Intermediate short-term outcomes after brain computed tomography and magnetic resonance imaging in neurology outpatients

Objective. The purpose of this study was to assess and compare the impact o f magnetic resonance imaging (MRI) and computed tomography (CT) on diagnost ic and therapeutic decision making, taking into account the real cost of bo th techniques at the authors' institution. Method. Brain CT and routine and rapid MRI were compared, and case files were prepared with either the CT o r the MRI findings. These files were separately presented to a neurologist, and different questions were asked about further management. The real cost of CT and MRI was calculated. A questionnaire was sent to the patients 3 m onths after imaging. Results. More lesions were detected on MRI than on CT Routine and rapid MPI were comparable. The analysis of the CT case files re vealed an additional request for MRI in 33% of the patients. An analysis of the MRI case files revealed that 20% more technical examinations were requ ested after MRI than after CT In the majority of the patients (90%), neuroi maging had no impact on therapy except by means of reassurance of the physi cian. The scan was considered useful for therapeutic planning by excluding the presence of a space-occupying lesion. The real cost of the MRI strategy was 9% higher than that of the CT strategy. Conclusion. In this patient po pulation, neuroimaging was normal in the majority of the patients. Undergoi ng an imaging examination was of benefit to the patients and improved their sense of well-being mainly by the reassurance they experienced, as reporte d by 91 % of the patients. At the authors' institution, the real cost of MR I in this patient population was only slightly higher than the real cost of CT The statistical analysis favors the use of MRI as a 1st imaging examina tion.