Radiographic screening for ECT: use and usefulness

Members of the Association for Convulsive Therapy were surveyed by mail about use of muscle relaxants and radiologic studies for ECT. One hundred eleven completed responses were received (69%), indicating that 40% routinely acquire pre-ECT spine and skull radiographs taking from 1 to 10 films. From patients receiving more than one course of ECT, 57 pre- and post-ECT pairs of films taken within 1 month of the start and end of a course, respectively, were selected. The films were identified only by age and sex of the patient and were evaluated by a radiologist. A senior psychiatrist reviewed the pre-ECT radiographic reports to determine whether a change in routine ECT procedure was required. Few clinically significant radiologic findings in the pre- or post-ECT films were noted.