Background Many neurological conditions manifest with psychiatric symptoms and may be misdiagnosed. Structural neuroimaging, that is, computerised tomography (CT) and magnetic resonance imaging (MRI), can aid in the diagnosis or exclusion of these conditions. Magnetic resonance imaging is preferable in this regard, but is more expensive and less readily available than CT. The indications for requesting MRI in the clinical psychiatric setting remain poorly defined. All published literature on the clinical utility of neuroimaging in Africa is on CT scans. Aim The aim of this study was to describe the clinical characteristics and MRI findings in a cohort of patients presenting with psychiatric symptoms. Setting A specialist psychiatric training hospital, Townhill Hospital, in Pietermaritzburg, KwaZulu-Natal. Methods A retrospective chart review of all patients who underwent MRI between 01 October 2010 and 31 June 2016 was done. Magnetic resonance imaging findings were correlated with socio-demographic and clinical information, including psychiatric diagnosis, indication for MRI imaging and effect on clinical management. Results Fifty-three MRIs were performed. Thirty-three (62%) were abnormal. Patients with HIV, neurocognitive disorders, chronic mental illness and involuntary admission were more likely to have abnormal scans (83%, p = 0.089; 80%, p = 0.496; 71%, p = 0.089 and 79%, p = 0.021, respectively). The findings of 54% of abnormal MRIs (24% of all MRIs performed) resulted in referral to other disciplines. No statistically significant associations were found with socio-demographic or clinical factors. Conclusion Abnormalities on MRI scans in mentally ill patients were common and a quarter of patients required referral to other disciplines. Further studies are required to clarify the clinical utility of MRI in patients with psychiatric illness, which could assist in the development of a guide for the rational use of this modality in a resource-constrained environment.

中文翻译：

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南非夸祖鲁-纳塔尔省精神病院患者临床特征和磁共振成像结果的回顾性图表回顾。

背景 许多神经系统疾病表现为精神症状，可能被误诊。结构神经影像学，即计算机断层扫描 (CT) 和磁共振成像 (MRI)，可以帮助诊断或排除这些疾病。在这方面，磁共振成像更可取，但比 CT 更昂贵且不易获得。在临床精神病学环境中请求 MRI 的指征仍然不明确。所有已发表的关于非洲神经影像学临床效用的文献都是关于 CT 扫描的。目的 本研究的目的是描述一组出现精神症状的患者的临床特征和 MRI 结果。设置 位于夸祖鲁-纳塔尔省彼得马里茨堡的一家专科精神病培训医院 Townhill 医院。方法对 2010 年 10 月 1 日至 2016 年 6 月 31 日期间接受 MRI 的所有患者进行回顾性图表审查。磁共振成像结果与社会人口学和临床信息相关，包括精神病诊断、MRI 成像适应症和对临床管理的影响。结果 进行了 53 次 MRI 检查。33 人 (62%) 异常。患有 HIV、神经认知障碍、慢性精神疾病和非自愿入院的患者更有可能出现扫描异常（分别为 83%，p = 0.089；80%，p = 0.496；71%，p = 0.089 和 79%，p = 0.021 ）。54% 的异常核磁共振检查结果（占所有核磁共振检查的 24%）导致转诊至其他学科。没有发现与社会人口或临床因素有统计学意义的关联。结论 精神病患者的 MRI 扫描异常很常见，四分之一的患者需要转诊至其他学科。需要进一步的研究来阐明 MRI 在精神疾病患者中的临床效用，这可能有助于制定在资源有限的环境中合理使用这种方式的指南。