Inclusions: (click for further info)
Exclusions: (click for further info)
If you have any queries or need clinical advice as to the appropriateness of the request, please contact the chosen provider for information. The provider is at liberty to refuse a request or phone the clinician for further details if they feel the imaging is inappropriate.
When considering ordering imaging, please consider the following:
MRI CONTRA-INDICATIONS: Signing the referral form implies NONE of the below apply:
Cardiac pacemaker; metal in orbit; internal hearing device; intracranial vessel clip; valve replacement; metallic foreign body; claustrophobia
Characterisation of a solitary liver lesion identified on US - e.g. haemangioma, metastasis, etc: (click for further info)
Palpable mass: (click for further info)
Lumbar Spine: (click for further info)
Dementia and memory disorders: (click for further info)
Structural imaging with MRI or CT should be used in the assessment of people with suspected dementia to exclude other cerebral pathology and help establish the subtype diagnosis. In a small minority of cases, imaging will show an alternative cause such as a tumour, hydrocephalus or subdural collection. The yield for these lesions is higher if imaging is restricted to those with a rapid or atypical presentation, patients with focal signs, history of gait ataxia, incontinence or head injury. MRI may be useful in acute dementias, including limbic encephalitis, and conditions such as Creutzfeldt-Jakob disease.
CT is generally adequate, MR only for specific problem solving
Only to be requested as part of full dementia assessment
Headache: chronic + these features significantly increase the odds of finding a significant abnormality on MRI or CT:
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Imaging is not usually useful for isolated headache without abnormal neurological features (see clinical problem).
Cervical spine XRs or paranasal sinus imaging are usually unhelpful even when neck signs suggest origin from the neck as they do not alter management.
Posterior fossa signs (lower cranial nerve palsies; signs of cerebellar or brainstem dysfunction): (click for further info)
MRI is the investigation of choice. Diffusion-weighted images are helpful for investigation of brainstem ischaemia.
Space occupying lesion: (click for further info)
MRI is more sensitive for early tumours and may distinguish between tumour and abscess. It will resolve exact position (useful for surgery), characterise tumours and is particularly helpful for posterior fossa lesions. MRI may miss calcification.
Direct Access MRI Referral Pathway: (click for further info)