More soothing mri option is a tradeoff gas bubble in back

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Manufacturers have made significant changes to make the process more comfortable. But for some people, sliding into a narrow tube for an extended period of time with nothing but a very loud pounding noise for company is unbearable. It’s estimated that up to 15 percent of potential MRI patients won’t have a scan because the machine is so confining, it makes them feel claustrophobic. Then there are those who don’t fit in a conventional MRI machine, a significant problem given the obesity epidemic.

Open MRI—machines that are open on two sides—were introduced years ago, and have been heavily promoted as the solution to confining closed machines. But the ads don’t tell you what many doctors know: Open scan machines, particularly those with lower-strength magnets, yield poorer-quality images than a good practitioner can get with a closed machine.

MRI scans offer a view inside the body that other types of imaging—X-ray, CT and ultrasound—can’t provide. A powerful magnet and pulses of radio wave energy generate highly detailed pictures revealing tumors, damage to organs and blood vessels, broken bones, infection, blockages and problems with discs, cartilage, ligaments, tendons and nerves.

The stronger the magnet, the better the picture — and for complicated reasons involving geometry and physics, open machines must use weaker magnets. Measured in units called Tesla, magnet strength ranges from 0.2 to 3.0 in most clinical settings. Open machines’ magnets usually are less than 1.0. But closed MRI ranges from 1.0 to 3.0.

"You can still get a look inside the body (with an open scan), but it’s not as good a look as you get with a closed scan," said Dr. Reed Murtagh, a neuroradiologist and professor of oncology and neuroradiology at Moffitt Cancer Center and USF Health.

In the past three years, BayCare added five new conventional 1.5 Tesla machines. They are not open, but they feel less intimidating than other closed machines because the opening is 5 inches wider and the tube is about 2 feet shorter than other closed MRIs.

But not surprisingly, the higher-powered machines come with a higher price tag. Nelson said an MRI with 0.7 Tesla and below runs about $250,000 to $500,000. The 1.5 T machine costs $1 million to $1.4-million, depending on options. At most imaging centers, patient charges vary by the body part being screened, not the machine used.

Jonnie-Mae Smith of Tampa appreciates the need for high resolution images, but, unless she’s completely sedated, she can tolerate only an open machine. "I have severe claustrophobia and can’t be in a closed MRI machine or CT scanner. I can’t even get in an elevator," said the 44-year- old who requires at least six scans each year because of a genetic disorder that affects her bones and connective tissue.

Some MRI centers offer special goggles and headphones that play movies or calming music, aromatherapy and specially trained technicians who can talk most patients through bouts of mild to moderate claustrophobia. Many allow a patient to have someone hold their hand during the scan.