Diagnostic radiologist in Latviawhen a referral is required, what MRI and CT cost, how to prepare

A diagnostic radiologist performs and reports imaging examinations. This doctor does not usually treat the patient but issues the report on which the treating doctor bases decisions.

• X-ray examinations
• Computed tomography
• Magnetic resonance imaging
• Ultrasound
• Mammography
• Bone densitometry
• Image-guided invasive procedures

The key difference between the two most requested methods: CT uses X-rays to produce images, while MRI uses a strong magnetic field and radio waves. MRI can therefore safely be repeated.

This is the most important practical distinction between scans.

Veselības centrs 4 states that state-funded MRI is available where the provider holds a National Health Service contract and quotas exist for that service, and that the average wait can be from one to several weeks.

MRI. No special preparation is needed: you may eat, drink and take your usual medicines. Before the scan you undress to your underwear, women also removing underwired bras, and put on disposable clothing without metal parts. All metal objects must be removed: earrings, chains, piercings.

CT with contrast. The Veselības centrs 4 diagnostic centre sets out these rules:

• Blood tests: glomerular filtration rate, creatinine and urea, no more than two weeks old.
• Drink at least two litres of water the day before.
• Drink water freely on the day of the scan.
• If the scan is before 12:00, eat nothing beforehand.
• If the scan is after 12:00, a piece of fruit, a vegetable or yogurt is allowed at breakfast.

Scans with intravenous contrast are not performed if the patient is allergic to the contrast agent or if serum creatinine exceeds the normal range. Scanning is not recommended during pregnancy unless the information gained outweighs the risk.

Contrast volumes differ: MRI uses up to 20 millilitres depending on the patient's weight and the pathology found, while CT uses 80 to 100 millilitres. After contrast, drink plenty of fluid, since it is excreted in urine.

• NVD contract and quotas. State-funded MRI is only possible where the provider holds a contract and quotas are available, so ask when you call.
• Who issues the referral. For state-funded MRI the referral comes from a specialist, not a family doctor.
• Waiting time. This ranges from one to several weeks and varies between providers.
• Report speed. If you need the result urgently, ask whether expedited reporting is available for a surcharge.
• Previous images. Using the same provider makes comparison with earlier scans easier.

• Veselības centru apvienība states that CT results are available within 5 to 7 working days at datamed.lv or from the polyclinic reception.
• Veselības centrs 4 states that an MRI report is usually ready within 1 to 3 working days, and that timing varies with the type and complexity of the scan and the radiologist's workload.
• Doctors with access to the Datamed system can view images directly, or using the username and password issued to the patient.
• Some providers offer expedited reporting within 24 hours for a surcharge.

In the public system the patient pays a set co-payment per scan.

• X-ray without contrastPatient co-payment EUR: 3.00Source: NVD
• UltrasoundPatient co-payment EUR: 4.00Source: NVD
• CT without contrastPatient co-payment EUR: 14.00Source: NVD
• MRI without contrastPatient co-payment EUR: 28.00Source: NVD
• Children under 18Patient co-payment EUR: 0.00Source: NVD
• Private scan without a referralPatient co-payment EUR: full price per price listSource: Veselības centrs 4

Surcharges may also apply for the contrast agent, for injecting it with a power injector, and for expedited reporting.

The specialty body is the association "Latvijas Radiologu asociācija", registration number 40008179307, president Atis Svare, radiologija.lv.

Certificates are issued by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate, with the State Environmental Service also overseeing ionising radiation.

If you have doubts about the quality of care, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.