Comparative analysis between clinical requests and magnetic resonance imaging results in neurological diseases

In order to rationalize the use of MR, which is a high cost technology and not widely available, we analysed comparatively the reasons of test requests and MR diagnosis. We selected three groups of motivations for requests: diagnosis, symptoms and aspecific symptoms: they all were related with MR results classifying concordance, negativity and discordance groups. The results were evaluated also considering whether the patients were hospitalized or outpatients and in relation to the brain, the cervical, thoracic and lumbar regions. Within the general group we found a negativity of 36%, which increases to 52.5% if the motivation of the exam was a symptom and to 88% if the symptom was aspecific, whereas it fell to 26% with the request belonging to the group diagnosis. Concordance was higher in the brain and in the cervical spine (62% and 61%) whereas it was 46% in thoracic and lumbar spine and higher, even if not statistically significative, in the group of hospitalized patients compared to the outpatients.