Related Experiment Video
Updated: Jan 19, 2026
Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study
Published on: August 18, 2020
Brain MRI in patients with psychiatric disorders: A retrospective evaluation in routine clinical practice
Andrianarivony Rakotondraibe1, Imen Megdiche1, Anne Maraval1
1Department of Neuroradiology, AP-HP, Henri Mondor University Hospital, Créteil, France.
Background:
The clinical utility of routine brain MRI in psychiatry is debated with heterogeneous practices.
Purpose:
To evaluate local brain MRI practices in patients with psychiatric symptoms by assessing imaging protocols and clinical relevance of findings.
Materials And Methods:
This single-center retrospective study included all brain MRIs requested by psychiatrists between October 2017 and June 2024. Imaging protocols were all reviewed, and MRI were classified as AF+ ("actionable finding"), corresponding to imaging findings that warranted clinical action, or AF-. AF+ were further stratified by urgency: immediate (<24 h), urgent (within weeks), or routine.
Results:
Among 532 patients (55% women; mean age 47 years, SD = 19.5), 82% underwent a protocol including DWI, SWI, FLAIR, and 3D T1. Overall, 37% of scans were AF+, with 1% requiring immediate, 6% urgent, and 93% routine management. AF+ were most frequently detected on FLAIR (72%) and 3D T1 (60%), while some lesions were only visible on dedicated sequences (e.g., microbleeds on SWI, ischemia on DWI). Frequency of AF+ increases with age (odds ratio = 1.06 per year; 95% CI [1.05-1.08]; p = 2.7 × 10⁻²⁴). AF+ were found in 28.8% of patients with psychotic disorders, 45.5% of those with depressive disorders, and 84.9% of those referred for neurocognitive symptoms.
Conclusion:
Routine brain MRI in psychiatry revealed actionable findings in one-third of cases, supporting its relevance in selected psychiatric patients when performed with a minimal protocol (FLAIR, 3D T1, DWI, SWI).
Insights
Routine brain MRI in psychiatry identified actionable findings in 37% of patients, supporting its use in selected cases. A minimal imaging protocol including DWI, SWI, FLAIR, and 3D T1 is recommended for psychiatric patients.
Area of Science:
- Neuroimaging
- Psychiatry
- Radiology
Background:
- The clinical value of routine brain MRI in psychiatric practice remains debated due to varied protocols.
- Practices for ordering and interpreting brain MRIs in psychiatric patients are inconsistent.
Purpose of the Study:
- To assess local brain MRI protocols used for psychiatric patients.
- To determine the clinical relevance and yield of findings from these brain MRIs.
Main Methods:
- A single-center retrospective study analyzed brain MRIs requested by psychiatrists from October 2017 to June 2024.
- Imaging protocols were reviewed, and findings were classified as actionable (AF+) or non-actionable (AF-).
- Actionable findings were further categorized by urgency: immediate, urgent, or routine.
Main Results:
- Of 532 patients, 37% had actionable findings (AF+), with most requiring routine management.
- Commonly used protocols included DWI, SWI, FLAIR, and 3D T1 sequences.
- AF+ detection varied by sequence (FLAIR: 72%, 3D T1: 60%), with specific lesions visible only on dedicated sequences (e.g., DWI for ischemia, SWI for microbleeds).
- The likelihood of AF+ increased with age and was higher in patients with neurocognitive symptoms (84.9%) compared to psychotic (28.8%) or depressive disorders (45.5%).
Conclusions:
- Brain MRI revealed actionable findings in approximately one-third of psychiatric patients.
- A minimal protocol (FLAIR, 3D T1, DWI, SWI) supports the clinical relevance of brain MRI in selected psychiatric populations.
- These findings advocate for the judicious use of brain MRI in psychiatry, guided by appropriate imaging protocols.
More Related Videos
09:14Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
Published on: March 14, 2025
08:20MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
Related Concept Videos
01:24Magnetic Resonance Imaging
01:14Brain Imaging
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic...
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...