MRI CLINICALS

The end of one semester of clinicals is here. Looking back at the past few months I realize how much I have learned in MRI. Yet, I also realize there is so much more to still learn. This week I was offered a full time position in MRI which I gladly accepted. Now the pressure is really on to learn it all. I will be working second shift- 11am to 9:30pm. The majority of my shift I will be working alone. This is even more pressure for me to really master the skills required for MRI. I am nervous to leave me comfort zone of special procedures, but am so happy to be working in the area I am studying. It will also be a stress relief to only be at work 40 hours a week instead of 52 that I am there now. I know that I am capable of scanning many different body parts if they are routine. I am nervous that when a difficult case presents itself I won't know how to handle it. I'm sure I will have plenty of training before I ever start working alone.

Avascular Necrosis

We had a 28 year old male come in for an MRI of his right hip. His symptoms were right hip pain for several weeks with no specific injury. The routine hip scan at my clinical site is to scan both hips for the majority of the series and then focus in on the hip of interest for two series. After running the first scan, it was apparent that the patient had something wrong with the bone in both hips. The tech that I was working with said that it could be avascular necrosis. He google searched MRI images of avascular necrosis so we could compare the images we were scanning to actual diagnosed avascular necrosis images. Although the patient had no complaints of left hip pain, given the obvious pathology we took it upon ourselves to scan an axial and coronal of just the left hip as well as the right. The next day I looked at the radiologist report to see if our diagnosis of avascular necrosis was actually the correct diagnosis, and it was. According to the report the patient had avascular necrosis of bilateral hips as well as a slight tear in the right labrum. This case was one of the most interesting pathologies I have seen so far in my clinical time.

October Clinical Experience

It has been three weeks since my last post. I have spent about 30 more hours doing clinicals. I have only seen a few cases with contrast because the hours I am spending in clinic are hours that the radiologists are not there, which means we do not give contrast. I am hopeful in the next few weeks to get more time seeing contrasts exams.

Knees are still the most popular exam I have seen. I have also scanned a few more cervical spines. I saw a patient with severe scoliosis and degenerative disc disease. It is amazing to me how the position of the kidneys and other organs are dependent on the shape of the spine. This patient had a curvature to the right at the level of her kidneys. The coronal images showed the kidneys, which sat at a similar angle to the curve of the spine. I also saw a femur and several ankles. I am having a hard time determining if the ordering doctor really wants an ankle or a foot, and what position the patient should be placed in for which part is being scanned. I am hopeful that with experience I will become more comfortable with it.

I saw a scan of an elbow that was in a cast. The patients arm was bend and casted at a 90 degree angle. The typical coil used is a flex coil, but because of the position on the elbow the tech used the small shoulder coil. The images were surprisingly crisp. I assumed that a cast would create an artifact like it does on an x-ray, but it did not.

I still have quite a few hours to spend in MRI this semester. I am hopefully to continue absorbing knowledge.

September MRI Experiences

Well, I have completed almost 50 hours of MRI time in the past four weeks. I have enjoyed every minute of it. There is so much to learn and some days I leave feeling overwhelmed and stupid. I know that is not the case, but I guess since I know the anatomy I feel I should easily pick up on it and I haven't yet. All the techs teaching me are awesome. They tell me not to feel stupid that there is so much to learn and it takes at least a year to really learn it all.

In my hours spent, I have actually done quite a bit of scanning. I like to watch a few and then scan. I feel I learn better when I am in the driver's seat and have a copilot leading me through. I have been writing tips and techniques down in a notebook that I keep at my clinical site. This helps me know what range the TE and TR must be in, as well as other information about creatinine checks and certain protocols for ordering physicians. This was a suggestion from a tech who actually completed his MRI training through USI's program. The three body parts I have scanned most are shoulders, knees, and lumbar spines. I am actually starting to become comfortable scanning these areas without being given instructions, but just asking the tech to check and make sure my alignments are good. I have seen scans of ankles, feet, wrists, elbows, forearms, brains, thoracic spines, cervical spines, and hips. One thing I am having a hard time seeing is subtle motion. I am able to identify flow and obvious motion. I was able to see a zipper artifact on a brain. There is so much to learn still.

I am having a great time learning MRI. I am hopefully that by my next post I won't feel quite as inadequate and more confident with what I am learning.

Introduction Blog

Hello! My name is Nichole. I am 22 years old. I work as a special procedures tech at an out-patient imaging center in Greenwood, IN. I am also doing my clinical experience in MRI at my place of employment. I still have 2 years of courses left, taking 2-3 per semester. In my free time I enjoy running, reading, boating, camping, gardening, and spending time with my family and friends. I have never created a blog before so this is new and exciting for me!