CLINICAL-ASSESSMENT OF MR OF THE BRAIN IN NONSURGICAL INPATIENTS

PURPOSE: To evaluate the effect of MR imaging of the brain on four dom ains of patient care: diagnosis, diagnostic workup, therapy, and progn osis. METHODS: Pre- and post-MR written questionnaires and oral interv iews were administered to the referring clinicians of 103 medical and neurologic inpatients at a tertiary care institution. Additional infor mation was obtained from radiologic reports and records, RESULTS: The study population had a diverse array of signs and symptoms and of pres umptive clinical diagnoses, reflecting the breadth of disease seen at our institution. The vast majority of physicians (89%) reported that M R imaging added significant diagnostic information, playing an importa nt role in guiding diagnostic workup (24%), planning treatment (34%), and estimating prognosis (47%). MR imaging was significantly more like ly to decrease than to increase confidence in the presumptive clinical diagnosis. Thus, MR imaging may be most useful in the setting of diag nostic uncertainty. CONCLUSION: Our results show that MR imaging of th e brain has important effects on each of the four domains of care for medical inpatients.