MRI

Special MRI scan could identify stroke risk in people with atrial fibrillation

Howard LeWine, M.D.

Chief Medical Editor, Harvard Health Publishing

Atrial fibrillation is a heart rhythm disorder that affects millions of people. It can lead to potentially disabling or deadly strokes. Researchers from Johns Hopkins University School of Medicine adding motion-tracking software to standard MRI heart scans of 149 men and women with atrial fibrillation. The scans revealed specific changes in the muscles of the left atrium that increased stroke risk in some of the volunteers. These changes were not associated with age or other risk factors for stroke. This could help many people with this condition to avoid taking warfarin or other clot-preventing medications for life. But it is much too early to include MRI as part of the standard evaluation of people with atrial fibrillation — not to mention that such scans would significantly increase the cost of these evaluations. For now, doctors will continue to use standard tools to help determine stroke risk.

Most headache-related brain scans aren’t needed

Severe headaches are a misery, whether they cause a dull ache or a steady, stabbing, or blinding pain. Such pain rarely comes from something catastrophic, like a tumor or a bleeding in the brain. Yet an estimated 12% of people with headaches get brain scans. A new study shows that these unnecessary scans add several billion dollars a year to health care costs for very little benefit. Excessive brain scanning costs more than just dollars. Repeated CT scans deliver enough radiation to increase the odds of developing cancer. Scans also tend to lead to more scanning if the test turns up something strange. Many people who see a doctor because of severe and recurrent migraine headaches don’t need brain scans. They need the right therapy to stop their pain.