Recall of structured radiology reports is significantly superior to that of unstructured reports.

OBJECTIVE: To measure recall of structured compared with unstructured radiology reports. METHODS: Institutional review board approval was obtained. Four hypothetical radiology reports, two structured and two unstructured reports, were created for the purposes of this study by an experienced consultant radiologist. The reports, each followed immediately by a multiple-choice questionnaire listing possible diagnoses from the report, were distributed to the members of two national physician associations using a web-based survey tool. Based on the number of correct responses, correct critical findings and incorrect responses, rates per number of potential diagnoses were calculated for each individual and averaged. The paired sign test compared results between structured and unstructured reports. RESULTS: 148 respondents completed the survey, 126 (85.1%) of whom were physicians. The mean percentage of incorrect diagnoses was 4.5% for structured reports compared with 16.7% for unstructured reports (p < 0.001). The average rate of critical diagnosis recall was 82.7% for structured reports and 65.1% for unstructured reports (p < 0.001). The average percentage of all diagnoses detected for structured compared with unstructured reports was 64.3 and 59.0%, respectively (p = 0.007). CONCLUSION: Recall of structured radiology reports is significantly superior to recall of unstructured reports immediately after reading the report. Advances in knowledge: A structured radiology report format can positively impact the referring clinician's ability to recall the critical findings with statistically significance.

Water-enhanced antegrade MR pyelography in pregnancy: a novel radiation-free approach.

Our aim was to determine if water-enhanced antegrade magnetic resonance (MR) pyelography can be an alternative to conventional antegrade pyelography in pregnant patients who require percutaneous nephrostomy placement for urosepsis and/or obstructive uropathy. The pregnant patient was placed supine in a 1.5-T MRI scanner seven days after percutaneous nephrostomy placement using ultrasound. Serial axial and coronal T2-weighted echo-planar fast spin-echo sequences were performed before and after injection of the catheter. The right nephrostomy catheter hub was sterilised using chlorhexidine. Sixty millilitres of sterile water were slowly injected. No Gd-based contrast agent was utilised due to safety concerns for the foetus. MR antegrade pyelography demonstrated the level of ureteric obstruction and the absence of renal calculi using sterile water as a contrast medium injected through a percutaneous nephrostomy followed by T2-weighted imaging. Air bubbles in the injected solution were differentiated from calculi due to their mobility on serial scans and their anti-dependent position. Water-enhanced antegrade MR pyelography was a safe and effective method of imaging the pregnant patient. It served as an alternative to conventional antegrade pyelography and minimised potential risks to the foetus.