Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 1999 Sep;45:2118-28, 2131-2.

Magnetic resonance imaging. Application to family practice.

R H Goh 1, S Somers 1, E Jurriaans 1, J Yu 1
PMCID: PMC2328549  PMID: 10509224

Abstract

OBJECTIVE: To review indications, contraindications, and risks of using magnetic resonance imaging (MRI) in order to help primary care physicians refer patients appropriately for MRI, screen for contraindications to using MRI, and educate patients about MRI. QUALITY OF EVIDENCE: Recommendations are based on classic textbooks, the policies of our MRI group, and a literature search using MEDLINE with the MeSH headings magnetic resonance imaging, brain, musculoskeletal, and spine. The search was limited to human, English-language, and review articles. Evidence in favour of using MRI for imaging the head, spine, and joints is well established. For cardiac, abdominal, and pelvic conditions, MRI has been shown useful for certain indications, usually to complement other modalities. MAIN MESSAGE: For demonstrating soft tissue conditions, MRI is better than computed tomography (CT), but CT shows bone and acute bleeding better. Therefore, patients with trauma or suspected intracranial bleeding should have CT. Tumours, congenital abnormalities, vascular structures, and the cervical or thoracic spine show better on MRI. Either modality can be used for lower back pain. Cardiac, abdominal, and pelvic abnormalities should be imaged with ultrasound or CT before MRI. Contraindications for MRI are mainly metallic implants or shrapnel, severe claustrophobia, or obesity. CONCLUSIONS: With the increasing availability of MRI scanners in Canada, better understanding of the indications, contraindications, and risks will be helpful for family physicians and their patients.

Full text

PDF
2118

Images in this article

2121Figure 1
on p.2121
2121Figure 2
on p.2121
2122Figure 3
on p.2122
2122Figure 4
on p.2122
2123Figure 5
on p.2123
2123Figure 6
on p.2123
2125Figure 7
on p.2125
2125Figure 8
on p.2125
2126Figure 9
on p.2126
2127Figure 10
on p.2127

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baldor R. A., Quirk M. E., Dohan D. Magnetic resonance imaging use by primary care physicians. J Fam Pract. 1993 Mar;36(3):281–285. [PubMed] [Google Scholar]
  2. Beltran J., Herman L. J., Burk J. M., Zuelzer W. A., Clark R. N., Lucas J. G., Weiss L. D., Yang A. Femoral head avascular necrosis: MR imaging with clinical-pathologic and radionuclide correlation. Radiology. 1988 Jan;166(1 Pt 1):215–220. doi: 10.1148/radiology.166.1.3336682. [DOI] [PubMed] [Google Scholar]
  3. Bollow M., Braun J., Hamm B., Eggens U., Schilling A., König H., Wolf K. J. Early sacroiliitis in patients with spondyloarthropathy: evaluation with dynamic gadolinium-enhanced MR imaging. Radiology. 1995 Feb;194(2):529–536. doi: 10.1148/radiology.194.2.7824736. [DOI] [PubMed] [Google Scholar]
  4. Bronen R. A. Epilepsy: the role of MR imaging. AJR Am J Roentgenol. 1992 Dec;159(6):1165–1174. doi: 10.2214/ajr.159.6.1442376. [DOI] [PubMed] [Google Scholar]
  5. Bryan R. N. Imaging of acute stroke. Radiology. 1990 Dec;177(3):615–616. doi: 10.1148/radiology.177.3.2243959. [DOI] [PubMed] [Google Scholar]
  6. Caldemeyer K. S., Smith R. R., Harris T. M., Edwards M. K. MRI in acute disseminated encephalomyelitis. Neuroradiology. 1994 Apr;36(3):216–220. doi: 10.1007/BF00588134. [DOI] [PubMed] [Google Scholar]
  7. Dujovny M., Kossovsky N., Kossowsky R., Valdivia R., Suk J. S., Diaz F. G., Berman S. K., Cleary W. Aneurysm clip motion during magnetic resonance imaging: in vivo experimental study with metallurgical factor analysis. Neurosurgery. 1985 Oct;17(4):543–548. doi: 10.1227/00006123-198510000-00002. [DOI] [PubMed] [Google Scholar]
  8. Elster A. D. Modern imaging of the pituitary. Radiology. 1993 Apr;187(1):1–14. doi: 10.1148/radiology.187.1.8451394. [DOI] [PubMed] [Google Scholar]
  9. Flaherty J. A., Hoskinson K. Emotional distress during magnetic resonance imaging. N Engl J Med. 1989 Feb 16;320(7):467–468. doi: 10.1056/nejm198902163200716. [DOI] [PubMed] [Google Scholar]
  10. Gilbertson J. R., Miller G. M., Goldman M. S., Marsh W. R. Spinal dural arteriovenous fistulas: MR and myelographic findings. AJNR Am J Neuroradiol. 1995 Nov-Dec;16(10):2049–2057. [PMC free article] [PubMed] [Google Scholar]
  11. Hailey D. An assessment of the status of magnetic resonance imaging in health care. J Qual Clin Pract. 1997 Dec;17(4):221–230. [PubMed] [Google Scholar]
  12. Hayes D. L., Holmes D. R., Jr, Gray J. E. Effect of 1.5 tesla nuclear magnetic resonance imaging scanner on implanted permanent pacemakers. J Am Coll Cardiol. 1987 Oct;10(4):782–786. doi: 10.1016/s0735-1097(87)80270-x. [DOI] [PubMed] [Google Scholar]
  13. Heinrichs W. L., Fong P., Flannery M., Heinrichs S. C., Crooks L. E., Spindle A., Pedersen R. A. Midgestational exposure of pregnant BALB/c mice to magnetic resonance imaging conditions. Magn Reson Imaging. 1988 May-Jun;6(3):305–313. doi: 10.1016/0730-725x(88)90407-9. [DOI] [PubMed] [Google Scholar]
  14. Hesselink J. R., Dowd C. F., Healy M. E., Hajek P., Baker L. L., Luerssen T. G. MR imaging of brain contusions: a comparative study with CT. AJR Am J Roentgenol. 1988 May;150(5):1133–1142. doi: 10.2214/ajr.150.5.1133. [DOI] [PubMed] [Google Scholar]
  15. Jordan J. E., Donaldson S. S., Enzmann D. R. Cost effectiveness and outcome assessment of magnetic resonance imaging in diagnosing cord compression. Cancer. 1995 May 15;75(10):2579–2586. doi: 10.1002/1097-0142(19950515)75:10<2579::aid-cncr2820751027>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  16. Kanal E., Shellock F. G., Talagala L. Safety considerations in MR imaging. Radiology. 1990 Sep;176(3):593–606. doi: 10.1148/radiology.176.3.2202008. [DOI] [PubMed] [Google Scholar]
  17. Klonoff E. A., Janata J. W., Kaufman B. The use of systematic desensitization to overcome resistance to magnetic resonance imaging (MRI) scanning. J Behav Ther Exp Psychiatry. 1986 Sep;17(3):189–192. doi: 10.1016/0005-7916(86)90026-1. [DOI] [PubMed] [Google Scholar]
  18. Matsumoto S., Hasuo K., Uchino A., Mizushima A., Furukawa T., Matsuura Y., Fukui M., Masuda K. MRI of intradural-extramedullary spinal neurinomas and meningiomas. Clin Imaging. 1993 Jan-Mar;17(1):46–52. doi: 10.1016/0899-7071(93)90013-d. [DOI] [PubMed] [Google Scholar]
  19. Murphy K. J., Brunberg J. A., Cohan R. H. Adverse reactions to gadolinium contrast media: a review of 36 cases. AJR Am J Roentgenol. 1996 Oct;167(4):847–849. doi: 10.2214/ajr.167.4.8819369. [DOI] [PubMed] [Google Scholar]
  20. Niendorf H. P., Haustein J., Cornelius I., Alhassan A., Clauss W. Safety of gadolinium-DTPA: extended clinical experience. Magn Reson Med. 1991 Dec;22(2):222–232. doi: 10.1002/mrm.1910220212. [DOI] [PubMed] [Google Scholar]
  21. Persad R., Kabala J., Gillatt D., Penry B., Gingell J. C., Smith P. J. Magnetic resonance imaging in the staging of bladder cancer. Br J Urol. 1993 May;71(5):566–573. doi: 10.1111/j.1464-410x.1993.tb16026.x. [DOI] [PubMed] [Google Scholar]
  22. Quirk M. E., Letendre A. J., Ciottone R. A., Lingley J. F. Anxiety in patients undergoing MR imaging. Radiology. 1989 Feb;170(2):463–466. doi: 10.1148/radiology.170.2.2911670. [DOI] [PubMed] [Google Scholar]
  23. Quirk M. E., Letendre A. J., Ciottone R. A., Lingley J. F. Evaluation of three psychologic interventions to reduce anxiety during MR imaging. Radiology. 1989 Dec;173(3):759–762. doi: 10.1148/radiology.173.3.2682775. [DOI] [PubMed] [Google Scholar]
  24. Schroth G., Kretzschmar K., Gawehn J., Voigt K. Advantage of magnetic resonance imaging in the diagnosis of cerebral infections. Neuroradiology. 1987;29(2):120–126. doi: 10.1007/BF00327535. [DOI] [PubMed] [Google Scholar]
  25. Shellock F. G., Kanal E. Policies, guidelines, and recommendations for MR imaging safety and patient management. SMRI Safety Committee. J Magn Reson Imaging. 1991 Jan-Feb;1(1):97–101. doi: 10.1002/jmri.1880010114. [DOI] [PubMed] [Google Scholar]
  26. Subak L. L., Hricak H., Powell C. B., Azizi L., Stern J. L. Cervical carcinoma: computed tomography and magnetic resonance imaging for preoperative staging. Obstet Gynecol. 1995 Jul;86(1):43–50. doi: 10.1016/0029-7844(95)00109-5. [DOI] [PubMed] [Google Scholar]
  27. Teitelbaum G. P., Yee C. A., Van Horn D. D., Kim H. S., Colletti P. M. Metallic ballistic fragments: MR imaging safety and artifacts. Radiology. 1990 Jun;175(3):855–859. doi: 10.1148/radiology.175.3.2343136. [DOI] [PubMed] [Google Scholar]
  28. Vogl T. J., Bergman C., Villringer A., Einhäupl K., Lissner J., Felix R. Dural sinus thrombosis: value of venous MR angiography for diagnosis and follow-up. AJR Am J Roentgenol. 1994 May;162(5):1191–1198. doi: 10.2214/ajr.162.5.8166009. [DOI] [PubMed] [Google Scholar]
  29. Weinreb J. C., Maravilla K. R., Peshock R., Payne J. Magnetic resonance imaging: improving patient tolerance and safety. AJR Am J Roentgenol. 1984 Dec;143(6):1285–1287. doi: 10.2214/ajr.143.6.1285. [DOI] [PubMed] [Google Scholar]
  30. Whiteman M. L., Post M. J., Berger J. R., Tate L. G., Bell M. D., Limonte L. P. Progressive multifocal leukoencephalopathy in 47 HIV-seropositive patients: neuroimaging with clinical and pathologic correlation. Radiology. 1993 Apr;187(1):233–240. doi: 10.1148/radiology.187.1.8451420. [DOI] [PubMed] [Google Scholar]
  31. Woodward P. J., Gilfeather M. Magnetic resonance imaging of the female pelvis. Semin Ultrasound CT MR. 1998 Feb;19(1):90–103. doi: 10.1016/s0887-2171(98)90026-9. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES