title: How has imaging of the head, neck and spine changed over 5 years in a district general hospital?
abstract: BACKGROUND
  Over recent years, MRI has become the imaging modality of choice for examination of the head, neck and spine.
  
  
  OBJECTIVE
  The primary objective was to compare the clinical benefit of CT with MRI for children being investigated at a district general hospital. Secondary outcome measures were the change in amount of and indications for imaging.
  
  
  METHODS
  This was a retrospective case note review of two 1-year periods. Clinical benefit was determined according to the diagnostic ability of the investigation. Statistical analysis was performed using the chi-square test.
  
  
  RESULTS
  In 1992-1993 (period I) there were 74 CT scans, (40 boys, median age 3.4 years, range 0-18.0 years). In 1996-1997 (period II) there were 104 scans (50 CT, 54 MRI; 49 boys, median age 6.2 years, range 0.2-16.7 years). Imaging increased by 40% between the two periods. MRI gave enhanced clinical benefit over CT (P<0.02). Within period II, indications for CT differed from MRI (P<0.01). For CT there was no change in indications or rate of diagnosis between the two periods (P>0.2).
  
  
  CONCLUSIONS
  MRI improves clinical benefit over CT. Imaging increased over 5 years with different indications for CT and MRI.
authors.affiliation: Department of Respiratory Paediatrics, Leighton Hospital, Crewe, Cheshire, UK. evans_hazel@hotmail.com
authors.forename: Hazel J
authors.initials: HJ
authors.lastname: Bunn
authors.forename: Robert E
authors.initials: RE
authors.lastname: Pugh
authors.forename: Alistair
authors.initials: A
authors.lastname: Thomson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006257:Head / Q000000981:diagnostic imaging; D006258:Head and Neck Neoplasms / Q000175:diagnosis; D006261:Headache / Q000209:etiology; D006769:Hospitals, General / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000639:trends*; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011872:Radiology Department, Hospital / Q000639:trends; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D013131:Spine / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000639:trends*