CT and MRI Records: What You Need to Know
How do I get a complete copy of my CT scan or MRI?
Request your records from the imaging facility's medical records department and specifically ask for all image sequences, reconstructions, and the radiology report in DICOM format. Most facilities provide these on a CD for $5-$25.
Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are two of the most powerful diagnostic tools in modern medicine. Unlike a simple X-ray, these "advanced imaging" modalities produce highly detailed, cross-sectional images of the body. The records they generate are correspondingly large and complex—and subject to intense scrutiny from insurance companies.
What Makes CT and MRI Records Different?
1. Data Size and Complexity
A single CT or MRI study can consist of hundreds or even thousands of individual images. This results in very large file sizes, often several hundred megabytes or even gigabytes.
Practical Implications:
- • Large Downloads: Portal downloads can be very large and slow
- • CD/DVD Limitations: A large study may require a DVD or multiple discs
- • Incomplete Transfers: Large file size increases risk of corrupted transfers
2. Multiple Series and Reconstructions
CT and MRI studies are composed of multiple "series" or "sequences." Each is designed to highlight different tissue characteristics.
MRI Sequences
- • T1-weighted
- • T2-weighted
- • FLAIR
- • Diffusion-weighted (DWI)
- • Gradient echo
CT Reconstructions
- • Axial views
- • Coronal views
- • Sagittal views
- • 3D reconstructions
- • Bone/soft tissue windows
A complete record must include all of these original and reconstructed series. If you receive a record with missing sequences, it may be insufficient for a second opinion.
3. Use of Contrast Agents
Many CT and MRI studies are performed "with contrast," meaning a special dye is injected into your bloodstream to highlight certain structures.
Important for Your Records:
- • The report will specify whether contrast was used
- • Records should include both pre-contrast and post-contrast image sets
- • This distinction is critical for radiologists performing a second opinion
The Critical Role of Prior Authorization
Because CT and MRI scans are expensive, insurance companies almost always require prior authorization before they will agree to pay for the study. This means your doctor must submit clinical documentation to prove the scan is medically necessary.
Why This Matters for Your Records
The documentation submitted for prior authorization is a key part of your imaging record's story. It contains the clinical reasoning behind why the scan was ordered.
If your insurance company denies a claim related to the scan, this documentation is a critical piece of evidence for your appeal. When dealing with a denial, you may need to request not only the imaging record itself but also a copy of the prior authorization request and the clinical notes submitted with it.
Common Failure Modes for Advanced Imaging Records
Missing Sequences
Due to the large number of images, it is common for a CD to be created with only a subset of the full study. Always verify that all sequences are included.
Loss of Fidelity
Sometimes, to save space, the images are compressed, resulting in a loss of diagnostic quality. Request original quality DICOM files.
Pre- and Post-Contrast Mix-ups
The sets of images may not be clearly labeled, making it difficult to distinguish between the pre-contrast and post-contrast series.
Expert Review Recommended
Because of their complexity, it is especially important to have your CT and MRI records reviewed for completeness by an expert if you plan to use them for a second opinion, an insurance appeal, or a legal case.