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When is MRI appropriate?

This article explores the appropriateness of MRI in clinical settings, highlighting guidelines from the American College of Radiology and other key organizations. It outlines when MRI is preferred for investigating central nervous system (CNS) and musculoskeletal conditions, while also addressing its role in chest, abdomen, and cardiovascular examinations. The piece further discusses the limitations of MRI compared to CT, emphasizing considerations like availability, patient tolerance, and examination suitability. Evidence-based practices and collaborative efforts in healthcare are also presented to improve decision-making in imaging.

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When is MRI appropriate?

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  1. When is MRI appropriate? B. McClarty Dept. of Radiology

  2. MRI Utilization

  3. Methods • 1.American College of Radiology Appropriateness Criteria • 2.CAR Medicalis Pilots • 3. BSCG project

  4. ACR Appropriateness Criteria • Recommendation of which examination is most useful for investigation of a clinical symptom or condition • MRI is the preferred method for investigation of the CNS and musculo skeletal complaints and is complimentary examination for the chest, abdomen, and cardiovascular conditions.

  5. ACR con’t • Shortened ACR criteria for CNS complaints • If you are ordering an infused CT of the brain or spinal cord, consider MRI • Do uninfused CT in preference to MRI for assessment of bone fractures or hemorrhage including SAH • Do CT for mastoids, sinuses due to high bone air contrast and better spatial resolution of CT

  6. CT vs. MRI Mastoids

  7. ACR con’t • Infused CT is the primary modality for the assessment of neck lesions /cervical lymphadenopathy • CT angiography has higher spatial resolution and better image quality than MRA • Consider local availability, patient’s ability to tolerate long MRI examination time

  8. Medicalis projects • Evidence based order entry system piloted in pediatrics and more recently SE Manitoba • Dr.Martin Reed /Canadian Association of Radiologists • British Society of Radiology criteria modified to Canadian environment and placed in an electronic order entry system

  9. BGSG Project • Bridging the generalist to specialist gap-Luis Oppenheimer • Initial project for assessment of low back pain. • Advantage for having patient and physician engagement in process

  10. Thank you

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