ArticleAJNR. American journal of neuroradiology2025
Contrast-Enhanced Brain MRI for Ambulatory Evaluation of Headache: Comprehensive or Excessive?
Article in AJNR. American journal of neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeHeadache is one of the most common indications for brain MR imaging. Our purpose was to assess the necessity and yield of contrast-enhanced brain MRI protocols relative to noncontrast protocols for the outpatient evaluation of headache in adults. MATERIALS AND
methodsWe retrospectively reviewed 874 consecutive adult outpatient brain contrast-enhanced MRIs for the indication of headache. Examination impressions were reviewed for any findings contributing to headache and stratified into 18 categories. Incidental findings unrelated to headache but mentioned in the report impressions were recorded. A subset of 100 contrast-relevant cases were selected for independent blinded review by 2 neuroradiologists first without contrast and then after a 3-week washout period, with and without contrast. Reviewers were asked to classify cases as positive/negative and to describe relevant findings. Specific diagnoses were compared between reviews and readers on a case-by-case basis. Intrareader agreement was calculated between noncontrast and postcontrast reviews.
resultsEighteen percent of examinations had findings potentially related to headaches. Two percent of cases were deemed contrast relevant. Incidental findings were reported in 4% of cases. On the blinded double review, the percentage of positive cases remained essentially unchanged, decreasing by 1.5% with contrast-enhanced images available. All intra- and extra-axial masses associated with parenchymal edema were detected without contrast. Detection rate of small, incidental meningiomas doubled on postcontrast sequences.
conclusionsRoutine acquisition of contrast-enhanced MRIs for outpatients with an indication of headache had a low yield. Noncontrast examinations demonstrated similar sensitivity for actionable intracranial pathology, while contrast-enhanced MRIs doubled the detection rate of incidental meningiomas. A more practical initial approach may be starting with noncontrast examinations with callbacks or additional imaging for a small percentage of patients.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.