This is a retrospective analysis of all CTAs, CE MRAs, and CE IAC studies acquired in patients with "dizziness" or "vertigo" performed between January 2011 and June 2012. Patients that had focal neurologic findings specified on the requestion or in the history on the EMR were excluded (clinical findings such as vomiting, focal weakness, aphasia, and vision loss). Also patients with prior history of a posterior mass, an underlying inflammatory condition or vascular abnormalities were excluded from the study.
A total of 798 studies were included (228 CTAs, 304 CE MR, and 266 CE IAC MR). The age range was 6-93 years. 32% of the studies were performed in the ER setting. Only 1.6 % of cases had a diagnostic efficacy* and 1.0% had a therapeutic efficacy**. There was no statistical significance difference between the modalities or the ordering specialty (ie. ER, ENT or primary care).
*Diagnostic Efficacy: defined by the ACR as the number of studies with a new or progressive major finding divided by the total number of studies.
**Therapeutic Efficacy: defined by the ACR as the number of studies resulting in a change in clinical management divided by the total number of studies
Population: All patients presenting to the ER, primary care physician, or otolaryngologist (including the pediatric population) with isolated dizziness or "vertigo". Patients with a known posterior fossa mass, underlying inflammatory conditions (such as MS), or vascular abnormalities were excluded. The age range in the study was 6-93.
Intervention: Utility of CTA, CE MR and/or CE IAC MR in the above stated patient population
Comparison: N/A
Outcome: The diagnostic and therapeutic efficacy of CTA, CE MR, and CE IAC MR for patients presenting with isolated dizziness is reported to be 1.6% and 1.0% respectively.
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