Certain structures and abnormalities can be distinguished more effectively with MRI than with other imaging methods. MRI can therefore be used to detect a wide range of diseases and abnormalities:

Central nervous system

• brain and spinal cord tumours;
• stroke and other cerebrovascular diseases;
• dementia, Alzheimer's disease and other neurological abnormalities;
• spinal cord injuries and herniated discs.

Musculoskeletal system

• herniated discs, vertebral compression fractures and inflammation;
• joint problems, pain, instability, ligament tears and meniscal injuries;
• arthritis and degenerative joint disease;
• bone marrow oedema, as well as soft-tissue injuries and abnormalities.

Abdominal and pelvic organs

• diseases of the liver, bile ducts and pancreas;
• kidney and urinary tract problems;
• abnormalities of the uterus, cervix, ovaries and prostate.

Breast

• abnormalities of breast tissue;
• assessment of the condition of silicone implants.

An MRI scanner is essentially a large magnet that uses a strong magnetic field and radio waves. It works by detecting the magnetic behaviour of hydrogen atoms in the water molecules within the body. Radiofrequency waves move the hydrogen atoms out of equilibrium. When the radiofrequency pulse stops, the atoms return to their original state and emit signals. These signals are detected by specialised “coils” designed for different parts of the body.

Different tissues—such as the brain, muscle and fat, as well as inflamed tissue and tumours—contain different amounts of water, so their hydrogen atoms return to equilibrium at different rates. These differences in magnetic behaviour determine the contrast in MRI images. In general, a higher magnetic field strength, measured in tesla, can provide higher spatial resolution.

Our Siemens Biograph mMR MRI scanner operates at a magnetic field strength of 3 tesla. This enables us to obtain images with higher spatial resolution, finer structural detail, better contrast and a higher signal-to-noise ratio without increasing examination time.

MRI contrast agent is a special gadolinium-based substance administered intravenously. In certain organs and for specific indications, a contrast agent can make structures easier to distinguish and abnormalities easier to assess accurately.

For some examinations, a non-contrast, or native, MRI scan is sufficient. However, certain examinations—for example, examinations of the abdominal and pelvic organs or investigations where inflammation or a tumour is suspected—may require contrast administration. This is decided in each case by your referring physician or radiologist. We perform contrast-enhanced examinations on the recommendation of a specialist.

Preparation

• Do not eat for 4 hours before your appointment. You may drink water and take your regular medication as instructed by your doctor.
• Bring a laboratory report issued within the past month that includes your creatinine and eGFR values.
• If you are breastfeeding, please discuss breastfeeding during the 24 hours following intravenous contrast administration with your doctor and our staff in advance.

Administration and observation

Before the examination, the radiographer will check your kidney-function laboratory results and insert an intravenous cannula into a vein in your arm or hand. The contrast agent will be administered through this cannula at the appropriate stage of the examination. An observation period of approximately 10–20 minutes is generally required after the examination.

Possible reactions

In very rare cases, a hypersensitivity reaction to the contrast agent may occur. Allergic reactions usually develop within 20 minutes of administration and are generally mild. Symptoms may include swelling of the face, lips, tongue or throat; a runny nose; sneezing; coughing; difficulty breathing; itchy hives; or a feeling of suffocation.

If you feel unwell during the examination or observation period, tell the radiographer immediately.

Our staff are trained and equipped to manage these types of adverse reactions. In very rare cases, symptoms may occur within 24 hours or later. If this happens, please contact your doctor or an out-of-hours medical service. If you experience difficulty breathing, choking, faintness or any other severe symptom, call 112.

MRI scanners use an extremely strong magnetic field. Certain implants, electronic devices and metallic foreign bodies may therefore pose a safety risk. Before the examination, we must always verify the exact type of device and its MR compatibility.

You must notify us in advance if:

• you have an implanted cardiac pacemaker or implantable cardioverter-defibrillator (ICD);
• you have an implanted drug-delivery device or other electronic implant;
• you have an orthopaedic implant in your body, such as a screw, plate, intramedullary nail, wire, clip or joint replacement;
• you have a prosthetic heart valve, vascular clip, stent, vascular occlusion device or other vascular implant;
• you have a cochlear or other ear implant;
• you have any other implanted metal object or an implant of unknown origin;
• a bullet, metal fragment or other metallic foreign body may have entered your body, particularly your eye or the area around it;
• you use an external prosthesis, artificial limb or other removable medical device;
• you are pregnant or pregnancy cannot be ruled out;
• Important: the bore diameter of our MRI scanner is 60 cm. Whether the examination can be performed may therefore be affected by the body area being examined as well as the patient's body shape and weight. If you weigh more than 150 kg, please consult our staff when booking your appointment.

When booking your appointment, please be sure to tell our staff if you have any metal implant in your body or if there is a possibility that a metallic foreign body from a previous accident—such as a metal fragment in the eye—may be present. Bring documentation relating to your implant, such as a medical certificate, hospital discharge summary or implant card, so that our staff can assess whether the examination can be performed safely. If you have an older implant or one of an unknown type, the MRI examination can only be performed after the device has been identified and its MR safety classification verified.

In general, no special preparation is required. However, if you are attending a contrast-enhanced MRI examination, do not eat for 4 hours before your appointment. You may drink fluids and take your usual medication.

Adequate kidney function must be confirmed before contrast agent can be administered safely. Please therefore bring a laboratory report issued within the past month that includes your current creatinine and eGFR values.

What to bring

• your identification and healthcare documents;
• your referral or written specialist recommendation;
• previous outpatient records, reports and diagnostic images, including any DVD containing them;
• documentation for any implant, if applicable;
• the required kidney-function laboratory report if you are having a contrast-enhanced examination.

Metal and magnetic objects

MRI scanners use an extremely strong magnetic field. Metal objects are therefore strictly prohibited in the examination room. They may interfere with image acquisition and reduce image quality, as well as pose a serious risk of injury. The magnetic field may also damage electronic devices and magnetic-stripe cards.

Before the examination, you must remove items including:

• watches, jewellery, piercings and hair clips;
• belts and clothing with metal buttons or zips;
• underwired underwear and clothing with metal decorations;
• hearing aids, glasses and removable metal dental appliances;
• mobile phones, keys, coins, bank cards and other magnetic-stripe cards.

Please bring any relevant medical history, previous outpatient records, imaging reports and images—including MRI, CT, X-ray or ultrasound images and any related DVDs—so that we can compare them with your current results and provide the most accurate possible medical opinion. If you would prefer to send these in advance, please forward them to the email address provided by the institute.

Arrival and administration

Please report to reception upon arrival. After your personal and billing details have been verified, you will be asked to complete a detailed MRI consent form before the examination begins. If you do not have a medical referral or written specialist recommendation, we will also complete a detailed medical questionnaire with you.

Safety screening and changing

After registration, the radiographer will call you in from the waiting area. Before you enter the MRI examination room, the radiographer will carefully review your completed consent form. To ensure that the examination proceeds safely and smoothly, we must confirm together that you do not have any metal, implant or electronic device in your body that could be affected by the magnetic field.

Before the examination begins, you must remove all metal and magnetic objects. You may store them in the lockable cupboard provided in the changing cubicle.

Before a contrast-enhanced examination

The radiographer will check your kidney-function parameters (creatinine and eGFR) and then insert an intravenous cannula into a vein in your arm or hand to allow the contrast agent to be administered safely.

• Position: you will usually lie on your back on the examination table. The radiographer will position the coils required for the body area being examined and then move you into the centre of the cylindrical scanner.
• Noise: the scanner produces loud rattling and knocking sounds. We will provide noise-reducing ear protection or earplugs.
• Keeping still: you must remain completely still throughout the examination to ensure adequate image quality.
• Breath-hold examinations: during certain examinations, you may be given breathing instructions, such as holding your breath for a short period.
• Contrast agent: if required, the contrast agent will be administered through the previously inserted intravenous cannula at the appropriate stage of the examination.
• Communication: if a problem occurs—for example, claustrophobia or a reaction to the contrast agent—you can immediately contact the radiographer through the built-in speaker and microphone by squeezing the alarm bulb. The radiographer will also monitor you continuously by camera.
• Examination duration: examining one body area takes approximately 30 minutes on average. The radiographer performing the examination will tell you the estimated duration and will also let you know when the examination has finished. Do not move out of position until instructed to do so.

Possible reactions to the contrast agent:
In very rare cases, a hypersensitivity reaction to the contrast agent may occur. Allergic reactions generally develop within 20 minutes of administration and are usually mild. Symptoms may include swelling of the face, lips, tongue or throat; a runny nose; sneezing; coughing; difficulty breathing; itchy hives; or a feeling of suffocation.
If you feel unwell, tell the radiographer performing the examination immediately.
Our staff are trained and equipped to manage these types of adverse reactions.

After a non-contrast examination

The examination is painless and safe, and no observation period is required afterwards. You may get dressed and resume your usual daily activities without restriction.

After a contrast-enhanced examination

• After the examination, you must remain in the preparation area for observation for 10–20 minutes so that we can ensure that no allergic reaction develops.
• Drink plenty of fluids during the day (2–3 litres of water) to help your kidneys eliminate the contrast agent as soon as possible.
• If you feel unwell or develop allergic symptoms, tell the radiographer immediately.

If you develop mild allergic symptoms after leaving, contact your doctor or an out-of-hours medical service. If you experience difficulty breathing, choking, faintness or any other severe symptom, call 112 (ambulance) immediately.

To ensure faster administration, our institute accepts electronic, cashless payments only, either by bank card or bank transfer.

• Bank card: the examination fee can be paid on site immediately after the examination.
• Bank transfer: the “Bank Transfer Details” card provided after the examination contains the information required to make the payment.

Bank transfer details

Images and written report

• Images: we will provide your images in digital format immediately after the examination.
• Written medical report: the images are reviewed by a specialist radiologist. The written assessment is generally not available immediately; it is usually sent by email and post within 3 working days and is also uploaded automatically to the EESZT system.

If you pay by bank transfer, your written report will be uploaded to EESZT and sent to you by email and post after the payment has been received. If you pay by bank card on site, this process will begin immediately.

For an unsuccessful examination, we charge an administration, scanner-time reservation and availability fee of HUF 10,000.

What is considered an unsuccessful examination?

• Claustrophobia or panic: the patient is unable to tolerate the examination.
• Restriction due to body size: the patient cannot fit safely into the scanner's 60 cm bore, or the patient's weight exceeds the scanner table's weight limit.
• Interrupted examination: the examination cannot be completed because of illness, pain, panic or another reason. In such cases, the images acquired up to that point are generally insufficient for diagnostic assessment.
• Contraindication identified on site: the examination cannot be performed because of an implant, metal object or other safety risk that was not disclosed in advance.
• If you arrive more than 30 minutes late: unfortunately, we will no longer be able to perform the examination, in order to ensure that other patients receive their scheduled care on time and to avoid disruptions to our appointment schedule. As the reserved appointment time was allocated exclusively to you, an administration fee of HUF 10,000 will be charged in such cases.

When do we waive the fee?

In certain exceptional cases, our institute waives the examination fee in full on compassionate or professional grounds. No fee will be charged in the following circumstances:

• if the examination cannot be performed because of an unexpected technical failure;
• if an unexpected, serious condition requiring immediate emergency treatment develops during the examination and the patient must be transported to hospital;
• if, in the reporting radiologist's professional judgement, additional or repeat images are required to clarify the diagnosis.

When must the examination fee be paid?

We are unable to waive the examination fee in the following circumstances:

• if a serious abnormality that does not require immediate emergency intervention is discovered during the examination; in such cases, we recommend an urgent specialist consultation;
• if the examination has to be interrupted because of panic or illness, but sufficient images of diagnostic quality have already been acquired;
• if a hypersensitivity reaction occurs following administration of the contrast agent.
• if the examination yields results of limited diagnostic value, meaning that the images obtained do not provide complete or sufficiently detailed diagnostic information. In such cases, the diagnostic value and level of detail of the examination may be lower than expected, and the image quality may also be reduced.

Our staff will provide immediate assistance in the event of illness, panic or an allergic reaction and will call an ambulance if necessary. If a diagnostically usable examination has been performed, the applicable fee must still be charged in these circumstances.