In writing about Chiari, I have often said that the advent of MRI's revolutionized how Chiari was diagnosed and treated.  As MRI's have become more and more common, the number of people being diagnosed with Chiari has increased dramatically.  While in some ways the MRI has also revealed how little we know about the condition (why doesn't size matter?) it truly has been revolutionary.
     The downside of today's MRI machines is that they are large and expensive.  A typical unit may cost more than $1,000,000 and requires a dedicated facility for its use.  Because of the high cost, there is a growing backlash (from insurance companies) against the rapidly growing number of imaging studies done each year.
    As pressure to reduce the number of scans grows, doctors who are already reluctant to order an MRI for "headaches" will become even more so.  So will the boom of the MRI introduction turn into a bust for Chiari patients?
    Maybe not.  A couple of weeks ago, a research team from Princeton University announced with much fanfare an experiment which they believe can lead to cheap, hand-held MRI's.  While today's MRI's use giant magnets to detect the movement of hydrogen atoms in the body, the Princeton team was able to use a small device, called an atomic magnetometer, to do something similar.  Their lab device consisted of a small, glass container filled with a gas (potassium vapor).  Using lasers to line up the atoms in the gas, they were then able to detect the wobble of hydrogen atoms in a beaker of water next to the magnetometer (an MRI detects the same type of wobble).
     It is not clear how easy it will be to turn their experimental device into a commercially available MRI scanner, but if they can do it, it will likely cost only thousands of dollars, not millions.  In addition to being cheap, the new technology would be able to scan almost instantly, unlike the current MRI's which seem to take forever.
    Let's hope they can do it; for the introduction of a cheap, portable MRI device would likely bring on a second Chiari revolution.  With cost barriers lowered, scans of the brain/cervical region would likely become routine in the case of "headaches" and other common complaints.  If people with Chiari can be diagnosed early, they are more likely to enjoy a complete recovery (this hasn't been proven conclusively, but it is difficult to imagine otherwise). 
     Perhaps with this breakthrough, the era where people go years without being properly diagnosed and Chiari destroys people and families will finally come to an end, and the era where Chiari becomes an acute condition instead of a chronic one will be ushered in.
    C&S News will monitor the progress of this exciting technology in anticipation of writing future headlines.

--Rick Labuda

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