What is NANO MRI?
NANO MRI is an examination in which a new contrast agent (Combidex) is used. This contrast agent is a fluid containing very small iron particles which is administered via an intravenous line. After 24 hours the iron particles are found in healthy lymph nodes. When an MRI scan is made, the healthy lymph nodes which contain the iron particles, show up black in the images. Unhealthy (metastases) lymph nodes show up white (no up-take of the iron particles). With this technique, even the smallest metastases are visible.
Metal / MRI safetyMetal objects in or outside your body can be attracted to the strong magnet in the scanner, therefore you may not enter the MRI examination room with, for example, a wheelchair, keys or coins. Credit/bank cards with a magnetic chip, hearing aids,mobile phones and watches, will be damaged when close to the strong magnet in the scanner (the magnet is always switched on!) Should you (or your companion) have a pacemaker/defibrillator (ICD), a spinal neurostimulator, aneurysm clips, dentures with implanted magnetic
fastenings, a bladder stimulator or a permanent insulin pump, then you may not enter the examination room. This also applies to other metal objects, like metal splinters (especially in or near the eyes), shrapnel or bullet wounds andolder types of heart valves, aneurysm clips or certain cochlear (ear) implants. You may be required
to remove medication patches if they contain metal foil. Usually modern hip and knee prosthesis are no problem. We request that you complete the attached ‘checklist’ and bring it with you to your appointment. Should you have answered any questions with a ‘yes’, we request that you contact the Radiology Department
Do you use a plaster or patch called Rotigotine/Neupro? This contains aluminium and must be removed before your examination. You may apply a new plaster after your examination.
How to prepare for the MRI examinationUnless otherwise requested by your specialist, you may continue to take any medications and eat and drink normally. Piercings made of gold or silver may be worn as the magnet doesn’t affect these items. All other items of jewellery and watches are best left at home. Please wear comfortable clothing with separate top and bottoms. Should any clothing contain metal parts (e.g. zips or underwired bras) you will be given a gown to wear. Please don’t apply hairspray and make-up as they can effect MRI images and cause some irritation.
MedicationsUsually you can continue to take your medications as prescribed, however your doctor may advise you to temporarily stop taking certain medications. We would advise you to bring your medication passport (available from your pharmacist) or alternatively, make a list of all medications that you are taking at the time of your
Pregnancy and breast-feedingThere is no evidence to suggest that MRI scans pose a risk during pregnancy. However, as a precaution, scanning is not usually recommended during the first 12 weeks of pregnancy. Contrast agents are not used throughout the whole term of the pregnancy. Should you be or think that you may be pregnant, please contact the Radiology Department. If you are breast-feeding and you are given a contrast agent for your examination, then you are requested to express and throw away the breast milk for 24 hours after the examination.
ClaustrophobiaIf you have severe claustrophobia you may be anxious about undergoing an MRI scan. Should you have severe claustrophobia, then please inform your specialist or GP as they may prescribe a mild sedative. Even a mild sedative will affect your ability to drive, so please make sure that you make other arrangements for transportation to and from the hospital.
During the examinationYou are required to report to the Radiology Department (Route 780) 10 minutes before the time stated on your appointment card or letter, keeping in mind that it’s a 10 minute walk from the main entrance to the Radiology Department.
Please contact the Radiology Department if you have hemochromatosis (an iron storage disorder) as you may not receive this contrast agent. The radiologist may consult your specialist for an alternative examination.
The MRI NANO procedure is carried out over 2 days. On day 1 the ‘NANO’ contrast agent (Combidex) will be administered and on day 2 the MRI will take place.
DAY 1: Contrast agentOn day 1 of the examination the ‘NANO’ contrast agent will be administered 24-36 hours before the MRI scan. In your appointment letter or email you can find time and place of your appointment. The radiographer or assistant will collect you (and your companion) from the waiting area and bring you to the preparation room. An intravenous line will be installed. Followed by a slow drip infusion of the contrast agent by the radiologistor his/her assistant. The whole infusion process takes approximately 60 minutes.
NOTE: Please contact the Radiology Department if you have hemochromatosis (an iron storage disorder) as you may not receive this contrast agent. The radiologist may consult your specialist for an alternative examination.
As with all medical procedures, the NANO contrast agent can occasionally lead to side-effects. Possible side-effects of the NANO contrast agent are tremors, headaches, abdominal pains, nausea, back pain, chest pain, chest tightness, redness, skin irritation or blemishes e.g. itching and a rash during or directly after the injection. In most cases these reactions disappear spontaneously without requiring anyfurther treatment.
Should you have had a reaction to a contrast agent in the past, please contact the Radiology Department as the radiologist can consult with your specialist and take preventative measures.
DAY 2: MRI NANOYou are required to report to the Radiology Department (Route 780) 10 minutes before the time stated on your appointment card or letter. When you check in at the Radiology Department, your details will be verified and corrected if necessary.
In case you did forget to bring your ´check list´ then you will be required to fill out a new one. You will then be directed to the correct waiting area where the radiographer or assistant will collect you (and your companion) and bring you to a changing room where you (and your companion) will be required to leave all metal objects, telephones, credit-bank cards etc, behind.
To facilitate sharper images is necessary to administer medications, Buscopan® and Glucagon®, to temporarily reduce movement of the bowels to facilitate sharper images. This is administered by the radiographer via the intravenous line and an intra-muscular injection in the upper leg, just before the start of the examination.
You may not receive these medications if you have:
- Increased eye-pressure (glaucoma);
- Increased or irregular heart rhythm;
- A muscle disease;
- Narrowing or obstruction of your large bowel;
- Problems with urinating, whereby you have to insert a catheter to empty the
- Use of blood thinning agents (anti-coagulants).
radiology department or ask the radiographer during the preparation for your
When you enter the MRI examination room, you will be asked to lie on the scanner
table. To detect the tiny radio signals that are emitted from the body, a ‘receiving device´ is placed behind or around the area to be examined. You are given the alarm-bell (rubber ball) and given earplugs or headphones to wear to protect your hearing from the very loud noises (knocking/buzzing) that you will hear during your examination. The examination table then slides into the scanner so that the part of your body being examined is positioned in the centre of the scanner (an open-ended, cylinder-shaped machine about a meter long). If you wish you may listen to the radio. During the examination many images are acquired, some taking a few seconds, others several minutes. Once one set of images have been acquired, there is a short pause before the onset of the following series. It is important that you lie very still during the whole procedure, which takes approximately 75 minutes.
After the examinationOne of the possible side-effects of the medication Buscopan®, is that you may have blurred vision. This is only a short-term, temporary side-effect.
One of the possible side-effects of Glugagon®, is that you may feel weak or dizzy after the MRI scan. We recommend that you bring some food for after the examination.