Is it now time to acquire magnetic resonance imaging? Issues and concerns

Magnetic resonance imaging (MRI) is a diagnostic modality that permits images of a variety of pathologic conditions to be acquired safely and painlessly with remarkable anatomic detail. In research sites and in a few clinical locations, MRI has become the definitive diagnostic tool for many neurological conditions and promises to become a valuable modality for diagnosing thoracic, abdominal, pelvic, and perhaps even breast and eye diseases. Despite its accolades, MRI's diffusion and adoption are at the center of a storm of controversy. The spread of MRI to non-research hospitals throughout the country--even to those with large neurology services--has not yet been shown to be clinically appropriate or cost effective. This article examines the accumulated information on MRI in order to help the administrator and trustees of a typical acute-care hospital to decide whether their community needs--and is able to support--an MRI service. Rather than reviewing the ever-changing frontiers of MRI research, this assessment considers the issues that are of immediate concern to hospital decisionmakers who must answer the question, "Should we plan to buy an MRI system in 1985?"