Emergency MRI utilization trends at a tertiary care academic medical center: baseline data.
OBJECTIVE
This study evaluates utilization trends of emergency department (ED)-ordered magnetic resonance imaging (MRI) examinations in an adult academic medical center over a 5-year period (2001-2005).


METHODS
MRI examinations from the ED-ordering location were identified by searching the radiology information system (RIS). Overall MRI volume and ED patient encounters were also assessed during the same period. Each examination was assessed by type of examination, examination completion time, and primary and secondary clinical indications by reviewing the RIS and medical record.


RESULTS
During the study period, 1,900 ED-ordered MRI examinations were performed on 1,020 patients. During the same period, 62,823 total MRI examinations were performed, and the total ED patient volume was 420,840. ED-ordered MRI volume increased 391% over the study period (125 to 614 examinations/year), whereas total MRI volume increased only 38.9% and ED patient volume in our institution actually decreased by -9%. MRI examinations of the brain, magnetic resonance angiography of the head and neck, and spinal MRI were the most commonly ordered tests. Clinical indications were analyzed. Peak times of ED-ordered examination completion were between 4:00 PM and 11:00 PM. A total of 15.5% of examinations required overtime or callback of MRI technologists for completion.


CONCLUSIONS
Multiple reasons are suggested that may increase utilization (perceived need for diagnostic certainty, as well as medico-legal and patient-driven factors). Whether this increase in MRI utilization resulted in improved patient outcomes is unclear and should be studied further. Implications for radiologist coverage and resident training are discussed.
Rankey
David
D
Department of Radiology, University of Cincinnati College of Medicine, University Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Leach
James L
JL
Leach
Sabrina D
SD
D000046:Academic Medical Centers; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*