The craniocervical junction (CCJ) is where the skull joins the spine and includes the occipital bone at the base of the skull and the first two bones of the spine called the axis and atlas bones. The atlas allows for the movement of your head. The opening at the base of the occipital bone is called the foramen magnum and it protects the brain stem, important nerves, and blood vessels.
This type of MRI scan is a useful imaging investigation for people suffering with neck pain, often accompanied by headaches at the back of the neck. This type of pain usually gets worse with movements such as coughing or bending forwards.
Medserena’s craniocervical junction MRI scan is one of the company’s clinical specialities and offers an upright scan that can be carried out with the patient in a comfortable position to allow full assessment of the foramen magnum and cerebellar tonsils (these are structures in the brain located at the base of the cerebellar hemispheres, two halves of the cerebellum (the part of the brain which control movements and balance). The scan takes around one and a half hours and the cerebellar tonsils can be assessed under the natural weight of gravity. This may show a more accurate degree of hind brain herniation (also known as coning), where part of the brain is squeezed through the foramen magnum. This can cause a range of neurological symptoms.
The scan is carried out in an open scanner and a variety of different views are taken using the company’s unique variPOSE sequence, for example showing the head turned to the right, ahead and then left, giving a rotational dynamic study. The neck is also scanned in flexion (bending), extension and neutral positions. Static measurements are then taken and compared to standardised normal levels. Further measurements are taken in flexion and extension to assess the degree of movement that person has. The alar ligaments are one of the key areas assessed to see if they are lax or damaged.
The big advantage of an open craniocervical junction MRI scan over a conventional flatbed MRI tunnel scan is that the upright spine can be viewed in a neutral upright position whilst weight bearing under the natural load of gravity. This gives a dynamic picture of what is happening in the CCJ and upper spine when it is subjected to normal everyday pressures picking up problems that might have been missed or underestimated on a conventional flatbed MRI scanner.
A craniocervical junction MRI scan is particularly useful for patients with whiplash type symptoms and those with the hypermobile connective tissue disease Ehlers-Danlos syndromes. Many ED patients complain their head feels too heavy and say that they are asymmetrical.
The CSF option is currently unavailable, please check your nearest centre for next availability.
Sometimes a referring physician may order an extra Cerebro spinal fluid (CSF) Flow test in conjunction with a CCJ MRI scan. This uses MRI and a pulsimeter to pick up a patient’s regular pulse and measure the flow of CSF, a liquid that bathes the brain and spinal cord. This can help diagnose a condition called craniocervical instability (CCI), (see below), common in patients with inherited hypermobility conditions.
During this scan the patient is in a seated position using the head coil and required to keep absolutely still so that the pulsimeter can pick up their regular pulse.
CCJ, Cervical Spine, CSF Flow
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Open MRI scanners are a stress-free alternative to using a conventional enclosed tunnel MRI scanner, providing comfort and reassurance for people who suffer from anxiety or claustrophobia. Sitting upright is more comfortable for patients and the open front means patients can speak to a friend or relative or watch television throughout as distraction.
Open MRI scans can also accommodate larger/ heavier patients who might have difficulty fitting comfortably into a conventional tunnel scanner, as they can take weights of up to 35 stone (226kg). However, suitability will depend on the patient’s build and the area of anatomy that needs to be scanned.
The Upright MRI is truly open. There are no tunnels, no narrow tubes. The system is particularly quiet, the examination is comfortable and does not trigger feelings of being in a confined space. This means that the Upright MRI is particularly tolerated by patients who suffer from “claustrophobia”.
Because the system offers you an unrestricted view, you can watch TV or see DVD movies on a large screen during the scan. Wearing headphones – as with other MRI systems – is usually not necessary.
According to the current state of knowledge, there is no danger to the patient’s health as magnetic resonance imaging only uses magnetic fields and radio waves.
Metallic foreign bodies within the patient, such as fixed dental prosthesis, artificial joints or metal plates after treatment for a fracture do not usually pose any danger. However, it is important to clarify that the implants you use are MRI-compatible before the examination.
MRI (Magnetic Resonance Imaging) utilises a large magnet, radio waves and a computer to form images of your body. It is non-invasive, painless and does not use any ionising radiation.
Our truly open MRI can scan you in different positions. Through the utilisation of a specially designed MRI system we can offer weight-bearing scans – sitting or standing. The design of the system allows the patient to be positioned in different postures (e.g. flexion or extension) so that the patient may be examined in the position where they experience pain. The reason to do this is that some pathologies are underestimated or even not seen in a conventional supine MRI scan. The technique has value in many applications: e.g. spine, knees, hips, ankles. This has been proven in scientific studies and documented in peer reviewed publications.
In addition, it offers the possibility of performing an MRI scan on patients who could not otherwise tolerate the examination. This may include the claustrophobic patient, who benefits from the truly open nature of the equipment, and the severely kyphotic patient or emphysema sufferer who simply cannot lie down. It can also facilitate scanning of large patients who struggle to fit conventional ‘bore’ MRI scanners.
Of course, we have a comfortable waiting area but if you want them to stay in the scan room with you, they will also need to fill out a safety questionnaire. There is enough space for a companion. The person can even hold your hand and communicate with you during the examination. This is particularly beneficial when examining teenager.
This depends above all on which part of the body needs to be examined. In the Upright MRI, special examinations can be carried out in various body positions. The entire scan generally takes between 30 and 45 minutes. However, since you have the opportunity to watch TV or DVD, this time will go by much quicker.
Eat and drink normally and, unless your doctor tells you otherwise, please continue taking medications as normal. If you have any special needs (e.g. wheelchair access) please inform us when making the appointment.
Your appointment confirmation; referral letter/form; Medical Insurance details if applicable. We accept all major debit/credit cards.
We will provide a gown/clothing for you to wear when you are scanned. If you prefer to wear your own, please ensure that you wear or bring clothing without any metal fasteners, zips or under-wiring as these cannot be worn in the scan room. The changing room can be locked for safe storage of your possessions.
You will be able to walk into the scanner. It has no tunnel or bore. You will be able to hear us and talk with us during your scan if necessary-and we will be able to see you at all times. Due to its open nature, you will even be able to watch TV or a DVD whilst having the scan. Depending on which part of you is being scanned, you may be asked to sit or stand, and assume different postures (for example bending forward.) The radiographer may place a receiver “coil” around the relevant area of your body. You will need to remain very still while the acquisition is done in order to prevent blurring of the images. You will hear some tapping from the scanner but in general it is much quieter than many other MRI scanners.
You will not feel anything while having the scan. There is no pain or unusual feeling of any type and you will experience no after effects.
YES. There are some things that can prevent you from having an MRI scan. You will be asked to complete a safety questionnaire on arrival at the Centre which will cover the contra-indications-but if you are making an appointment and any of the factors below affect you, please discuss this with us in advance as it may save you a wasted trip.
Contra-indications can include:
It is also important to tell us if you have any tattoos or piercings.
Watches, jewellery, coins, keys, cigarette lighters, penknives, credit cards. piercings, hairgrips, wigs, nicotine patches, and hearing aids must be removed.
Your scan will be reported by a Consultant Radiologist. It will normally be available in a couple of days unless needed urgently. The images and report will be sent to your referring practitioner. If you have a follow up appointment, please make us aware of the details so we can ensure the report and images are available in time.