title: Emergent, After Hours Magnetic Resonance Imaging of the Spine.
abstract: OBJECTIVE
  Requests for after-hours emergent spine MR imaging seem to be increasing. We sought to review the trend in after hours spine MRI utilization at our institution and to determine how these results impacted therapeutic intervention.
  
  
  METHODS
  Following Institutional Review Board approval, reports from 179 after hours spinal MRI's performed over the past 13 years were obtained and the relevant electronic medical records were reviewed.
  
  
  RESULTS
  Emergent after hours spine MRI utilization increased from 7 per year to 23 over 13 years. Fifty-eight percent (104/179) had significant findings. Twenty-nine percent (52/179) of all patients imaged underwent surgery to treat pathologies identified on MR. Surgery was performed in only 2% (4/179) of these patients within 3 hours and 6% (10/179) within 6 hours of MRI completion. Five percent (8/179) had findings that were treated with radiation therapy and in 78% of these it was performed within 6-12 hours. Of those in whom steroids or antibiotics were initiated, 41% and 50% were treated within 3 hours of MR scanning, respectively.
  
  
  CONCLUSIONS
  Clinical use of emergent after hours spine MRI is steadily increasing at our institution. While MR imaging often discerned significant pathologies, performing these emergent studies rarely resulted in immediate surgical or radiotherapeutic intervention.
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: David F
authors.initials: DF
authors.lastname: Black
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Wood
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Wells
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Erickson
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Felix E
authors.initials: FE
authors.lastname: Diehn
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kaufmann
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Charlotte H
authors.initials: CH
authors.lastname: Rydberg
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gilbertson
authors.affiliation: Radiology Department, Mayo Clinic, Rochester, MN.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Hunt
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D013122:Spinal Diseases / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D014600:Utilization Review; D055815:Young Adult
keywords: MRI; Spine; after-hours care