MRI and CT scan for mental/maybe neurological condition

Hello everyone.  I was wondering if someone could tell me which is better to examine someone looking for any cause of psychotic episodes -- MRI or CT scan?  Also, what conditions might show up on either exam as the source of the problem?

Thank you.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you, it is difficult to answer this question fully. However, I will try to provide you with some information regarding this matter.

Psychotic episodes can be of different types. They can be primary psychiatric diagnoses, such as schizophrenia, or they may be associated with another neurological disorder such as a movement disorder like that seen in Huntington’s disease. Furthermore, psychotic episodes may be an acute change like that seen in delirium, stroke, or seizure. Depending on the complete history, including family history, associated symptoms, and clinical examination, imaging findings will likely be in different anatomical locations.

As a general rule, MRI is better for looking at anatomy and for pathological conditions (e.g., multiple sclerosis, stroke, infection, tumor, etc) of the brain whereas a CT scan is better when wanting to evaluate for blood, bone, or quick, initial evaluation.  To answer your question, which would be recommended, an MRI would likely provide the most information, particularly if the psychosis is chronic. Anatomical locations of interest will include ventricle size, frontal lobe abnormalities, and abnormalities of the basal ganglia, particularly the caudate head.  If the psychosis is acute in onset, information should be obtained quickly, which would be with a CT scan. Conditions such as stroke and seizure should be considered with changes in mental status. They should be evaluated quickly for potential therapeutic interventions.

If the psychosis is chronic, it is recommended that you discuss the clinical history further with the ordering physician. In this case, an MRI would likely provide the most information. If the psychosis is acute in onset, a CT scan would be helpful for initial evaluation.

Thank you for using the forum, I hope you find this information useful, good luck.

[MMahon]

Best to let your doc decide this one but I have had both.  These were to rule out a 'mass' or other physiological reason that might effect thoughts and behavior.  Cancer, tumors, blood flow are a few i can think of.
Good luck