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1.
Emerg Radiol ; 28(4): 857-862, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33778917

RESUMO

This article describes the variable appearance of the normal postpartum uterus and reviews complications which can occur in the postpartum period, with particular emphasis on the sonographic findings. Postpartum complications are a common presentation to the emergency department. The majority of these patients present with secondary postpartum hemorrhage. Additional symptoms of pain or clinical findings of pyrexia and leukocytosis confound the clinical scenario and necessitate further evaluation with imaging. Ultrasonography is the mainstay in the initial imaging evaluation of the postpartum patient, with occasional progression to CT, MR, or angiography. We sought to provide a brief review of the literature, with pictorial review of key imaging findings, with a focus on ultrasonography. We provide a pictorial and brief literature review, with case examples from our institution, of key postpartum complications. Ultrasonography is an important component of evaluation in postpartum patients, particularly those with hemorrhage or other complication.


Assuntos
Hemorragia Pós-Parto , Período Pós-Parto , Serviço Hospitalar de Emergência , Feminino , Humanos , Hemorragia Pós-Parto/diagnóstico por imagem , Gravidez , Ultrassonografia
2.
AJR Am J Roentgenol ; 215(6): 1384-1388, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33052740

RESUMO

OBJECTIVE. Radiology departments in tertiary care centers are frequently asked to perform secondary interpretations of imaging studies, particularly when a patient is transferred from a community hospital. Discrepancy rates in radiology vary widely, with low rates reported for preliminary resident reports that are overread by attending radiologists (2-6%) and higher rates (up to 56%) for secondary interpretations. Abdominal and pelvic imaging and cross-sectional imaging have the highest discrepancy rates. The purpose of our study was to determine the discrepancy rate and the most common reasons for discrepancies between abdominal and pelvic MRI reports obtained from outside institutions and secondary interpretations of these reports by a fellowship-trained radiologist at a tertiary care center. MATERIALS AND METHODS. We retrospectively identified 395 secondary MRI reports from January 2015 to December 2018 that were labeled as body MRI examinations at a tertiary care center. Thirty-eight cases were excluded for various reasons, including incorrect categorization or lack of outside report. We reviewed the outside reports, compared them with the secondary interpretations, and categorized the cases as discrepancy or no discrepancy. The discrepancies were subdivided into the most likely reason for the error using previously published categories; these categories were also divided into perceptive and cognitive errors. RESULTS. Of the 357 included cases, 246 (68.9%) had at least one discrepancy. The most common reason for error was faulty reasoning (34.3%), which is a cognitive error characterized by misidentifying an abnormality. Satisfaction of search, which is a perceptive error, was the most common reason for second discrepancies (15.0%). CONCLUSION. Secondary interpretations of body MR images at a tertiary care center identify a high rate of discrepancies, with cognitive error types predominating.


Assuntos
Abdome/diagnóstico por imagem , Competência Clínica , Erros de Diagnóstico/estatística & dados numéricos , Imageamento por Ressonância Magnética/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Retrospectivos
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