Abstract:
Introduction: The aim of this study was to investigate current brain MRI practice, pattern of brain MRI
requests, and their appropriateness using the American College of Radiology (ACR) Appropriateness
Criteria.
Material and methods: We used direct observation and questionnaires to obtain data concerning routine
brain MRI practice. We then retrospectively analyzed (i) demographic characteristics, (ii) clinical history,
and (iii) appropriateness of brain MRI requests against published criteria.
Results: All patients were administered the screening questionnaire; however, no reviews were under-
taken directly with patients, and no signature of the radiographer was recorded. Apart from routine brain
protocol, there were dedicated protocols for epilepsy and stroke. Brain MRI images from 161 patients (85
Males; 76 Females) were analyzed. The age group with most brain MRI requests were from 26 to 45 year
olds. The commonest four clinical indications for imaging were brain tumour, headache, seizure, and
stroke. Using the ACR Appropriateness Criteria, almost 43% of the brain MRI scans analyzed were found
to be “usually appropriate”, 38% were “maybe appropriate” and 19% were categorized as “usually not
appropriate”.
Conclusion: There was knowledge gap with regards to MRI safety in local practice, thus there is the
utmost need for MRI safety training. Data on the commonest indications for performing brain MRI in this
study should be used to inform local neuroradiological practice. Dedicated stroke and epilepsy MRI
protocols require additional sequences i.e. MRA and 3D T1 volume acquisition, respectively. The ACR
Appropriateness Criteria is recommended for use by the referring practitioners to improve appropri-
ateness of brain MRI requests.
