The diagnostic and therapeutic impact of MRI: an observational multi-centre study.

AIM To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health.Hollingworth (2000). Clinical Radiology55, 825-831.

[1]  Economics of MRI technology , 1996, Journal of magnetic resonance imaging : JMRI.

[2]  A. Dixon,et al.  Magnetic resonance imaging or arthrography for shoulder problems: a randomised study. , 1999, European journal of radiology.

[3]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[4]  W. Huk,et al.  The accuracy of CT and MR evaluation of the sella turcica for detection of adrenocorticotropic hormone-secreting adenomas in Cushing disease. , 1993, AJNR. American journal of neuroradiology.

[5]  B. McClarty,et al.  Influence of magnetic resonance imaging on diagnosis and therapeutic intention. , 1996, Academic radiology.

[6]  D. Streiner,et al.  Health Measurement Scales: A practical guide to thier development and use , 1989 .

[7]  D L Kent,et al.  Disease, level of impact, and quality of research methods. Three dimensions of clinical efficacy assessment applied to magnetic resonance imaging. , 1992, Investigative radiology.

[8]  B. Condon,et al.  Comparison of magnetic resonance imaging and computed tomography in suspected lesions in the posterior cranial fossa. , 1989, BMJ.

[9]  N. Obuchowski,et al.  Magnetic Resonance Imaging of the lumbar spine in people without back pain , 2017, AL-QADISIYAH MEDICAL JOURNAL.

[10]  K. Berbaum,et al.  Impact of MR imaging on clinical diagnosis and management: a prospective study. , 1986, Radiology.

[11]  L. Hall,et al.  Magnetic resonance imaging of the head and spine: effective for the clinician or the patient? , 1991, BMJ.

[12]  M McCally,et al.  The poor quality of early evaluations of magnetic resonance imaging. , 1988, JAMA.

[13]  Potchen Ej.  Magnetic resonance imaging of the lumbar spine. , 1994, The New England journal of medicine.

[14]  E. Larson,et al.  Magnetic resonance imaging of the brain and spine. Is clinical efficacy established after the first decade? , 1988, Annals of internal medicine.

[15]  N. Semmer,et al.  The Diagnostic Accuracy of Magnetic Resonance Imaging, Work Perception, and Psychosocial Factors in Identifying Symptomatic Disc Herniations , 1995, Spine.

[16]  C. Heron.  Review article: MRI of the knee. , 1993, The British journal of radiology.

[17]  J R Mallard,et al.  A brief personal account of the Aberdeen story--with particular reference to SPECT and MRI. , 1993, Journal of medical engineering & technology.

[18]  D. Lomas,et al.  Computed tomography or magnetic resonance imaging for axillary symptoms following treatment of breast carcinoma? A randomized trial. , 1993, Clinical radiology.

[19]  M D Schnall,et al.  Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. , 1995, Radiology.

[20]  S. Siegel,et al.  Nonparametric Statistics for the Behavioral Sciences , 2022, The SAGE Encyclopedia of Research Design.

[21]  E. Weis.  Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. , 1991, The Journal of bone and joint surgery. American volume.

[22]  Nicholas,et al.  Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. , 1990, The Journal of bone and joint surgery. American volume.

[23]  C. Higgins,et al.  Heart disease: functional evaluation with MR imaging. , 1996, Radiology.

[24]  C. Hutchinson,et al.  The therapeutic impact of lumbar spine MRI on patients with low back and leg pain. , 1998, Clinical radiology.

[25]  S. Renowden,et al.  The effective use of magnetic resonance imaging in the diagnosis of acoustic neuromas. , 1993, Clinical radiology.

[26]  R. Deyo,et al.  Rapid MR imaging versus plain radiography in patients with low back pain: initial results of a randomized study. , 1997, Radiology.

[27]  R A Deyo,et al.  Magnetic resonance imaging of the lumbar spine. Terrific test or tar baby? , 1994, The New England journal of medicine.

[28]  S. Young.  Magnetic Resonance Imaging: Basic Principles , 1987 .

[29]  A. Dixon,et al.  Measuring the effects of imaging: an evaluative framework. , 1995, Clinical radiology.