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It seems that MRIs (Magnetic Resonance Imaging examinations) may not be as infallible as many believe them to be. Problems arise from both the quality of the MRI machine, as well as the experience and skill of the radiologist reading the scan.

An MRI machine uses magnetic and radiofrequency fields to manipulate hydrogen atoms in the body. Protons in the hydrogen atoms respond differently to these fields in different types of tissue, which allows for information to build up and form an image.

Differences arise in the quality of the images produced because of various reasons. Magnet strengths vary enormously, and the imaging coils used to fit around the body part being scanned may not be sufficiently sensitive. The computer program used to control and analyze the images may vary the quality of the image. Additionally, many machines are not up-to-date and may not use the best available technology.

In addition to technology problems, the skill and experience of the radiologist reading the scans may affect the diagnosis. Radiologists ought to be specialized in reading MRIs from particular parts of the body, and not a generalist without any special training, said Dr. G. Scott Gazelle, a professor of radiology at Harvard Medical School.

A radiology center should be accredited by the American College of Radiology, but that doesn’t mean the scan will be reliable. Dr. Jeffrey Jarvik, a professor of radiology and neurological surgery at the University of Washington, believes that going back to the basics of using history and an examination to diagnose problems, instead of relying on imaging alone, should help relieve some of the misdiagnoses based on faulty scans. And when in doubt, seek a second opinion.

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