Βι¶ΉΤΌΕΔ

Raise Your Game: How did MRI (magnetic resonance imaging) scanners come about?

Patrick Revell: The first ideas of magnetic resonance were formed in the 1940s. Scientists found that it allowed you to look at the content of a substance from different positions and make a picture of it. The first MRI images were produced in the 1960s. CAT scans had just been invented and were taking off. Cross-sectional images were a hit already and MRI was another way of doing that. It was used as a chemistry tool for a while but now it's a clinical tool.

RYG: How is MRI technology useful for sports people?

PR: After most injuries, many sports people, especially professionals, would probably have scans. There are major decisions to be made and medical technology can help you decide what to do. Do you mobilise the injury? Push through it? Keep training? Advisers can say 'you'll be fine tomorrow', or 'no, you'll do permanent damage if you train too soon.' You can decide whether to push through the pain - and these athletes are capable of doing so.

Injuries in adolescence can be career threatening, but if you have the technology you can assess the extent of the injury, whether to train again and when. You can get clear advice so you can have a career and manage the injury and can do so on a weekly basis if necessary.

The latest scanner allows you to get a full body image for the first time, so a patient doesn't need multiple scans to look at different body parts, and because it's not known to be harmful there's no limit to the number of scans you can have.

RYG: Any examples?

PR: On the morning the 2nd test of England vs. Australia was due to start in the Ashes 2005, Glenn McGrath, the Australian fast bowler, twisted his knee. He had an MRI scan which showed extensive ligament damage, but he was back the following week for the 3rd test. Before MRI technology, the way to investigate a joint injury was to inject dye and air into the joint and take x-rays. The joint would then swell up, potentially damaging it, and be at risk of infection. With MRI there's no radiation and no needles.

Because transfers for some footballers are expensive, it's common for them to have a scan. If a player's tools of their trade - their knees, ankles etc - aren't in working order, buying them could be an expensive mistake for a club to make. Managers can see if the players' injuries have cleared up. You can see cartilage in the knee and the joint and coating on the bone surface and early signs of degeneration.

James Cracknell, the double Olympic rowing champion, and Jo Fenn, the 800m runner, recently had images taken using the latest full-body MRI scanners. Jo was targeting the Commonwealth Games for a comeback. You could see the fluid around her knee from an operation she'd had 2 weeks previously. You can use colour to look for fluid which can increase after an injury to protect the joint. Jo was going to take these images back to her coach so he could evaluate how her recovery was going.

The scanner can also pick out older injuries so you can see how things have healed. James was fascinated. Both had a high level of knowledge of their own anatomy. Jo had a vast medical knowledge. The body is the tool of their trade so it pays them to know about it and how to look after it.

RYG: The images can help with assessing injuries. Can they also help you plan training?

PR: A rowing club in Oxford was looking to improve its performance. We worked with the team using an MRI scanner. We scanned the team and discussed the results with the trainer. The way they were training wasn't encouraging the muscles they needed for racing. They changed their training and their performance improved as a result.

RYG: How do people feel about having scans done?

PR: In any healthcare profession, you're dealing with people in stressful, unusual circumstances. There's psychology involved in getting people into the scanner because it can be scary for some. Even young, fit, sports people sometimes freak out. I think it's to do with the lack of control. They're used to their body doing whatever they ask of it. But if they get injured, they may be sent to see people who are telling them what to do - 'stop training', 'get into the scanner' etc. It can freak them.

RYG: So communication skills are important?

PR: You need to gain confidence and cooperation from the patient. You'll get a better examination if the patient is cooperative - keeping still and doing what you ask of them. If they're stressed it won't help their recovery. It's a real skill for a radiographer, knowing how to connect with people. There was a 5 year old boy who came in for a scan, and he really didn't want to get into the machine. Stamford Bridge football ground was just down the road from the hospital, and the boy was wearing a Chelsea FC kit. The radiographer told him that one of the Chelsea FC players had been in the machine having his knee scanned the previous week. That worked - there was a total change in the child's attitude.

I worked with another brilliant radiographer who knew how to adjust her style to suit the patient. She'd be stern with some people and tell them to stop messing about, but with others she'd sit down with them and talk them through it. It's a talent she has, and one that you can develop.