuning/matching

Why must coil tuning and matching be performed, and how is it done?

mriquestions.com

The way that the techs explained it to me was that the coils in the MRI have to be tuned to each persons specific body composition(subq fat:lm:water ratios) and they are built to be able to auto adjust. If your body comp causes the electrical load on the coil to change too much it can't adjust and makes false/random scans that are misrepresentative of your anatomy. My issue was that they weren't able to make images of my pathology in my wrist but were still able to get some imaging done. Just not enough to determine what is causing the neuropathy.

 

[sionnach]

Coil tuning/matching

Why must coil tuning and matching be performed, and how is it done?

mriquestions.com

The way that the techs explained it to me was that the coils in the MRI have to be tuned to each persons specific body composition(subq fat:lm:water ratios) and they are built to be able to auto adjust. If your body comp causes the electrical load on the coil to change too much it can't adjust and makes false/random scans that are misrepresentative of your anatomy. My issue was that they weren't able to make images of my pathology in my wrist but were still able to get some imaging done. Just not enough to determine what is causing the neuropathy.

The machine is perfectly capable of scanning you, the tech just didn't know what he was doing. You're still just meat and bones, not some MRI-befuddling alien anomaly.

But sometimes, the MRI just doesn't get a good pic of the damage. Sometimes you have to repeat them. And occasionally, only exploratory surgery can pinpoint the damage. Symptoms associated with ulnar tunnel syndrome are particularly hard to diagnose, because the actual issue could be anywhere between your wrist and your spine.

Good luck figuring it out. Have you tried everything you can to reduce inflammation?

 

[Raiders789]

The machine is perfectly capable of scanning you, the tech just didn't know what he was doing. You're still just meat and bones, not some MRI-befuddling alien anomaly.

But sometimes, the MRI just doesn't get a good pic of the damage. Sometimes you have to repeat them. And occasionally, only exploratory surgery can pinpoint the damage. Symptoms associated with ulnar tunnel syndrome are particularly hard to diagnose, because the actual issue could be anywhere between your wrist and your spine.

Good luck figuring it out. Have you tried everything you can to reduce inflammation?

I'm fairly confident the techs knew what was going on as they had multiple techs + a radiologist all discussing the issue. And from what I've read they followed standard protocol by putting saline bags around my wrist and switching to a larger coil but still couldn't get it to work. But they said only having access to a 1.5T MRI makes it a bit harder to render clear images especially in my case, so they have me booked at a 3T one which'll hopefully work.

They were able to generate images, but couldn't get consistent renderings of the pathology in the wrist which was the only thing my hand doc needed. A previous ultrasound demonstrated a ulnar neuropathy specifically in the wrist, they originally thought it was because of a scaphoid fracture but a ct scan ruled that out. So now my doc thinks it's either being caused by (hopefully) just local swelling or some pathology issue, likely either a trauma caused thrombosis or hematoma.

 

[BigDadd7]

Sounds frustrating

 

[buck]

As most peoples wrist and forearms are not all that fat i would think the tech may need more training to adjust things correctly.
A CT scan i had 3 years back reported a few issues that i have going on. But also made a note that some abdominal views were not good as i lacking internal body fat.

 

[malfeasance]

MR Imaging in a case of severe anorexia nervosa: the ‘flip-flop’ effect - PMC

We report an MR imaging phenomenon that can lead to misinterpretation. The unique appearance of the soft tissues and bone marrow in a 19-year-old severely malnourished woman with anorexia nervosa raised concerns about technical failure or systemic ...

pmc.ncbi.nlm.nih.gov

 

[Matty_G]

This is a great question for @bigdaddyandfriends !

 

[Raiders789]

As most peoples wrist and forearms are not all that fat i would think the tech may need more training to adjust things correctly.
A CT scan i had 3 years back reported a few issues that i have going on. But also made a note that some abdominal views were not good as i lacking internal body fat.

Yeah so the 3T MRI ended up working out - they told me they were able to get a good enough image for the radiologist to diagnose whats causing the UTS

They told me the image was good enough for a diagnosis but compared to other people, was a lot less detailed. I hope I never have to do an MRI like that again tho. They had to put my entire body in the tube(vrs just my wrist previously) and some of those scans had me tweaking like crazy. It felt like my abs had one of those electrode trainers on them. And some of those scans had my entire body twitching in the weirdest ways- was such an uncomfortable experience. But just happy I got it all done with, and got a free MRI out of it too.

 

[sionnach]

And some of those scans had my entire body twitching in the weirdest ways- was such an uncomfortable experience. But just happy I got it all done with, and got a free MRI out of it too.

Certain pulse sequences during the MRI create magnetic gradient fields that can induce electric fields, depolarizing your peripheral nerves.

Hope the new data helps you fix the issues.

 

[malfeasance]

some of those scans had me tweaking like crazy. It felt like my abs had one of those electrode trainers on them. And some of those scans had my entire body twitching in the weirdest ways- was such an uncomfortable experience. But just happy I got it all done with, and got a free MRI out of it too.

Now THAT is weird

 

[Raiders789]

Now THAT is weird

Yea some of the scans were pretty bad - During the first intense scan that had me twitching everywhere I pressed the emergency stop button and climbed out of the machine because of how it caught me off guard. The tech said it was normal tho so I just locked in and put up with it. But some of them had my muscles tensing so much it was painful. Essentially got a free full body lift in

 

[malfeasance]

I have had two MRI's . . . maybe three (two for the shoulder, and I can't remember maybe one for my knee) and never had anything like that happen.