Magnetic resonance imaging: Clinical experience with an open low-field-strength scanner in a resource challenged African state

Abstract

Introduction: Despite the fact that an magnetic resonance imaging (MRI) has been in clinical use for over 20 years, its use and availability in Nigeria, a West African state, is still extremely low. Hence, only few publications are available on the clinical experience with MRI from Nigeria. We set out to evaluate our initial clinical experience with a low-field-strength MRI in a Nigeria's foremost university hospital.

Materials and methods: A retrospective review of all studies, performed with an open 0.2 Tesla MAGNETOM Concerto (Siemens Medical) MRI scanner over a 5-year period (2006 - 2010) was conducted. All patients with complete records were evaluated for their clinical and demographic characteristics.

Results: The records of 799 MRI studies were available. Patients' ages ranged from 1 day to 90 years, with a mean of 40.1 years (± 20.7 SD). There were 463 (57.9%) males and 336 (42.1%) females. Over 90% of the studies were requested to evaluate brain or spine lesions. Low back pain represented the commonest (161/799, 20.7%) clinical indication for MRI. The largest number of patients was referred by physicians from surgical specialties (65.6%).

Conclusion: The awareness and competence for proper use of MRI in Nigeria appears high. Low back pain is the commonest indication for MRI in our institution, and surgeons make a greater use of the facility. The provision of high-signal strength MRI may be beneficial in making a wider range of applications available to clinicians.

Keywords: Clinical experience; Nigeria; magnetic resonance imaging.

Figure 1

Bar chart showing the age distribution of the study population

Figure 2

T2-weighted image of the lumbosacral region showing multiple posterior disc herniation between L2 and L5 vertebral bodies with associated L4/L5 mild spondylolisthesis

Figure 3

T1-weighted post gadolinium axial (a) and sagittal (b) images showing a right parafalcine brilliantly enhancing meningioma in a 45-year-old male

Figure 4

Magnetic resonance images (a and b) showing multiple skull, leptomeningeal and orbital metastasis in a 43-year-old female with carcinoma of the breast

Figure 5

Lumbosacral magnetic resonance images showing an extensive intra-spinal tumor in a 30-year-old female. The mass is isointense on T1-weighted images (a) but heterogeneous on T2-weighted images (b). It shows a heterogeneous enhancement with contrast (c). Note the posterior scalloping of the vertebral bodies

Figure 6

Magnetic resonance images (a and b) showing cystic dilatation of the posterior fossa with hypoplasia of the cerebellar vermis and elevation of the torcular heterophils and tentorium in a 9-month- old male infant with Dandy-Walker syndrome