Portland Brain Injury Lawyer Aaron DeShaw:
Brain MRI Resolution
There's a very substantial difference in brain imaging between MRI machines. There are essentially three varieties of MRI machines and the public and even some doctors don't know much about this but it becomes very critical in brain injury litigation. The open MRI machines have a very low strength magnet and as a result of that you get very low resolution images that are really not useful in traumatic brain injury cases. A standard closed MRI machine that you will find at most radiology facilities is also not great at imaging traumatic brain injuries.
Part of the reason why is it has a 1.5 T ("Tesla") magnet in the structure around the MRI. That provides a lower resolution to the brain than is necessary to see specific types of injuries. There is now being used at a small number of facilities what's called a 3.0 T MRI machine, and that is a much higher resolution MRI than the 1.5 T and certainly much higher than the 0.2 T to 0.7 T open MRI machines. You can see so much more on those. And we're taking cases now that are done at different imaging facilities and sometimes we'll have the study redone on the high resolution imaging set at the 3.0 T machine.
MRI Slice Thickness
There's also another really major issue here and it's one that even for those who understand the difference between MRI machines don't understand. It's the slice thickness. When you have an MRI, the machine essentially comes down and takes little slices through your head at different intervals. It also takes them this way and as a result, it then composes the image of what you get and creates this image for you of what the brain looks like. To some degree, those other machines, the lower resolution machines, they take much wider slices and then the machine essentially reconstitutes what the MRI looks like or what the brain would look like in the MRI.
Forensic Neuroradiology Evaluation
What we ask for when we do a traumatic brain injury case and we get the imaging ourselves to evaluate the claim is we take, instead of a five millimeter slice, which is pretty large chunks through your brain, we ask for one millimeter slices. And so what they do in the 3.0 T machine is they will go through the head, it takes a little bit longer, but they will take one millimeter slices each one millimeter.
Can the quality of Brain MRI make a difference in a legal case?
Yes. I've had a number of legal cases now where with the five millimeter slices at the standard resolution you won't see very much of anything. And with lower quality brain imaging some of the radiologists will think that it's what's called "small vessel disease." In other words, sort of plaquing in your blood vessels in your brain and they'll think it's just a minimal issue, everybody's got it, no big deal, and they'll read the MRI is normal.
But when you go to the 3.0 T machine and you take the one millimeter slices, you can see that what the other radiology facility saw was only the tip of the iceberg. And if you've ever seen one of those illustrations, you know that the iceberg really only sits on top and the vast majority of it sits underneath. And so what we've seen is sometimes really significant brain injuries show up on the 3.0T MRI with the one millimeter slices that you barely saw anything about in the standard resolution and which you would have seen nothing on in the open MRI. And so what we're doing is we're essentially investigating these cases that we accept and providing the very best care that we can in terms of traumatic brain injury office and understand what's going on with our clients so that we can objectively prove that to the insurance adjuster or to the jury.
Is there a difference in the experience of lawyers claiming to handle brain injury cases?
Yes. Many lawyers advertise for traumatic brain injury cases. Far fewer have extensive experience handling traumatic brain injury cases. If you want an Oregon personal injury lawyer with over 20 years of experience and record setting verdicts and arbitration awards to handle your brain injury case, please contact us on this web page, or call our office at (503) 227-1233 for a free consultation.
To learn more on this topic, see this blog post on medical brain imaging in traumatic brain injury legal cases.