A Study on the Appropriate Use of Magnetic Resonance Imaging (MRI) for Outpatients Referred to Hajar University Hospital in Shahrekord City, Iran, in Year 2017

Document Type : Original Article (s)

Authors

1 BSc Student, Department of Radiology, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Assistant Professor, Ayatollah Kashani Hospital AND Department of Cardiology and Cardiac Surgery, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

3 Assistant Professor, Department of Medical Physics and Radiology, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran

4 Associated Professor, Department of Clinical Radiology, Shahrekord University of Medical Sciences, Shahrekord, Iran

5 Department of Diagnosis Radiology, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: Magnetic resonance imaging (MRI) is a valuable diagnostic tool by its noninvasive/nonionizing nature. The aim of the current study was to determine the justification of MRI in outpatients referred to Hajar university hospital, In Shahrekord City, Iran, in a one-year period of 2017.Methods: A retrospective descriptive cross-sectional study was conducted on 438 outpatients referred for MRI during the year 2017, who were selected using systematic random sampling method. Intended data including age, gender, investigated organ, the specialty of requesting physician, MRI with or without contrast, and MRI diagnostic outcome were extracted from patient charts, and collected using checklists. Descriptive statistics and chi-square test were used for data analysis.Findings: Requested MRI led to a diagnosis in 81.3% of the patients. Women patients represented 64.4% of the requested MRI cases. 45.2% of the exams were performed for the patient with the age range of 41 to 60 years. The most prevalent investigated organ was the lumbosacral (43.2%). Age classes significantly influenced investigated organ (P = 0.001), as well as the prevalence of MRI diagnostic outcome (P < 0.001). The percentage of MRI diagnostic outcome differed significantly among clinical physicians (P <0.001). The prevalence of MRI diagnostic outcome significantly differed in respect to the investigated organ (P < 0.001), with lumbosacral (50%) as the most prevalent.Conclusion: Requested MRI in tertiary referral center of Shahrekord city led to a diagnosis in an acceptable manner. However, there is need to study appropriate imaging in view of taking most advantages from medical practice guidelines.

Keywords

References

  1. Pezeshki MZ, Pezeshki S. Educating quaternary prevention (P4) in Iran for decreasing the harms and costs of unnecessary services in clinical medicine and public health. Payesh 2013; 12(4): 329-33. [In Persian].
  2. Smith-Bindman R, Miglioretti DL, Larson EB. Rising use of diagnostic medical imaging in a large integrated health system. Health Aff (Millwood) 2008; 27(6): 1491-502.
  3. Bernardy M, Ullrich CG, Rawson JV, Allen B, Thrall JH, Keysor KJ, et al. Strategies for managing imaging utilization. J Am Coll Radiol 2009; 6(12): 844-50.
  4. Sadeghi A, Keshavarz K, Ahmadzadeh MS, Yousefi A. Survey of appropriate use of magnetic resonance imaging services provided in Shahid Chamran Hospital of Shiraz. J Health Res Commun 2015; 1(3): 33-40. [In Persian].
  5. Kabiri M, Raeisi E, Taheri A, Aazami MH, Dayani MA, Aghamiri SMR, et al. A one-year study on the rationality of requested sonography in emergent patients at ayatollah kashani university hospital in Shahrekord city, Iran. J Isfahan Med Sch 2019; 37(525): 438-42. [In Persian].
  6. Fossati N, Giannarini G, Klatte T, Catto JW, Briganti A. The rapidly evolving role of imaging in urology: How to balance breakthroughs in knowledge with overuse. Eur Urol Focus 2016; 2(2): 111-2.
  7. Issa K, Jauregui JJ, McElroy M, Banerjee S, Kapadia BH, Mont MA. Unnecessary magnetic resonance imaging of hips: An economic burden to patients and the healthcare system. J Arthroplasty 2014; 29(10): 1911-4.
  8. Emery DJ, Shojania KG, Forster AJ, Mojaverian N, Feasby TE. Overuse of magnetic resonance imaging. JAMA Intern Med 2013; 173(9): 823-5.
  9. Jahanmehr N, Bigdeli AS, Salari H, Mokarami H, KhodaKarim S, Damiri S. Analyzing inappropriate magnetic resonance imaging (MRI) prescriptions and resulting economic burden on patients suffering from back pain. Int J Health Plann Manage 2019; 34(4): e1437-e1447.
  10. Sedaghat M, Rashidian A, Hosseini SD. Is lumbosacral MRI in complemetary health insured patients, requested based on scientific guidelines? Tehran Univ Med J 2013; 71(6): 382-8. [In Persian].
  11. Vejdani M, Taleghani Y, Kachoei A, Hosseini R, Salehi S, Foji S, et al. Appropriateness of knee MRI prescriptions in a hospital of Birjand, 2014. Int J Sci Rep 2015; 1(8): 299-302.
  12. Barzin M, Alaei A, Gholian Jouybari S. MRI findings in patients with headache referred to Imam Khomeini Hospital, Sari, Iran, from October 2007 To February 2009. J Mazandaran Univ Med Sci 2010; 20(75): 64-9. [In Persian].
  13. Williamson BD, Gohn DC, Ramza BM, Singh B, Zhong Y, Li S, et al. Real-world evaluation of magnetic resonance imaging in patients with a magnetic resonance imaging conditional pacemaker system: Results of 4-year prospective follow-up in 2,629 patients. JACC Clin Electrophysiol 2017; 3(11): 1231-9.
  14. Michelotti BF, Mathews A, Chung KC. Appropriateness of the use of magnetic resonance imaging in the diagnosis and treatment of wrist soft tissue injury. Plast Reconstr Surg 2018; 141(2): 410-9.
  15. Bouette A, Karoussou-Schreiner A, Ducou Le Pointe H, Grieten M, de Kerviler E, Rausin L, et al. National audit on the appropriateness of CT and MRI examinations in Luxembourg. Insights Imaging 2019; 10(1): 54.
  16. Sherman SL, Gulbrandsen TR, Lewis HA, Gregory MH, Capito NM, Gray AD, et al. Overuse of magnetic resonance imaging in the diagnosis and treatment of moderate to severe osteoarthritis. Iowa Orthop J 2018; 38: 33-7.
  17. Oikarinen H, Karttunen A, Paakko E, Tervonen O. Survey of inappropriate use of magnetic resonance imaging. Insights Imaging 2013; 4(5): 729-33.
  18. Khoury M, Tolentino M, Haj-Ahmad Z, Lilek C, Law MP. Assessing appropriateness of ct and MRI referrals for headache and lumbar: A Canadian perspective on patient-centered referrals. J Med Imaging Radiat Sci 2019; 50(4): 506-13.
  19. Jame SZ, Sari AA, Majdzadeh R, Rashidian A, Arab M, Rahmani H. The extent of inappropriate use of magnetic resonance imaging in low back pain and its contributory factors. Int J Prev Med 2014; 5(8): 1029-36.
  20. Wang KY, Yen CJ, Chen M, Variyam D, Acosta TU, Reed B, et al. Reducing inappropriate lumbar spine MRI for low back pain: Radiology support, communication and alignment network. J Am Coll Radiol 2018; 15(1 Pt A): 116-22.
  21. Xu SS, Berkovitz N, Li O, Garvin G. Reduction in inappropriate MRI knee studies after implementation of an appropriateness checklist: Experience at a tertiary care centre. Eur J Radiol 2020; 123: 108781.
Journal of Isfahan Medical School
Volume 38, Issue 565 - Serial Number 565
January and February 2020
Pages 107-114

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History

  • Receive Date: 21 January 2020
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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