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Objective: The purpose of this study is to compare patients of a University Hospital inpatient clinic based on whether a cranial MRI (Magnetic Resonance Imaging) scan was ordered for them by their clinicians, and evaluate the patients’ sociodemographic characteristics, diagnoses and reasons for ordering an MRI scan, and the pathological findings and related factors.
Methods: A total of 279 patients who were treated in the Suleyman Demirel University Psychiatry Department inpatient clinic in the two-year period of January 2013 to December 2014 were included in this study. The data of this study is gathered through retrospective analysis of the patients’ records. Statistical analysis was conducted using SPSS 15.0 for Windows.
Results: The number of patients who were evaluated with MRI scan in the two-year period was 23.6% (n=66). 27% (n=18) of these MRI scans were ordered after a consultation with the neurology department of the hospital, and 73% (n=48) of them were ordered by psychiatric clinicians. MRI order reasons by clinicians were: suspicion of any kind of organic pathology related to primary diagnosis 77.5% (n=51), persistent headache 7.5% (n=5), suspicion of delirium 4.5% (n=3), suspicion of dementia 3% (n=2), suspicion of Parkinson’s disease 3% (n=2), suspicion of a space-occupying lesion of the brain 1.5% (n=1) and others 3% (n=2). Of these patients who were evaluated with a MRI scan, in 75% (n=50) of the cases findings of the scans were in the normal range, in 25% (n=16) there was evidence for probable pathological findings. These pathological findings were atrophy consistent with age, possible ischemia-gliosis, left lateral ventricle expansion, arachnoid cyst, bifrontotemporal atrophy, and calcification.
Conclusion: Advanced MRI techniques have substantially increased our knowledge of the human brain’s structure and function related to psychiatric disorders. Today neurological imaging is being used in psychiatric differential diagnosis processes (especially for general medical conditions) in our country like elsewhere in the world. The more the MRI becomes widespread, the more it is used in diagnostic processes. However, there has been some criticism of imaging methods in psychiatric clinical practice, pointing out that no reliable anatomical or functional alterations have been confirmed in psychiatric neuroimaging. Results of this study show that in the majority of cases the findings were determined as being in the normal range. In this context, although invaluable in differential diagnosis, costeffectivity of the use of neurological imaging might be an issue worth considering.