Approach to Brain Magnetic Resonance Imaging for Non-Radiologists

Abstract

The goal of this review is to provide a guide to magnetic resonance imaging (MRI) reading for non-radiologists. A thorough literature search was conducted using the keywords “MRI”, “CT”, “Non-radiologist” and “MRI interpretation” to develop an approach to MRI reading for non-radiologists. Common indications for a brain MRI include workup of an intracranial tumor, chronic headache, seizure disorder, and confirmation of a stroke. When assessing for an intracranial tumor, MRI is the preferred diagnostic modality. Computed tomography (CT) has much lower resolution and is typically reserved for the emergency setting. T1 weighted images provide anatomically relevant images of the brain parenchyma that will be familiar to non-radiologists. In contrast to T1 weighted images, fluid is bright in T2 and white matter will appear darker than gray matter. Fluid attenuation inversion recovery (FLAIR) is most sensitive for edema and parenchymal abnormalities like a low-grade glioma. The main purpose of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences are to visualize acute ischemic stroke. Although non-radiologists generally have a greater exposure to head CT images, the same foundational principles of CT head interpretation can apply to brain MRI reading. Benefits of brain imaging by MRI includes obtaining a multi-planar assessment of the brain, highly detailed images of the brain, and using different MRI sequences to assess for different pathology. J Neurol Res. 2020;10(5):173-176 doi: https://doi.org/10.14740/jnr628