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MRI/CT Scan Decision Tool
Dec 21, 2024
•
Mark Morgan
categories:
radiology
This is a tool to help with ordering advanced imaging.
MRI/CT Scan Decision Tool
Summary: This tool provides suggestions for Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) studies based on body area and clinical condition. Other studies, including ultrasound exist and may be more appropriate. It is always wise to consult with radiology regarding the proper study to order.
...........ABDOMEN AND PELVIS...........
Abnormal Enzymes
Abscess
Adrenal Mass
Appendicitis
Biliary Obstruction
Cancer
Cirrhosis
Colitis
Crohns
Diffuse Small Bowel Disease/Gluten Enteropathy
Endometrioma
Fibroid
Gall Bladder Stones
Hemangioma
Hematuria with Pain
Hepatitis
Hepatoma
Incomplete Colonoscopy or Screening
Inflammatory Bowel Disease
Jaundice
Occult Gastrointestinal Bleeding
Ovarian Mass
Pain
Pancreatitis
Post Liver Embolization
Pre/Post Fibroid Embolization
Pseudocyst
Stone Survey
Tumor
...........ABDOMINAL AORTA/VESSELS...........
Aneurysm
Dissection
Mesenteric Stenosis
Post Stent Grafting
Renal Artery Stenosis
...........BRAIN...........
Alzheimer
Aneurysm
Arteriovenous Malformation (AVM)
Bleeding
Cerebrovascular Accident
Confusion
Cranial Nerve Lesions
Dizziness
Elevated Prolactin Levels
Headache
Hearing Loss
Infection
Memory Loss
Mental Status Change
Multiple Sclerosis
Pituitary Lesions
Seizures
Shunt Check
Stroke
Transient Ischemic Attack
Trauma
Tumor
Vertigo
...........BRAIN/VESSELS...........
Aneurysm
Cerebrovascular Accident
Intracranial Hemorrhage
Transient Ischemic Attack
...........CERVICAL, THORACIC, AND LUMBAR SPINE...........
Cancer
Compression Fracture with History of Malignancy
Degenerative Disease
Disc Herniation
Discitis
Epidural Abscess
Fracture
Fusion
Metastasis
Multiple Sclerosis
Myelopathy
Osteomyelitis
Pain
Post Op Fusion
Radiculopathy
Syrinx
Trauma
Tumor
...........CHEST...........
Brachial Plexus Pathology
Cough
Hilar or Mediastinal Mass
Idiopathic Pulmonary Fibrosis
Interstitial Lung Disease
Lung Cancer
Lymphoma
Mesothelioma
Metastatic Workup
Neural Tumor
Nodule
Pain
Sarcoid
Staging
Usual Interstitial Pneumonia
...........CHEST/PULMONARY ARTERIES/VESSELS...........
Aneurysm
Chest Pain
Dissection
Dyspnea
...........CHEST/THORACIC AORTA/VESSELS...........
Deep Vein Thrombosis
Hemoptysis
Pulmonary Hypertension
Pulmonary Venous Mapping
Screening Cardiac Calcium Scoring
SOB
Tachypnea
...........FACIAL BONES...........
Pain
Trauma
...........LOWER EXTREMITIES/VESSELS...........
Peripheral Artery Disease
...........NECK...........
Adenopathy
Infection
Mass
Pain
Vocal Cord Paralysis
...........NECK/CAROTID/VESSELS...........
Bruit
Cerebrovascular Accident
Stenosis
Transient Ischemic Attack
Vascular Tumor
...........ORBITS...........
Exopthalmus
Foreign Body
Fracture
Graves Disease
Infection
Mass
Proptosis
Pseudotumor
Trauma
Vascular Lesions
...........PELVIS/BONY...........
Avascular Necrosis
Fracture
Mass
Muscle/Tendon Tear
Osteomyelitis
Pain
Septic Arthritis
Tumor
...........SINUSES...........
Congestion
Pain
Sinusitis
...........TEMPORAL BONES...........
Cholesteatoma
Pain
Tinnitus
Trauma
...........UPPER AND LOWER EXTREMITIES/JOINTS...........
Abscess
Avascular Necrosis
Cellulitis
Fascitis
Internal Derangement
Labral, Meniscal, Ligament, and Cartilage Tears
Mass
Myositis
Osteochondritis Dessecans
Osteomyelitis
Tumor
...........UPPER AND LOWER EXTREMITIES/NONJOINTS...........
Abscess
Cellulitis
Fascitis
Fracture
Fusion
Malunion
Morton Neuroma
Muscle/Tendon Tear
Osteomyelitis
Pain
Soft Tissue Tumor
CT/MRI Ordering Suggestion (It's always a good idea to verify the appropriate test with radiology) -->
RECOMMENDATION
score=(Q1);score>44?'MRI Head Without Contrast':score>43?'CTA Head With Contrast or MRI Head Without Contrast':score>42?'CTA Neck With Contrast':score>41?'CTA Abdomen and Runoff With Contrast':score>40?'CT Screening Cardiac Calcium Scoring':score>39?'CTA Chest, CTA Abdomen and Runoff With Contrast':score>38?'CTA Chest With IV Contrast':score>37?'CTA Chest With IV Contrast':score>36?'CTA Abdomen with IV Contrast':score>35?'MRI Pelvis Without and With Contrast':score>34?'MRI Pelvis Without Contrast':score>33?'CT Pelvis Without':score>32?'MRI Without and With of Body Part':score>31?'MRI Without Contrast of Body Part':score>30?'MRI Without and With Contrast of Body Part':score>29?'MRI Without Contrast of Body Part':score>28?'CT Without Contrast of Body Part':score>26?'MRI Without Contrast of Specific Area':score>25?'CT Without Contrast of Specific Area':score>24?'CT Colonography':score>23?'MRI Pelvis Without and With Contrast':score>22?'CT Enterography':score>21?'MRI Abdomen Without Contrast/MRCP':score>20?'MRI Abdomen Without and With Contrast':score>19?'CT ABD and Pelvis Without Oral and IV Contrast':score>18?'CT ABD and Pelvis With Oral and IV Contrast OR CT Enterography':score>17.9?'CT ABD and Pelvis With Oral and IV Contrast':score>17.4?'CT Chest With Contrast OR CT Chest, High Resolution No Contrast':score>16?'MRI Chest Without Contrast':score>15?'CT Chest, High Resolution No Contrast':score>14?'CT Chest Without Contrast':score>13?'CT Chest With Contrast':score>12?'MRI Neck Without and With Contrast':score>11?'CT Neck With IV Contrast':score>10?'CT Temporal Bones Without Contrast':score>9?'CT Facial Bones Without Contrast':score>8?'MRI Orbits Without and With Contrast':score>7?'CT Orbits With IV Contrast':score>6?'CT Orbits Without Contrast':score>5?'CT Sinus Without Contrast':score>4?'MRI Brain Without Contrast':score>2?'MRI Brain Without and With Contrast':score>0?'CT Head Without Contrast or MRI Brain Without Contrast/MRI for more severe symptoms or persistent symptoms after a CT Head without contrast was performed':'Please be more specific/NOT ALL CAPS'
display/hide references
references:
#1
Salmela MB, Mortazavi S, Jagadeesan BD, et al. ACR Appropriateness Criteria cerebrovascular disease. J Am Coll Radiol. 2017;14(5S):S34-S61.
#2
Whitehead MT, Cardenas AM, Corey AS, et al. ACR Appropriateness Criteria headache. J Am Coll Radiol. 2019;16(11S):S364-S377.
#3
Aulino JM, Kirsch CFE, Burns J, et al. ACR Appropriateness Criteria neck mass-adenopathy. J Am Coll Radiol. 2019;16(5S):S150-S160.
#4
Kirsch J, Brown RKJ, Henry TS, et al. ACR Appropriateness Criteria acute chest pain-suspected pulmonary embolism. J Am Coll Radiol. 2017;14(5S):S2-S12.
#5
Earls JP, Woodard PK, Abbara S, et al. ACR Appropriateness Criteria asymptomatic patient at risk for coronary artery disease. J Am Coll Radiol. 2014;11(1):12-19.
#6
Expert Panel on Cardiac Imaging:; Shah AB, Kirsch J, Bolen MA, Batlle JC, Brown RKJ, Eberhardt RT, Hurwitz LM, Inacio JR, Jin JO, Krishnamurthy R, Leipsic JA, Rajiah P, Singh SP, White RD, Zimmerman SL, Abbara S. ACR Appropriateness Criteria® Chronic Chest Pain-Noncardiac Etiology Unlikely-Low to Intermediate Probability of Coronary Artery Disease. J Am Coll Radiol. 2018 Nov;15(11S):S283-S290.
#7
McComb BL, Chung JH, Crabtree TD, et al. ACR Appropriateness Criteria routine chest radiography. J Thorac Imaging. 2016;31(2):W13-W15.
#8
Koberlein GC, Trout AT, Rigsby CK, et al. ACR Appropriateness Criteria suspected appendicitis–child. J Am Coll Radiol. 2019;16(5S):S252-S263.
#9
Garcia EM, Camacho MA, Karolyi DR, et al. ACR Appropriateness Criteria right lower quadrant pain-suspected appendicitis. J Am Coll Radiol. 2018;15(11S):S373-S387.
#10
Peterson CM, McNamara MM, Kamel IR, et al. ACR Appropriateness Criteria right upper quadrant pain. J Am Coll Radiol. 2019;16(5S):S235-S243.
#11
Bhosale PR, Javitt MC, Atri M, et al. ACR Appropriateness Criteria acute pelvic pain in the reproductive age group. Ultrasound Q. 2016;32(2):108-115.
#12
Patel ND, Broderick DF, Burns J, et al. ACR Appropriateness Criteria low back pain. J Am Coll Radiol. 2016;13(9):1069-1078.
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