The effect of magnetic resonance imaging in a teaching hospital on patient management.

An observational study was undertaken to obtain measures of the impact of magnetic resonance imaging (MRI) on diagnosis, patient management and patient outcome. A minimum data set at the time of examination was used for 1119 consecutive patients referred by specialists for MRI of the brain or spine. Three month follow up of 707 brain examinations and 235 spinal examinations was undertaken using a questionnaire on diagnosis and patient management. Magnetic resonance imaging made a dominant contribution to final diagnoses of neoplasia and vascular disorders, but was less significant for white matter disease. In a high proportion of cases other types of examination also influenced the final diagnosis. Magnetic resonance imaging affected patient management in a high proportion of spinal examinations and in cases of cerebral neoplasm, with lesser contributions to cases of cerebrovascular disorder and white matter disease. While MRI was considered superior to other imaging methods, which it could often replace, in practice it will form only one input to the diagnostic decision.