Overnight radiology resident discrepancies at a large pediatric hospital: categorization by year of training, program, imaging modality, and report type.

BACKGROUND: Overnight radiology resident discrepancies have been described in multiple studies; however, study of resident discrepancies specific to pediatric radiology is limited. PURPOSE: To examine radiology resident discrepancies as they pertain to a large pediatric hospital system. MATERIAL AND METHODS: A total of 21,560 preliminary reports issued by 39 residents over a one-year period were scored as agreement, minor discrepancy, or major discrepancy by faculty members using a modification of the 2009 RADPEER scoring system. Residents were trainees of three different diagnostic radiology programs: large university-based, medium-sized community-based, or small community-based. Discrepancy rates were evaluated based on resident postgraduate year, program, and imaging modality. The effect of a general pediatric radiology report versus pediatric neuroradiology report of a CT scan was also tested. CT was the only modality in which there were comparable numbers of studies scored by both general pediatric radiologists and neuroradiologists. RESULTS: The rate of major resident to faculty assessment discrepancies was 1.01%, and the rate of minor resident to faculty assessment discrepancies was 4.47%. Major discrepancy rates by postgraduate years 3-5 were 1.08%, 0.75%, and 1.59%, respectively. Major discrepancy rates were highest for MR (11.22%), followed by CT (1.82%), radiographs (0.91%), and ultrasound (0.56%). There was no significant difference in discrepancy rate between residency programs and general pediatric radiology report of a CT versus pediatric neuroradiology report of a CT. CONCLUSION: Radiology discrepancy rates for residents issuing preliminary reports at a large children's hospital system are similar to those reported for adult procedures.

CT and MRI findings in infantile vanishing white matter.

Infantile vanishing white matter disease is an uncommon cause of developmental delay and seizures in children. Presented here is a case of vanishing white matter disease diagnosed at 6 months of age. Imaging findings demonstrated widespread white matter abnormalities throughout the supratentorial and infratentorial brain. The diagnosis of infantile vanishing white matter disease was confirmed via molecular analysis which revealed a rare mutation in the gene responsible for this disorder.

MRI findings in neuronal ceroid lipofuscinosis.

Neuronal ceroid lipofuscinosis is a rare cause for developmental delay and seizures that results in neurodegeneration. Presented here is a case of a 5-year-old male who presented for MRI following a delay in achieving developmental milestones and epilepsy. MRI was performed demonstrating a thinned corpus callosum and generalized low parenchymal volume with periventricular gliosis. Magnetic resonance spectroscopy showed glutamate/glutamine accumulation and diminished N-acetylaspartate. The diagnosis of neuronal ceroid lipofusciosis was revealed following genetic testing. This case is useful in showing findings of this rare disorder.