Pattern Of Findings In Mri Studies Of The Central Nervous System In Port-harcourt Urban

REFERENCES

Appendix

Table 1: Distribution of MRI Findings of Disorders in the Central Nervous System according to Age

Table 2: Distribution of MRI Findings Central Nervous System according to sex

Table 3: Distribution of Clinical History/Diagnostic Queries for Brain MRI Examinations

Table 4: Distribution of Clinical History/Diagnostic Queries for Spinal Cord MRI Examinations

Table 5: Distribution of MRI Findings of Brain Disorders

Table 6: Distribution of MRI Findings of Spinal Cord Disorders 

Fig iii: Frequency Distribution of Monthly MRI Findings of Disorders in the Spinal Cord

Table 7: Estimation of the Diagnostic Yield of MRI as a modality for investigation of the Central Nervous System

Table 8: Diagnostic Yield of MRI for the Brain

Table 9: Diagnostic Yield of MRI for the Spinal Cord

The brain, cranial nerves, leptomeninges, spinal cord and eye make up the Central Nervous System (CNS) 1. Study of this part of the body as well as its associated disease conditions give rise to the medical field of Neurology. Diseases of the CNS can be congenital (16.4%) or acquired (83.6%) 1. Of the acquired cases, trauma (82%), including road traffic accident (RTA), forms the leading cause of neurological disorders1.

Accurate diagnosis of neurological disorders requires highly specialised imaging equipment. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) have proven to be most useful in neuro-imaging – radiographic investigation of the CNS2. However, MRI (with or without Gadolinium Contrast) is the preferred neuro-imaging modality. For instance, examination of metabolite peaks with MR Spectroscopy can differentiate between cerebral tumours, radiation tumours and cerebral abscess by identifying their different spectral profiles. Similarly, Emejulu et al3 refers to MRI as the “gold standard” for imaging soft tissue including the spinal cord. MRI can pin-point the location and extent of spinal cord trauma and demonstrate compressive lesions.

The most distinguishing features that make for the diagnostic excellence of MRI include its knack for accurate delineation of soft tissues, and its specificity in differentiating between cerebral pathologies3. Others are its non-utilisation of x-rays, saving the patient risk of the possible effects of ionizing radiation. It is said that the radiation received from one non-contrast CT examination is equivalent to that received from 8 months of the natural backgroun4. Also, it has much higher spatial resolution. Studies show that MRI can reveal subtle lesions that were previously not seen on CT. It is much less invasive. MR angiography, unlike CT angiography, does not require percutaneous catheterization. Contrast media used for MRI have less propensity to cause allergic than reactions than conventional media4. 

Many studies carried out mostly on Caucasian populations have reveal that incidental findings exist in MRI scans of healthy asymptomatic subjects. No such study has been carried out in the Negro population to know if findings would be the same. In the State of Port-Harcourt, South-South Nigeria, two MRI equipment that serve patients from all over the region is located at the University of Port-Harcourt Teaching Hospital (UPTH), and at Braithwaite Memorial Specialist Hospital (BMSH), both in Port-Harcourt. But there has not been any documented study on the study described above. Neither is there any on the pattern of findings from the investigations carried out with these equipment.

This study aims to study the pattern of results of MR studies involving the CNS that have been done in the region so far to establish a reference point for health policy makers and other entrepreneurs who may want to establish new MRI facilities in the region.