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- Talk
- UK
An Audit of the Usefulness of Repeat MRIs for Suspected Cauda Equina Syndrome
Description
The presentation by Mohammed Ashhad covers an audit examining the usefulness of repeat MRI scans for patients with suspected Cauda Equina Syndrome at the Bradford Royal Infirmary. Following an introduction, Ashhad presents the background on the significance of lumbosacral MRIs in diagnosing various spinal pathologies, including degenerative diseases and tumors. He addresses the unclear value of repeat scans when clinical symptoms change and the implications on departmental workload and patient care due to resource constraints. The audit's methodology involves retrospective data analysis over ten years, focusing on patients who underwent repeat MRIs within a 12-month period.
The results reveal a total of 787 patients identified for the study, with a significant number excluded due to criteria like lack of comparable MRI reports or being part of the same clinical episode. Of the 460 patients with degenerative issues, only 89 showed a significant change in MRI findings, while a higher percentage (around 70-80%) in those classified with infections or tumors demonstrated notable changes. He emphasizes that most changes in the degenerative group were mild and clinically insignificant, while a very small fraction progressed to Cauda Equina Syndrome requiring surgical intervention. In contrast, the audit found that repeated MRI scans in infection or tumor cases were more likely to reflect significant changes in clinical presentation.
The overarching conclusions draw attention to the recommendations for more judicious use of repeat MRIs, suggesting they be reserved for cases with strong indications of significant clinical presentations, particularly for degenerative conditions. Ashhad wraps up the presentation by inviting questions, indicating his presentation was well-received, and followed up on by participants curious about the specifics of clinical relevance regarding the MRI changes observed.