A CT Scan (or CAT Scan) is best suited for viewing bone injuries, diagnosing lung and chest problems, and detecting cancers. An MRI is suited for examining soft tissue in ligament and tendon injuries, spinal cord injuries, brain tumors, etc. CT scans are widely used in emergency rooms because the scan takes fewer than 5 minutes. An MRI, on the other hand, can take up to 30 minutes.
An MRI typically costs more than a CT scan. One advantage of an MRI is that it does not use radiation while CAT scans do. This radiation is harmful if there is repeated exposure.
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How the scans work
How MRIs work
Using a very powerful magnet and pulsing radio waves, the detection coils in the MRI scanner read the energy produced by water molecules as they realign themselves after each RF alignment pulse. The collected data is reconstructed into a two-dimensional illustration through any axis of the body. Bones are virtually void of water and therefore do not generate any image data. This leaves a black area in the images. MRI scanners are best suited for imaging soft tissue.
How a CT Scan works
CT, Computerized Axial Tomography, uses x-rays to generate images of the body, including bone. In the CT scanner the x-ray tube, (source) rotates around the patient laying on the table. On the opposite side of the patient from the tube is the x-ray detector. This detector receives the beam that makes it through the patient. The beam is sampled via some 764 channels, (approximate number of channels). The signal received by each channel is digitized to a 16 bit value and sent to the reconstruction processor. Measurements are taken about 1000 times per second. Scan rotations are usually 1 to 2 seconds long. Each view/channel chunk of scan data is compared to calibration scan data of air, water and polyethylene (soft plastic), previously acquired in the exact same relative location. The comparisons allow the image pixels to have a known value for a particular substance in the body regardless of differences in patient size and exposure factors. The more samples or views, the better the picture.
Pros and Cons
Advantages of MRI over CAT Scan
- A CAT scan uses X rays to build up a picture. MRI uses a magnetic field to do the same and has no known side effects related to radiation exposure.
- MRI gives higher detail in soft tissues.
- One of the greatest advantages of MRI is the ability to change the contrast of the images. Small changes in radio waves and magnetic fields can completely change the contrast of the image. Different contrast settings will highlight different types of tissue.
- Another advantage of MRI is the ability to change the imaging plane without moving the patient. Most MRI machines can produce images in any plane.
- Contrast agents are also used in MRI but they are not made of iodine. There are fewer documented cases of reactions to MRI contrast and it is considered to be safer than X-ray dyes.
- For purposes of tumor detection and identification, MRI is generally superior. However, CT usually is more widely available, faster, much less expensive, and may be less likely to require the person to be sedated or anesthetized.
- CT may be enhanced by use of contrast agents containing elements of a higher atomic number (iodine, barium) than the surrounding flesh. Contrast agents for MRI are those which have paramagnetic properties. One example is gadolinium. Iodine use may be associated with allergic reactions.
CT scans and cancer
The radiation from CT scans is harmful and repeated scans can even cause cancer. In a February 2014 article, the New York Times reported that
The radiation doses of CT scans (a series of X-ray images from multiple angles) are 100 to 1,000 times higher than conventional X-rays.
A single CT scan exposes a patient to the amount of radiation that epidemiologic evidence shows can be cancer-causing. The risks have been demonstrated directly in two large clinical studies in Britain and Australia. In the British study, children exposed to multiple CT scans were found to be three times more likely to develop leukemia and brain cancer. In a 2011 report sponsored by Susan G. Komen, the Institute of Medicine concluded that radiation from medical imaging, and hormone therapy, the use of which has substantially declined in the last decade, were the leading environmental causes of breast cancer, and advised that women reduce their exposure to unnecessary CT scans.
Advantages of CT Scan over MRI
- CT is very good for imaging bone structures.
- Some patients who have received certain types of surgical clips, metallic fragments, cardiac monitors or pacemakers cannot receive an MRI.
- The time taken for total testing is shorter than taken by MRI.
- MRI cannot be done on patients who are claustrophobic as the patient has to remain inside the noisy machine for about 20-45 minutes.
- CT scan is cheaper than an MRI. A CT scan costs $1,200 to $3,200 while an MRI can cost up to $4,000.
Cost of Machines
Not surprisingly, there are various CT scanners available and there is a large variation in price depending upon the features and brand. This is a good pricing guide for CT scan machines. A vanilla 4-slice CT scanner costs $85,000 to $150,000. A 16-slice scanner costs $145,000 to $225,000 and the top-of-the-line 64-slice CTs can cost up to $450,000. The machines may typically need annual maintenance, which can cost tens of thousands of dollars.
MRI machines are available in 1.5 T and 3 T (T stands for Tesla) models. 3T models are more expensive but offer higher image quality and shorter scanning times. 1.5 T MRI scanners start at around $1 million and 3T models are 50% more expensive. Manufacturers may include accessories, such as a workstation to view images and contrast injectors, in their quotes for MRI scanners. (For a guide on MRI scanners, see here.)