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Clinical guidance for MRI referral
Use of MRI
The following information has been adapted from the RANZCR Guidance for GP referrals for MRI studies.6
Intravenous contrast is not routinely required for MR imaging. It is usually confined to looking for tumours or inflammatory lesions.
Contrast agents used for MRI are different to those used for CT and X-ray contrast studies. MRI contrast agents have lower rates of anaphylactoid reaction and are given at much lower doses than those used for CT. There is minimal risk of causing or aggravating renal impairment. However, patients with severe renal disease are at risk of nephrogenic systemic sclerosis if given MRI contrast agents (i.e. gadolinium). This is a rare but serious condition and deaths have occurred.
Prior to referral, GPs need to inform the MRI site if the patient has known significant renal impairment (i.e. eGFR <30mL/min/1.73m2). If risk factors for potential renal impairment are present, an eGFR result (taken up to 3 months before intended MRI) will be required before administration of contrast for MRI.
For patients with significant medical illness in the 3 months preceding MRI, and for hospital inpatients, a more recent eGFR (timing will be related to the nature, severity and timing of the illness) is a wise precaution.
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Guidance-for-MRI-referral.pdf (PDF 1.54 MB)
Summary-sheet-MRI-for-cervical-radiculopathy.pdf (PDF 0.49 MB)
Summary-sheet-MRI-of-the-head-for-unexplained-chronic-headache.pdf (PDF 0.46 MB)
Summary-sheet-MRI-of-the-head-for-unexplained-seizure-s.pdf (PDF 0.46 MB)
Summary-sheet-MRI-of-the-knee-for-meniscal-and-anterior-cruciate-ligament-tears.pdf (PDF 0.46 MB)
Summary-sheet-MRI-of-the-spine-for-cervical-trauma.pdf (PDF 0.46 MB)
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