MRI FAQ

What does an MRI scan show?

An MRI scan can be used to examine the brain for:-

  • tumours
  • multiple sclerosis
  • changes that have occurred after bleeding in the brain
  • to discover if the brain tissue has suffered a lack of oxygen after a stroke

Examining the heart and large blood vessels in the surrounding tissue make it possible to detect:-

  • heart defects that have been developing since birth
  • changes in the thickness of the muscles around the heart following a heart attack

An MRI scan may be used to examine:-

  • the spinal chord
  • joints
  • the soft tissue parts of the body such as the liver, kidneys and spleen
  • female pelvic problems
  • ailments of the gastro-intestinal tract
  • certain ear, nose and throat problems
  • musculoskeletal problems

How long does the MRI scan take?

The scan takes about 25-40 minutes.

Are there any risks from the examination?

For most people, there is no danger associated with having an MRI scan.  It is, however, very important, that you tell the radiologist if you have any metal implants in your body.  The radiographer will therefore ask for your complete medical history and whether you have any of the following:

  • pacemakers
  • implanted insulin pumps
  • aneurysm clips
  • vascular coils and filters
  • heart valves
  • ear implants
  • surgical staples and wires
  • shrapnel
  • bone or joint replacements
  • metal plates, rods, pins or screws
  • contraceptive diaphragms or coils
  • penile implants
  • permanent dentures

It is also important to tell a member of the staff if you are pregnant or if you believe there is a possibility you are pregnant.

Who analyses the images?

A radiologist, who has been trained in MRI scan analysis, reviews the results of your MRI scan.  The results cannot be given to you on the day because the analysis takes a relatively long time and can include a comparison with any previous MRI scans.

Do I really have to keep still?

It is important that you remain still during your MRI scan as any movement causes the pictures to blur.  This then makes it difficult for the radiologist to interpret the scan results. In addition, the MRI scan is often focused on a specific part of the body. If you move, the area that is being examined may no longer be in the correct position.

What is the difference between an MRI and a CT scan?

Both MRI and CT scans provide detailed pictures of areas of the body that used to be inaccessible by conventional x-rays. They use a sophisticated computer system to make cross-sectional pictures of areas of the body being scanned.  The major difference between CT and MRI, is that an MRI uses a large magnet and radio waves to produce images, whereas a CT scanner uses x-rays. There is, therefore, no exposure to x-rays in an MRI scan.

Because MRI scanning is very sensitive to movement during the scanning procedure, CT scanning can be preferable in some circumstances if the patient is unable to stay still.

Why do you need my previous x-rays, CT and MRI scans?

The more information that our radiologist has when he/she reviews the results of your MRI scan, the more specific the interpretation will be. Correlations with other MRI scan results are helpful.

What if I am claustrophobic?

As there is little room inside the tunnel, people who suffer from severe claustrophobia sometimes have problems with MRI scans. Please do let the radiographers know if this might be a problem, before the day of your appointment.  If necessary, you can have a tablet or injection to calm you down before the scan.   However, if you need a sedative, it needs to be organised in advance, so please telephone the health clinic in advance if you think you’ll need a sedative.  In addition, you will need to arrange for someone to drive you to and from the health clinic.

If your radiographer knows you are nervous, he/she will take extra care in making sure you are comfortable during your MRI scan He/she will be able to see you at all times through a large window and will also be able to talk to you and listen to you through an intercom system.  You will be able to communicate with the radiographer by pressing the button of the intercom system.

Keeping your eyes closed throughout the scan can sometimes help.

How should I dress for the examination?

It is recommended that you dress in light cotton clothing which does not contain metal such as zippers, metal buttons etc. You will be offered a cotton robe which you can wear for the examination if you arrive with inappropriate clothing.

May I bring a friend or relative with me?

Yes and in special circumstances we can allow your friend or relative to accompany you into the MRI Scanning room. Also, if you need a sedative, you will need someone to take you home after the MRI scan.

Do I need to be referred by my doctor?

No. If you are covered by private health insurance you can book your own private MRI scan.

Ultrasound FAQ

How long does Ultrasound scan take?

The scan may take between 10 and 45 minutes, during which time you may be asked to change position to allow the area to be examined from different angles.

What will I feel during the Ultrasound scan?

Ultrasound scans are a simple examination; they are non-invasive and are not painful. There may be varying degrees of discomfort from pressure as the transducer is pressed against the area being examined.

Are there any risks from the Ultrasound scan?

For standard diagnostic ultrasound there are no known harmful effects on humans.

What does the equipment look like?

The Ultrasound scanner consists of a console (computer), a video display screen and a transducer (probe) that is used to scan the body.

How and when will I receive the Ultrasound scan / test results?

The scan/test results will be sent by post to your home address or your GP or consultant, within 48 hours of the examination.

Bone Density FAQ

How long does the scan take?

The scan takes about 20 minutes.

What will I feel during the examination?

Bone density scans are a simple examination, which are non-invasive and are not painful. In order to obtain different images, you will be asked to lie in different positions for a number of seconds.

Are there any risks attached to the examination?

Bone density scans do not involve any dangers and have no negative impact on your health. The radiation dosage involved in these examinations is extremely low.

What are the differences between a bone density scan and a regular X-ray scan?

Bone density scans measure the level of calcium in the bone: this cannot be done with a regular X-ray. In addition, the dosage of radiation of a bone density scan is much lower than that of an X-ray scan.

What is a Bone Density DEXA Scan Test?

The results will be sent by post to your home and your GP or consultant, within two days of the examination.

When will I receive my results?

The results will be sent by post to your home and your GP or consultant, within two days of the examination.

Which Clinics do we offer this service?

Primarily in our Manchester but can be offered on other sites please call the office to check availability 0161 929 5679.

Varicose Veins FAQ

Do I need a referral?

No, you can make an appointment directly to see one of our specialist vascular consultants.

What should I do if I would like to be assessed for the treatment?

Call 0844 335 8993 to arrange an appointment.

What are varicose veins?

Varicose veins are veins that lie just below the surface of the skin which have become enlarged and tortuous.  All veins have valves within them which are responsible for preventing blood from pooling in the leg.  If valves fail to work, pressure increases in the veins and causes them to swell and bulge.  Varicose veins are usually most noticeable in the calf and ankle.  Standing for prolonged periods may cause the calf to ache or ankle to swell. Temporary pain relief can be achieved by use of stockings available from the NHS (in certain cases) or commercial suppliers such as The Leg-Care Company.

How are varicose veins diagnosed?

The best way to diagnose varicose veins is a duplex ultrasound. During the assessment, a water-based gel is placed on to the skin of your leg (from groin to ankle) and an ultrasound probe is run over the skin surface, giving a picture of the veins and the direction of blood flow. The scan provides a ‘map’ of the varicose veins in your leg to determine which treatment will be the best option for you. As the main veins in your leg (the deep veins) are also checked during the scan, any underlying problems which may exclude you from treatment will also be identified.

What is radiofrequency endovenous treatment and how does it work?

Radiofrequency generates heat which seals the varicose veins from the inside. A small (2mm) incision is made in the skin (in the thigh or calf) and a catheter is inserted in to the vein until it reaches the groin.  Anaesthetic fluid is then injected into the tissues surrounding the vein in order to numb the area. As the catheter is withdrawn down radiofrequency energy is applied to the vein wall, generating heat which seals the vein.  Over time, the treated vein hardens and shrinks down, eventually becoming indistinguishable from the surrounding tissue.

Ultrasound is used throughout the procedure to identify the main vein in the leg and to ensure the catheter and anaesthetic fluid are in the correct position.

How long does the RF treatment take?

RF treatment is usually carried out under local anaesthetic and takes approximately 30-60 minutes, though you can expect to be at the clinic for 1-2 hours on the day of your treatment.  You will be able to go home on the same day as your treatment.

What are the benefits of RF treatment?

Compared to conventional varicose vein surgery, where the faulty vein is “stripped” from the leg (usually under general anaesthetic), RF treatment has several benefits:

  • Performed under local anaesthetic
  • Minimal scarring – usually one 2mm scar
  • Less painful
  • Less bruising
  • Shorter recovery time – patients can resume normal activites within 20 minutes
  • Fewer complications

What are the possible side effects or complications of RF treatment?

As with any medical procedure, some side effects or complications can occur with RF treatment, therefore it is important to discuss any existing medical conditions or concerns with your consultant prior to going ahead with the treatment.

Side effects are rare and usually minor:

  • Minor pain/discomfort and bruising, which can be treated with common pain relief (paracetamol/ibuprofen)
  • Tingling or numbness, or a “pulling “ sensation in the thigh
  • Burning sensation in the varicose veins (phlebitis)
  • Wound infection
  • Skin discolouration
  • In less than 0.5% of cases more serious side effects can occur, specifically deep vein thrombosis (DVT) or pulmonary embolism (PE).

What is a Deep Vein Thrombosis (DVT)?

A DVT is the formation of blood clot in the deep veins usually in the leg which can cause acute pain and swelling. The risk of DVT is increased by any type of surgery but is an extremely rare side effect of RF treatment.

What is a Pulmonary Embolus (PE)?

A PE is blood clot which blocks of the vessels in the lung and can sometimes occur following a DVT.

How effective is RF treatment?

Multiple studies have shown that RF treatment provides significantly better outcomes than conventional surgery in terms of improvement in the appearance and symptoms of varicose veins, and patient experience.

Does it hurt?

There is slight pain when local anaesthetic is injected to make the small cut and feeling of pressure in the leg when the anaesthetic is injected around the vein.

There should be no pain when the vein is treated with heat. After the treatment patients may feel and ‘pulling’ or tightening sensation as the vein heals and occasionally burning sensation in the vein (phlebitis) which usually settles within 1-2 weeks.

Can I drive after treatment?

Yes, you normally will be able to resume your normal activities within 20 minutes of the treatment.

Do I need to make any special preparations for the treatment?

You will need to ensure that you wear loose fitting trousers or a skirt because dressings may be applied after the treatment.

What are spider veins?

Spider veins are like varicose veins but smaller. They also are closer to the surface of the skin than varicose veins. Often, they are red or blue. They can look like tree branches or spider webs with their short, jagged lines. They can be found on the legs and face and can cover either a very small or very large area of skin.

What causes spider veins?

Spider veins can be caused by be caused by hormone changes, sun damage or local injury. They can also occur as a result of larger underlying varicose veins which are not always visible. It is important that spider veins are fully investigated using ultrasound to identify associated varicose veins. Failure to treat the underlying varicose veins may result in early recurrence of spider veins.

What is the treatment for spider veins?

Spider veins can be treated by injection of a chemical which causes the veins to stick together and seal up (Sclerotherapy).

Spider veins less than 3mm and close to the skin surface can be treated with laser. The laser is a specific wavelength which is absorbed by red blood cells to generate heat which seals spider veins.

Are there any side effects?

Sclerotherapy – This can be quite painful, lead to temporary bruising which settles over a few days and rarely may lead to permanent skin staining.

Laser – Can cause slight discomfort at the time of treatment similar to a ‘nettle sting’. May lead to redness and swelling which settles within a few days

Health Screening FAQ

What are the benefits of having a Health Screening (Health MOT)?

The tests you will have will enable us to detect any signs or risk factors for major diseases. This will give you information that will allow you to take action to prevent or slow the progress of major diseases.

You are able to discuss your test results with one of our qualified GP after the tests. We will provide you with a separate appointment to discuss and conclude all your results. In addition, at the second appointment of your health screening, you will receive a personalised report and action plan which will help you to keep in the best possible health for the future.

How long will the health screening take?

The first appointment will take approximately 2 hours. The second appointment to discuss the results will take approximately half an hour.

How soon do I get my results?

Most of your test results will be available on the same day of your Health Screening. Some tests such as pathology tests, cervical smear and prostate tests will need to go to special laboratories and their results might take longer.

The test results will be included in your personal medical health report, which we will discuss with you at your second appointment. We will also use this personal medical report at future appointments to identify trends and compare changes.

What happens if my results are abnormal?

We always recommend that we keep your GP informed. With your agreement, we would write to your doctor informing him or her of any significant findings and advise you to see your GP as soon as possible.

Our team will be available for further discussion and can provide additional information at any time after your initial Health Screening.

How regularly do I need to have a Health Screening (Health MOT)?

The doctor/nurse will recommend a date for your next health screening (Health MOT) depending on your individual requirements. However, our general recommendation is for people over 50 to have an annual visit. For younger people we recommend once every two years.

If I eat healthily, take exercise and generally feel fine – do I need a Health Check Up?

Yes – just because you eat healthily and take regular exercise and feel fine, you cannot be sure that you don’t have any underlying health problems. Many conditions are present with no obvious symptoms. Diseases can be more successfully treated when detected early and so regular checks could save your life.

A health screening (Health MOT) is an excellent way to help you understand your current health and wellbeing. It also helps to identify areas of risk for the future.

What if I have an existing medical condition?

A health screening is not suitable for people who are seeking a specialist medical opinion about an existing medical condition. You should discuss your condition with your own doctor.

Where can I have my Health Screening (Health MOT)?

Our  facilities in Manchester and our new Birmingham office, are well equipped for Health Screening (Health Check Ups). All you need to do is book an appointment by calling: 0161 929 5679.

Lab Services FAQ

What is blood made up of?

Plasma, the liquid part of blood, makes up about 60% of the blood’s volume. Plasma is mainly made from water, but contains many different proteins and other chemicals such as hormones, antibodies, enzymes, glucose, fat particles, salts, etc.

Blood cells, which can be seen under a microscope, make up about 40% of the blood’s volume. Blood cells are made in the bone marrow by blood ‘stem’ cells. Blood cells are divided into three main types:
Red cells (erythrocytes). These make blood a red colour. One drop of blood contains about five million red cells. A constant new supply of red blood cells is needed to replace old cells that break down. Millions are released into the bloodstream from the bone marrow each day. Red cells contain a chemical called haemoglobin. Haemoglobin is attracted to oxygen and the two substances can bind together. This allows oxygen to be transported by red blood cells from the lungs to all parts of the body.
White cells (leucocytes). There are different types such as neutrophils (polymorphs), lymphocytes, eosinophils, monocytes, basophils. They are a part of the immune system and are mainly involved in combating infection.
Platelets. These are tiny and help the blood to clot if we cut ourselves.

In order constantly to make blood cells, haemoglobin, and the constituents of plasma, you need a healthy bone marrow and nutrients from food including iron and certain vitamins.

When blood spills from your body (or a blood sample is taken into a plain glass tube) the cells and certain plasma proteins clump together to form a clot. The remaining clear fluid is called serum.

How is a blood test normally done?

The vein used for blood sampling is usually on the inside of your elbow or the back of your wrist. A tourniquet (tight band) is usually placed around your upper arm. This makes the vein fill with blood and makes it easier for the blood sample to be taken. The skin over the vein is cleaned with an antiseptic wipe. A needle is then inserted into the vein through the cleaned skin. The needle is connected either to a syringe, or directly to blood sample bottles.

When the required amount of blood is taken, the needle is removed. The small wound is pressed on with cotton wool for a few minutes to stop the bleeding and prevent bruising. A sticky plaster may be put on. The blood is placed in bottles.

What are the variations of blood taking?

Some blood tests require several samples taken over a period of time. For example, they may be done to check how you respond to something. If you require repeated samples fairly close to each other (over the following few hours or so) a doctor may insert a ‘butterfly’ needle into the vein, which can be taped to the skin. Samples of blood can then be taken without using a needle each time. If only a small amount of blood is needed then a few drops of blood can be squeezed out from a small prick in the tip of the finger or earlobe. For example, only a small amount of blood is needed for checking the blood sugar (glucose) level using a test strip of paper.

Some blood tests are taken from an artery in the wrist. For example, to measure the level of oxygen in the artery. This is usually only done in hospital in certain circumstances. You may be told to not eat for a time before certain tests. For example, a test of blood glucose is commonly done first thing in the morning before you have anything to eat.

Are there any complications from blood taking?

Sometimes a bruise develops where the needle was inserted. This is much less likely to happen if you press over the site with cotton wool for several minutes with your arm left straight (not bent). As with any wound, an infection may develop where the needle was inserted. See your doctor if the wound site becomes red and inflamed. Rarely, some people feel faint during a blood test. Tell the person doing the test if you feel faint as you should immediately lie down to prevent fainting.

Why are several blood samples taken?

Blood can be tested for many different things. The person who requests the blood test will write on the form which tests they want the ‘lab’ to do. Different blood bottles are used for different tests. For example, for some tests the blood needs to clot and the test is looking for something in serum. For some tests, the blood is added to some chemicals to prevent it from clotting. If the blood glucose is being measured, then the blood is added to a special preservative, etc. This is why you may see your blood added to blood bottles of different sizes and colours.

What do doctors examine in the blood?

Blood contains two main elements: the fluid that is called plasma and cells. There are three kinds of cells: red blood cells, white blood cells and platelets. To get the information they need from the blood, doctors actually do several tests with the blood sample. These include measurements of the levels of the cells and a blood smear. A blood smear is a film of blood placed on a slide to allow doctors to look at the individual cells under a microscope.

What does a test of red blood cells (RBC) indicate?

To test how much haemoglobin there is in the blood. The mean corpuscular volume or MCV test, measures the size of the red blood cells. If you are suffering from anaemia the haemoglobin level will always be less than normal but the size of the red blood cells depends on the type of anaemia you have.

A haematocrit test measures the total volume that red blood cells take up in the blood. Almost all types of anaemia will cause a low red blood volume as will very severe bleeding. A high haematocrit can occur if a person is dehydrated from not drinking enough fluid or because they are losing fluid which can happen with diarrhoea, burns and sometimes surgery.

If the red blood cells are pale, it can be a sign of iron deficiency anaemia. If they have a strange shape, it may be because of sickle cell anaemia or pernicious anaemia. Doctors also add stains to the blood smear to test for parasites for example in the case of sleeping sickness or malaria and also for bacteria in the case of food poisoning.

What do the white blood cells (WBC) indicate?

A raised white blood cells count may be because of a bacterial infection, bleeding or a burn. More rarely the cause of a raised white count is due to leukaemia, cancer or malaria. A person may lose white blood cells because they have autoimmune problems – this is where the antibodies that should fight diseases attack the body instead. Other reasons for loss of white blood cells include viral infections. More rarely, this can be a side effect of certain kinds of medication. Doctors keep an eye on white blood cells to work out how a disease is changing. By monitoring the blood count in this way they can alter the patient’s treatment as necessary.

What do the platelets indicate?

Platelets are very small cells in the blood that clump together at sites of injury to blood vessels. They form the basis of the blood clot that would form if you cut yourself.
Low numbers of platelets can make a person vulnerable to bleeding, sometimes even without injury occurring. Causes of low platelet counts include autoimmune diseases where you produce an antibody to your own platelets, chemotherapy, leukaemia, viral infections and some medicines. High numbers of platelets make a person more vulnerable to blood clots. High platelet counts are found in conditions involving the bone marrow such as leukaemia and cancer.

Why are blood tests taken?

Blood tests are taken for many different reasons. For example:

  • Help diagnose certain conditions, or to rule them out if symptoms suggest possible conditions
  • Monitor the activity and severity of certain conditions. For example, a blood test may help to see if a condition is responding to treatment
  • Check the body’s functions such as liver and kidney function when you are taking certain medicines which may cause side-effects
  • Check your blood group before receiving a blood transfusion.

The most common blood tests are:

  • Full blood count – checks for anaemia, and other conditions which affect the blood cells
  • Kidney function
  • Liver function
  • Blood glucose (sugar) level
  • Blood clotting tests
  • Tests for inflammation
  • Blood cholesterol level
  • Immunology – such as checking for antibodies to certain viruses and bacteria
  • Blood grouping
  • Thyroid function

What are blood coagulation examinations?

If a patient is found to be suffering from a blood coagulation disorder so that either their blood does not clot properly, or if it clots too well then a blood coagulation examination will be necessary. When a vein is damaged, usually a little blood clot will form on the inside. This clot is made of blood platelets and proteins from the blood plasma (called the coagulation factors). A person will bleed more than normal if they have a low number of blood platelets, if there is a lack of coagulation factors, or if they do not work.

If the bleeding disorder is caused by problems with the coagulation factors more tests will be needed. Sometimes a coagulation disorder is passed on in the family, but it could also be due to a liver problem, as the liver makes many of the blood clotting factors. Coagulation tests will be performed regularly for people who are on blood thinning medicines such as warfarin. Doctors will change the dose of these medicines depending on the test results.