How has imaging of the head, neck and spine changed over 5 years in a district general hospital?

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.

Materials And 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.