Contrast-Enhanced Brain MRI for Ambulatory Evaluation of Headache: Comprehensive or Excessive?

Routine acquisition of contrast-enhanced MRIs for outpatients with an indication of headache had a low yield. Noncontrast examinations demonstrated similar sensitivity for actionable intracranial pathology, while contrast-enhanced MRIs doubled the detection rate of incidental meningiomas. A more practical initial approach may be starting with noncontrast examinations with callbacks or additional imaging for a small percentage of patients.