Freeman Richard, Khanna Sanjay, Ricketts David
Royal Sussex County Hospital, Brighton & Sussex University Hospital Trust, Eastern Road, Brighton, BN2 5BE, UK,
Int Orthop. 2013 Nov;37(11):2181-4. doi: 10.1007/s00264-013-1968-4. Epub 2013 Jun 22.
Magnetic resonance imaging (MRI) scans are a useful investigation for some shoulder pathology. They are costly however and a significant burden on radiology departments. In most cases clinical examination, plain radiography or ultrasound scan (USS) are sufficient for a diagnosis. There are no current UK guidelines regarding MRI shoulder scan requests.
We reviewed 100 consecutive MRI shoulder scan requests and the associated formal reports; other investigations were also assessed.
Overall, 56% of MRI scans were ordered inappropriately. Shoulder consultant's requests were more appropriate than other groups (70% vs. 38%. p = 0.04). Excluding shoulder consultants 63 % of scans were inappropriately ordered. Shoulder consultants were more likely to order a preceding X-ray (80% vs. 53% respectively, p = 0.03). Of those with a clinical diagnosis of cuff pathology only 29% had an USS.
A high percentage of MRI shoulder scans are performed inappropriately. Shoulder consultants are more appropriate in their ordering than other groups. If all groups performed as well 50 % less MRI scans would need to be performed.
磁共振成像（MRI）扫描对某些肩部病变是一种有用的检查方法。然而，其成本高昂，给放射科带来了巨大负担。在大多数情况下，临床检查、X线平片或超声扫描（USS）足以做出诊断。目前英国尚无关于肩部MRI扫描申请的指南。
我们回顾了连续100例肩部MRI扫描申请及相关的正式报告；还评估了其他检查。
总体而言，56%的MRI扫描申请不合理。肩部专科医生的申请比其他组更合理（70%对38%，p = 0.04）。排除肩部专科医生后，63%的扫描申请不合理。肩部专科医生更有可能先安排X线检查（分别为80%对53%，p = 0.03）。在临床诊断为肩袖病变的患者中，只有29%进行了超声检查。
很大比例的肩部MRI扫描是不合理进行的。肩部专科医生在申请方面比其他组更合理。如果所有组都能做到同样合理，那么MRI扫描的数量将减少50%。
