Background Imaging techniques such as computerised tomography (CT), magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) scans are used in various clinical and diagnostic neuropsychiatric assessments. However, these investigations may be costlier when compared to their clinical utility. Aim To examine the clinical utility of neuroimaging in an acute adolescent psychiatric inpatient population admitted to Tygerberg Hospital between January 2012 and December 2013. Setting The study was conducted at a tertiary level adolescent psychiatric inpatient unit at Tygerberg Tertiary Hospital, Parow, Cape Town, Western Cape, South Africa. Method A retrospective chart review was conducted to gather data from 125 inpatient adolescents who had neuroimaging performed during admission. Clinical information was obtained from folders and collated with neuroimaging data. The Pearson Chi-squared test was used to test for correlations between clinical variables and the outcomes (abnormalities) of CT scans. There were too few MRI or SPECT scans to warrant statistical testing for these modalities. Results Out of the total CT scans performed (n = 120), 11 (9.2%) were clinically significant or pathological. Five cases (4.2% of all CT scans) resulted in a change in diagnosis and management. There was no association between clinical variables and clinically relevant CT abnormalities (n = 11). There were three MRI abnormalities (30%), with two resulting in changes in management. Single photon emission computed tomography scans revealed abnormalities in all 10 cases. Conclusion Routine neuroimaging in this population of psychiatric adolescents has high clinical utility. However, the decision to conduct structural neuroimaging should be guided by good clinical assessment. Single photon emission computed tomography scanning is useful for detecting underlying neurophysiological abnormalities in patients presenting with psychiatric and behavioural symptoms to potentially aid diagnosis and for interventional purposes.

中文翻译：

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扫描还是不扫描？检查在三级精神病住院病房就诊的青少年患者进行神经影像学检查的争议性问题

背景成像技术，如计算机断层扫描 (CT)、磁共振成像 (MRI) 和单光子发射计算机断层扫描 (SPECT) 扫描，用于各种临床和诊断性神经精神病学评估。然而，与临床实用性相比，这些研究的成本可能更高。目的 研究神经影像学在 2012 年 1 月至 2013 年 12 月期间在 Tygerberg 医院收治的急性青少年精神病住院患者中的临床效用。 设置 本研究在西部开普敦帕罗泰格伯格三级医院的三级青少年精神病住院病房进行南非开普敦。方法 进行回顾性图表审查以收集 125 名住院青少年的数据，这些青少年在入院期间进行了神经影像学检查。临床信息是从文件夹中获得的，并与神经影像数据进行核对。Pearson 卡方检验用于检验临床变量与 CT 扫描结果（异常）之间的相关性。MRI 或 SPECT 扫描太少，无法保证对这些方式进行统计测试。结果 在进行的全部 CT 扫描 (n = 120) 中，有 11 例 (9.2%) 具有临床意义或病理性。5 例（占所有 CT 扫描的 4.2%）导致诊断和管理发生变化。临床变量与临床相关 CT 异常之间没有关联（n = 11）。有 3 例 MRI 异常（30%），其中 2 例导致管理变化。单光子发射计算机断层扫描显示所有 10 例异常。结论 对这类青少年精神病患者进行常规神经影像学检查具有很高的临床效用。然而，进行结构性神经影像学检查的决定应以良好的临床评估为指导。单光子发射计算机断层扫描可用于检测出现精神和行为症状的患者潜在的神经生理异常，从而可能有助于诊断和干预目的。