Abstract
Purpose
The purpose of this study was to assess the diagnostic yield of abdomen magnetic resonance imaging (MRI) in the inpatient setting following a computed tomography (CT).
Methods
All inpatient abdominopelvic MRIs performed on patients for a 1-year period were identified and medical records were retrospectively reviewed for the following information. Only MRIs with a preceding CT were included in the study.
Results
A total of 221 MRIs were included. Forty exams were deemed technically inadequate due to motion, while 9 more patients did not tolerate a full examination. The most common indications were focal liver lesion (n = 101), pancreaticobiliary ductal dilatation (n = 39), abnormal liver function tests (n = 26), acute pancreatitis (n = 14), abdominal pain (n = 10), and fever/sepsis (n = 10). 83 MRIs were recommended on CT and 138 were requests from the care team. In 63 cases, MRI offered new information over CT. Thirty-two MRIs recommended by radiologists affected patient management, while only 31 MRIs recommended by the care team affected management. Of these 63 MRIs, 29 cases changed immediate inpatient management, requiring further intervention. In these cases, MRI identified abscesses, choledocholithiasis, or made other diagnoses such as cholecystitis, which were not diagnosed on CT. Patient LOS increased in 24 patients in order to receive an MRI. Average costs of outpatient CTs and MRIs are typically 20% less than inpatient costs.
Conclusion
Inpatient abdomen MRIs have limited impact on patient care following a CECT and entail higher cost, utilize more resources, scanner time, and increase patient LOS. Therefore, it should be reserved for select clinical indications.
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References
Agarwal R, Bergey M, Sonnad S, et al. Inpatient CT and MRI Utilization: Trends in the Academic Hospital Setting. JACR. 2010;7:949–955.
Lee KS, Rofsky NM, Pedrosa I. Localization of the appendix at MR imaging during pregnancy: utility of the cecal tilt angle. Radiology. 2008;249:134–141.
Cobben L, Groot I, Kingma L, et al. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy. Eur. Radiol. 2009;19:1175–1183.
Cobben L, Groot I, Haans L, et al. MRI for clinically suspected appendicitis during pregnancy. Am. J. Roentgenol. 2004;183:671–675.
Rauch DA, Carr E, Harrington J. Inpatient Brain MRI for New-Onset Seizures : Utility and Cost Effectiveness. Clin. Pediatr. (Phila). 2008;47(5):457–460.
Beker K, Troy K, Lee K, et al. Optimizing Inpatient Body MRI Utilization : A Granular Look at Trends, Quality, Yield, and Timing. Am. J. Roentgenol. 2018;211:1273–1277.
Latzer I, Orbach R, Ben-Siran L, et al. The Clinical Utility of Inpatient Brain Magnetic Resonance Imaging in Children. J. Child Neurol. 2020;35(11):744–752.
CMS. Medicare Physician Fee Schedule. Available at: https://www.cms.gov/apps/physician-fee-schedule/overview.aspx.
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HY: Data Collection, Manuscript Preparation, Revision, and Final Approval. DR: Manuscript Revision. GL: Data Collection and Manuscript Revision. DS: Study Design, Manuscript Preparation, Revision, and Final Approval.
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Yu, H., Rosman, D., Likhari, G. et al. The clinical utility of inpatient MRI following an abdominopelvic CT. Abdom Radiol 46, 5443–5448 (2021). https://doi.org/10.1007/s00261-021-03237-y
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DOI: https://doi.org/10.1007/s00261-021-03237-y