When is MRI appropriate

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When is MRI appropriate?

• B. McClarty
• Dept. of Radiology

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MRI Utilization
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Methods

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

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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.

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ACR cont

• 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

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CT vs. MRI Mastoids
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ACR cont

• 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, patients ability to
  tolerate long MRI examination time

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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

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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

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Thank you
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