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Chung M, Dahabreh IJ, Hadar N, et al. Emerging MRI Technologies for Imaging Musculoskeletal Disorders Under Loading Stress [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Nov. (Comparative Effectiveness Technical Briefs, No. 7.)

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Emerging MRI Technologies for Imaging Musculoskeletal Disorders Under Loading Stress [Internet].

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Appendix CExamples of Commercially Available Devices That Allow MRI Under Weight-Bearing or Stress-Loading Conditions

Please note that permissions have been obtained to reproduce the following photographs. Sources for each photograph are listed in the respective figure legend.

Appendix C Figure 1 is a photograph of the FONAR Upright multipositional MRI. This device allows positional (flexion, extension), weight bearing (upright and sitting) imaging, and has an open configuration (the patient does not enter a closed bore). The FONAR Upright MRI has a 0.6 T horizontal field generated between two resistive magnets. A tilting table placed at right angles between these coils can be positioned at any angle from −20 to 90 degrees (vertical), allowing for supine as well as standing imaging. An MRI compatible seat can be added in the upright position. Extension is achieved by positioning of a small cylindrical cushion just above the lumbrosarcal junction. Flexion is achieved by leaning forward over a wedge-shaped cushion and supporting the hands on a horizontal bar.

aUpright® MRI

The FONAR Upright multipositional MRI allows positional (flexion, extension), weight-bearing (upright and sitting) imaging and has an open configuration (the patient does not enter a closed bore). The device has a 0.6 T horizontal field generated between two resistive magnets. A tilting table placed at right angles between these coils can be positioned at any angle from −20 to 90 degree (vertical), allowing supine and standing imaging. An MRI compatible seat can be added for imaging in a sitting position. Extension is achieved by positioning of a small cylindrical cushion just above the lumbrosarcal junction. Flexion is achieved by leaning forward over a wedge-shaped cushion and supporting the hands on a horizontal bar (as shown in the photograph).

Source: Jinkins JR, Dworkin JS, Damadian RV. Upright, weight-bearing, dynamic-kinetic MRI of the spine: initial results. Eur Radiol 2005 Sep;15(9):1815–25. Epub 2005 May 20. Reproduced with permission from the publisher (Springer).

Appendix C Figure 2 is a photograph of the Signa SP/i system. This device was originally indented for use in interventional procedures, as it allowed physician access to the patient while in the MRI field. The MRI system is characterized by two vertically oriented, doughnut-shaped superconducting magnetic coils. Several investigators have modified the scanner to allow for imaging of the patient in different functional orientations (flexion, extension) or weight-bearing (upright, sitting, or other) positions. Due to the 56 cm vertical gap between the two magnet poles, the Signa SP/i system can also be considered an open system.

bSigna SP/I

The Signa SP/i system was originally indented for use in interventional procedures as it allowed physician access to the patient while in the MRI field. The MRI system is characterized by two vertically oriented, doughnut-shaped superconducting magnetic coils. Several investigators have modified the scanner to allow imaging of the patient in different positions (flexion, extension), weight bearing (upright, sitting, or in other weight-bearing positions) and (because of the 56 cm vertical gap between the two magnet poles) can also be considered an open system. The photograph demonstrates the placement of an MRI-compatible chair (panel a) between the magnetic coils (arrow in panel b). Note: the device is no longer manufactured or sold by GE Healthcare in the US.

Source: Hébert LJ, Moffet H, Dufour M, Moisan C. Acromiohumeral distance in a seated position in persons with impingement syndrome. J Magn Reson Imaging 2003 Jul;18(1):72–9. Reproduced with permission from the publisher (John Wiley and Sons).

Appendix C Figure 3 is a photograph of the G-Scan (Esaote SpA, Genoa, Italy) MRI device. This device has an open and tilting design and can perform scans in the supine and upright, weight-bearing position. Another unique feature, termed “instant positioning,” allows the patient, once having been positioned on the table, to be automatically isocentered with the coil for investigation of the particular joint of interest at the push of a button.

cG-scan®

G-Scan (Esaote SpA, Genoa, Italy) has an open and tilting design and can perform scan in the supine position and in the upright weight-bearing position. Another unique feature is “Instant positioning.” Once the patient has been positioned on the table, just press the button of the joint under investigation which automatically moves the patient and coil in the isocenter. Note this device can image any body area (in this case, the feet).

Source: Sutera R, Iovane A, Sorrentino F, Candela F, Mularo V, La Tona G, Midiri M. Plantar fascia evaluation with a dedicated magnetic resonance scanner in weight-bearing position: our experience in patients with plantar fasciitis and in healthy volunteers. Radiol Med 2010 Mar;115(2):246–60. Epub 2010 Feb 22. Reproduced with permission from the publisher (Springer).

Appendix C Figure 4 is a photograph of the DynaWell L-spine device. This device consists of a harness attached to a nonmagnetic compression platform by nylon straps, which are tightened to axially load the lumbar spine. By tightening or loosening the adjustment knobs on the foot plates, the load can be regulated and equally distributed on the legs.

dDynaWell L-spine

Simplified schematic modeled on the DynaWell L-spine device. The device consists of a harness attached to a nonmagnetic compression part by nylon straps which are tightened to axially load the lumbar spine. By tightening or loosening the adjustment knobs on the foot plates, the load can be regulated and equally distributed on the legs.

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