MRI vs CT

MRI Procedure of Choice	CT Procedure of Choice (Patients with a contraindication for MRI, e.g., pacemaker)
HEAD
Arteriovenous malformations Encephalomalacia Epilepsy and adult onset seizures Hemangiomas Hydrocephalus Infection / Inflammation Infratentorial tumors Lacunar infarcts Lyme disease Meningiomas Multiple sclerosis Neurodegenerative disease Orbit and optic nerve disease Pituitary dysfunction Posterior fossa abnormalities (acoustic neuroma and skull base pathology) Radiation injury Space occupying lesions Stroke—(Use diffusion-weighted MR imaging) Supratentorial tumors Syringomyelia and Chiari malformations Vascular/congenital abnormalities White matter disease	Acute trauma Calcified lesions Suspected acute intracerebral hemorrhage Suspected subarachnoid hemorrhage (“The worse headache of my life.”)
ENT
Disease of the larynx (staging) Paranasal sinus diseases (soft tissue masses, CA staging) TMJ meniscal and soft tissue evaluations Sensorineural hearing loss	Cholesteatoma Conductive hearing loss Evaluation of the oro-, hypo-, and nasopharynx Facial bone trauma Orbital trauma Ossicular or vestibulocochlear deformities Otosclerosis/otospongiosis continuum Sinusitis Salivary gland disease TMJ – bone destruction or arthritis
SPINE
Any intrinsic disease of the cord Infection / inflammation Disc disease (cervical, thoracic, lumbar) Multiple sclerosis and demyelinating disease Myelopathy – all levels Paraspinal masses Postoperative evaluation (differentiate disc herniation from scar tissue) Scoliosis (MRI best to evaluate cord) Spinal cord tumors Syringomyelia, Chiari malformations, hydromyelia Syrinx Tethered cord Vascular abnormalities Vertebral column bone destruction by tumor (evaluation of spinal canal integrity only) Vertebral osteomyelitis	Post discography to assess the morphology of an intervertebral disc Scoliosis (CT best for bone detail) Vertebral fractures – all levels
CHEST
Assessment of cardiac function Brachial plexus and axillary pathology Congenital heart lesions or cardiac abnormalities Great vessel anomalies Intracardiac or pericardial masses Mediastinal masses Vascular structures of the mediastinum and chest Valvular disease	Aortic dissection Hilar and parenchymal nodules Lung disease
ABDOMEN
Evaluation of renal vasculature (MRA) MRCP recommended when Diagnostic component needed before therapeutic ERCP When ERCP is impossible Patients who have failed ERCP Patients who only require a diagnostic study To exclude sclerosing cholangitis, pancreatic neoplasm or chronic pancreatitis Tumor invasion of vena cava	Abdominal aortic aneurysm Benign and malignant disease of the liver Diagnosis and staging of nonhepatic intraabdominal infections and tumors Screening examination for symptoms when detail of the liver, spleen, kidneys or pancreas is needed
PELVIS
Bladder carcinoma staging Prostate carcinoma staging Uterine carcinoma staging Seminal vessical tumor invasion	Nodal assessment Pelvic Mass (useful, but ultrasound still preferred) Pelvic pain
MUSCULOSKELETAL
Achilles tendon injury Ankle – ligamentous injuries Avascular necrosis Bone and soft tissue tumors Knee injury including meniscal, cartilaginous and tendinous Metastatic disease of bone Occult fractures not apparent on plain films Osteoarthritis of hip, knee, shoulder and ankle Osteochondritis dissecans Osteomyelitis Rotator cuff injuries Tendon injuries of the elbow	Complex fractures (3-D CT reconstruction)

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