MR SPECTROSCOPY(MRS)

128 SLICE CARDIAC CT SCANNER

Doon MRI and Diagnostics is equipped with the state of the art bone densitometer (DEXA) capable of whole body densitometry as well as whole body fat assessment. DEXA is considered to be the gold standard for diagnosis of osteoporosis which can either be post menopausal or age related.

Non-invasive CT Angiography is a technique that shows the blood vessels of the body in great detail, without any discomfort to the patient. The scan hardly takes a few minutes to perform but the information it provides is very precious. It can show the functioning of the heart, the blood vessels of the legs, thigh, arms, abdomen, lungs etc in great detail.


Precautions to be taken before a non-invasive CT angiography:-


  • We need the patients kidneys to be working fine. For this we need the patients Kidney Function Tests to be done. We need the patients Blood Urea Nitrogen and Serum Creatinine reports
  • The patient would need to be fasting for 4 hours prior to the test.


In cardiac CT all scans are gated to the ECG trace. This allows us to position our data acquisition accurately in specific phases.


Using this modality we can perform the following procedures as part of a cardiac CT examination.


  • Calcium scoring
  • Coronary artery imaging
  • Functional assessment


Calcium scoring is a technique where the extent of calcification in the coronary arteries is measured and scored. There is a direct correlation between the extent of calcium in the coronary arteries and the risk of a future cardiac event. For example, a calcium score of more than 400 is considered severe and it would be necessary to take steps to prevent further advancement of atherosclerosis and plaque formation. The higher the calcium score, more likely is there a chance of severe stenosis as well. A calcium score of 0 does not rule out soft plaques, but statistically rules out significant coronary artery disease. Though the calcium score does not show soft plaques (which however are best seen on a CT angiogram), the higher the calcium score, the more is it likely that there are soft plaques as well. Rupture of a soft plaque is the commonest cause of an acute coronary syndrome (i.e. a heart attack). Calcium scoring is offered as a separate stand-alone test, but this is routinely performed as an initial part of the entire cardiac CT examination.


Indications of CT coronary angiography


  • Asymptomatic patients with family history of coronary artery disease
  • Patient with high risk factors
  • Prior to non-coronary surgery in the adult population, e.g.,

    - Pre – ASD repair
    - Pre – valvular repair
    - Pre – tumor surgery


  • Follow up post CABG
  • Atypical chest pain with doubtful coronary origin
  • Evaluation of coronary anomalies
  • Exclusion of coronary stenosis in symptomatic high risk patient
  • Assessment of cardiac neoplasm
  • Assessment of stent patency
  • Detection and characterization of congenital heart disease
  • Diagnosis of pericardial disease
  • Prior to major (non-cardiac) surgery
  • Non-conclusive stress tests 

TRUE DIGITAL X-RAY DR SYSTEM

MR ANGIOGRAPHY(MRA)

DIFFUSION MRI

Doon MRI & Diagnostics has been a pioneer in the field of Magnetic Resonance Imaging(MRI) in Uttarakhand.


We were the first to introduce a 0.5 Tesla Super Conducting MRI in the State in 2001 and also the first 1.5 Tesla Volume HD MRI in a stand-alone facility in the State in 2013.


Our centre is equipped with the latest and most advanced High-Definition 1.5 Tesla MRI system from GE Healthcare and all MR examinations, including ultrafast sub-second scans are routinely performed.


Truly representative MRCP and whole spine imaging are instantly available.


We are doing pioneering work in the state in the field of Spectroscopy & Functional MRI, TRICKS multi-phase MR angiography, VIBRANT MR mammography, LAVA liver imaging and MR Cartigram.


Brain diffusion, perfusion and CSF flow studies and excellent musculoskeletal(MSK) imaging are our salient features.


Wide bore magnet and quick throughput ensure excellent patient comfort. 


Even uncooperative patients who move in the MRI machine can be scanned using special PROPELLOR sequences.




MR defecography is technique to study disorders of ano-rectal function. It is indicated in patients having constipation, rectal incontinence, painful defection and rectal prolapse.. It permits analysis of the ano-rectal angle, opening of the anal canal, function of the puborectalis muscle and descent of pelvic floor during defecation. It provides good demonstration of the rectal wall, intussusception, enteroceles and rectoceles with excellent demonstration of the perirectal soft tissue. It allows assessment of spastic pelvic floor syndrome and descending perineum syndrome. No radiation hazard is associated with this procedure as was there in fluoroscopic x ray defecography. Images are obtained with patient at rest, at maximal sphincter contraction, during straining and during defection.

Functional MRI (fMRI) measures signal changes in the brain that are due to changing neural activity and is also referred to as BOLD imaging (Blood oxygen level dependent).

A person's brain is scanned while he or she is performing a certain physical task such as squeezing a ball or looking at a particular type of picture. When the neural activity is increased, there is increase in oxygen demand and the vascular system actually overcompensates for this, increasing the amount of oxygenated hemoglobin relative to deoxygenated hemoglobin.

Such techniques are being used in pre-surgical planning and in basic neuroscience research in areas such as memory, expressive and receptive speech, visual spatial processing and other cognitive processes

4D ULTRASOUND AND COLOR DOPPLER

​MR DEFECOGRAPHY

Although X-Ray Mammography remains the primary imaging modality in the evaluation of breast disease, the mammogram can at times be inconclusive for the presence or location of an abnormality. MR imaging has been used as an adjunct to mammography, particularly for patients with equivocal mammographic findings. The main advantage of breast MR imaging is its high sensitivity, with reported sensitivities for cancer ranging from 91% to 100% with varying specificity. Multiple investigators have shown that MR mammography may be useful to verify multifocality and multicentricity of breast cancer, differentiate scars from recurrences after breast-conserving therapy, screen high-risk groups who have a family history of breast cancer, investigate breast implants, examine breasts in cases of histologically proven breast cancer, metastasis with unknown primary

  • Quantitative measurement of tissue stiffness 


  1. Shear Wave speed (m/s)
  2. Young’s Modulus (kPa)


  • 2D color coded visualization of tissue stiffness


  • Image guidance with B-mode ultrasound images, allows for :-


      1.  Instant visual quality assessment of spatial stiffness, useful for detection and characterization of focal lesions


      2.  Better diagnostic interpretation with overlaying of shear wave stiffness images on the B-mode images 

     

      3.  Optimal placement of Regions of Interest (ROI) for quantitative stiffness measures


      4.  Sampling within the ROI provides tissue stiffness measures at any location in the ROI, unlike conventional fibroscan which  

            measures only the average stiffness within a ROI in a blind manner


  • Assessment and comparison of the degree of fibrosis in the same site of the liver on follow up imaging using this technique, which was not possible earlier




















Image shows measured and colour coded tissue stiffness in a patient with stage F1 fibrosis (left) and a patient with cirrhosis, suffering from portal hypertension and hepatitis C (right)

BONE DENSITOMETRY (DEXA)​

T2* MR IMAGING 

​MR spectroscopy is a noninvasive method providing metabolic information about the brain. MR spectroscopy enables tissue characterization on a biochemical level surpassing that of conventional MR imaging. MR spectroscopy is also able to detect abnormalities that are invisible to conventional MRI because metabolic abnormalities often precede structural changes.

FIBROSIS SCAN OF LIVER BY SHEAR WAVE ELASTOGRAPHY WITH ULTRASOUND

Doon MRI & Diagnostics

​          From x-rays to Functional Imaging 

MR angiography is used to generate pictures of the arteries to detect any abnormal narrowing/dilatation or abnormal arterio-venous connections. MR angiography is often used to evaluate the arteries of the neck and brain, the thoracic and renal arteries and the arteries of legs. Magnetic Resonance Venography (MRV) is a similar procedure used to image veins.

In keeping with our tradition of introducing high quality medical imaging services Doon MRI & Diagnostics is proud to introduce Digital Mammography system Senographe Care by GE Healthcare, USA.


Its soft gentle design complete with arm-rests, chest padding and arm-pit padding provides the highest level of comfort for the patient during the scan.


The machine automatically controls the degree of compression applied to the breasts for optimizing the amount of radiation exposure.


It automatically releases the compression once the scan is done.

High resolution imaging with enhanced sensitivity for cancer detection is ensured.  

SHEAR WAVE FIBROSIS SCAN FOR LIVER

Doon MRI & Diagnostics has installed the State's first true Digital X-ray system from Carestream Health which is a mark of the global quality that we strive to provide. This is integrated with an advanced high frequency 800 mA X-ray equipment with IITV from Allengers Medical Systems.


DR Systems provide unparalleled image quality and drastically lower the radiation exposure to the patient.


They also improve the workflow of a radiology department by digitizing the entire process of taking an X-Ray.


All routine plain X-rays and special procedures including barium studies, intravenous urography (IVU), hysterosalpingography (HSG), retrograde cystourethrography (RGU) and micturating cystourethrography (MCU), etc. are performed using the DR system. 

MR MAMMOGRAPHY

Estimation of iron deposits in different organs of thalassaemia patients is an important aspect of their medical management . Serum ferritin has been used as a surrogate marker, but it is not specific because its level can be raised in inflammations such as hepatitis, infections and in liver damage . Although biopsy is the most reliable method for estimating organ iron overload, its invasive nature makes its implementation very limited.


The T2* magnetic resonance imaging (MRI) technique is a non-invasive, valid and reproducible method for assessing tissue iron loading, and therefore has important implications for clinical management of iron overload and the tailoring of chelation regimes. This method has allowed for early diagnosis of liver and heart haemosiderosis and a reduction in morbidity and mortality in thalassaemia patients

Doon MRI & Diagnostics is equipped with the most advanced 3D/4D Ultrasound and Color Doppler system Voluson E-8 Expert from GE Healthcare, USA having a break-through pure wave single crystal technology delivering high quality images.


It provides very high resolution 2D and LIVE 3D (4D) images, sonomammography, small parts and high-resolution MSK ultrasound.

2D echocardiography is also routinely performed.


VOCAL(Volumetric organ calculation), Multislice CT like images and Panoramic images to include a wide area in single image. Broadband frequency compounding, tissue harmonic imaging, high resolution musculoskeletal imaging and breast elastography are routinely performed.


Color Doppler with HD flow to study the blood flow in carotid (in CVA) and limb vessels (pain in limbs), renal arteries (in hypertension), testicular torsion, tumors etc.


It provides excellent 3D/4D study in pregnancy as well as fetal doppler study. 

NON-INVASIVE CT ANGIOGRAPHY

Shear Wave Elastography on the LOGIQ S8 XD Clear ultrasound is the latest and advantageous technique for non-invasive quantification of liver tissue stiffness.

DIGITAL MAMMOGRAPHY

Doon MRI & Diagnostics is the first in the State to be equipped with the latest 128 Slice CT scanner from GE Healthcare, USA. The equipment is capable of performing cutting-edge tests like Coronary Angiograms(Heart Scan), Pulmonary Angiograms, Brain Angiograms, Triple Phase Organ Imaging, Tru-match imaging etc.


The state of the art 128 detector row(500 slice) CT from GE Healthcare, USA provides ultra-fast volume imaging with a capability of a 5 beat heart scan(coronary angiography). 


Further all routine CT scans are done using ultra-thin 0.625mm slices with volume acquisition and isometric reconstruction can be obtained in any plane. 3D-CT examinations are routinely performed along with virtual colonoscopy, virtual bronchoscopy, and whole body scanning.


The 128-channel configuration also provides breakthrough performance in advanced pulmonary imaging, multi-organ trauma evaluation and low-dose pediatric applications to boost clinical capabilities to the highest level attainable.


Non-invasive imaging technologies continue to revolutionize ever subspecialty of medicine.

FUNCTIONAL MRI​

Diffusion weighted images are very commonly used in the assessment of acute stroke and are also widely used in oncology.

Diffusion Tensor Imaging , also known as MR Tractography non-invasively maps white matter tracts. Diffusion parallel to nerve fibers has been shown to be greater than diffusion in the perpendicular direction. This provides a powerful tool to study in vivo fiber connectivity in the brain in a noninvasive manner and preoperative planning of resectability of brain tumors. Application of this technique to stroke, Alzheimer's disease and pediatric brain development are being investigated.

1.5 TESLA HD VOLUME MRI