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1.
Can Assoc Radiol J ; 70(4): 329-334, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31585825

RESUMO

This is a condensed summary of an international multisociety statement on ethics of artificial intelligence (AI) in radiology produced by the ACR, European Society of Radiology, RSNA, Society for Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine. AI has great potential to increase efficiency and accuracy throughout radiology, but it also carries inherent pitfalls and biases. Widespread use of AI-based intelligent and autonomous systems in radiology can increase the risk of systemic errors with high consequence and highlights complex ethical and societal issues. Currently, there is little experience using AI for patient care in diverse clinical settings. Extensive research is needed to understand how to best deploy AI in clinical practice. This statement highlights our consensus that ethical use of AI in radiology should promote well-being, minimize harm, and ensure that the benefits and harms are distributed among stakeholders in a just manner. We believe AI should respect human rights and freedoms, including dignity and privacy. It should be designed for maximum transparency and dependability. Ultimate responsibility and accountability for AI remains with its human designers and operators for the foreseeable future. The radiology community should start now to develop codes of ethics and practice for AI that promote any use that helps patients and the common good and should block use of radiology data and algorithms for financial gain without those two attributes.


Assuntos
Inteligência Artificial/ética , Radiologia/ética , Canadá , Consenso , Europa (Continente) , Humanos , Radiologistas/ética , Sociedades Médicas , Estados Unidos
2.
Br J Radiol ; 92(1104): 20181055, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31596129

RESUMO

OBJECTIVE: We proposed to determine whether the performance of inexperienced radiologists in determining extramural vascular invasion (EMVI) in rectal cancer on MRI can be promoted by means of targeted training. METHODS: 230 rectal cancer patients who underwent pre-operative chemoradiotherapy were included. Pre-therapy and post-therapy MR images and pathology EMVI evaluation were available for cases. 230 cases were randomly divided into 150 training cases and 80 testing cases, including 40 testing case A and 40 testing case B. Four radiologists were included for MRI EMVI evaluation, who were divided into targeted training group and non-targeted training group. The two groups evaluated testing case A at baseline, 3 month and 6 month, evaluated testing case B at 6 month. The main outcome was agreement with expert-reference for pre-therapy and post-therapy evaluation, the other outcome was accuracy with pathology for post-therapy evaluation. RESULTS: After 6 months of training, targeted training group showed statistically higher agreement with expert-reference than non-targeted training group for both pre-therapy and post-therapy MRI EMVI evaluation of testing case A and testing case B, all p < 0.05. Targeted training group also showed significantly higher accuracy with pathology than non-targeted training group for post-therapy evaluation of testing case A and testing case B after 6 months of training, all p < 0.05. CONCLUSION: The diagnostic performance for MRI EMVI evaluation could be promoted by targeted training for inexperienced radiologist. ADVANCES IN KNOWLEDGE: This study provided the first evidence that after 6 month targeted training, inexperienced radiologists demonstrated improved diagnostic performance, with a 20% increase in agreement with expert-reference for both pre-therapy and post-therapy MRI EMVI evaluation and also a 20% increase in or accuracy with pathology for post-therapy evaluation, while inexperienced radiologists could not gain obvious improvement in MRI EMVI evaluation through the same period of regular clinical practice. It indicated that targeted training may be necessary for helping inexperienced radiologist to acquire adequate experience for the MRI EMVI evaluation of rectal cancer, especially for radiologist who works in a medical unit where MRI EMVI diagnosis is uncommon.


Assuntos
Competência Clínica , Imagem por Ressonância Magnética , Radiologistas/educação , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Vasos Sanguíneos/diagnóstico por imagem , Vasos Sanguíneos/patologia , Quimiorradioterapia , Consenso , Endotélio Vascular/diagnóstico por imagem , Endotélio Vascular/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Variações Dependentes do Observador , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Radiologistas/normas , Distribuição Aleatória , Neoplasias Retais/irrigação sanguínea , Neoplasias Retais/terapia , Padrões de Referência , Estudos Retrospectivos , Fatores de Tempo
3.
Can Assoc Radiol J ; 70(4): 337-343, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31561924

RESUMO

PURPOSE: To determine medical students' and radiologists' attitude toward radiology electives at a distributed medical school and identify specific areas for improvement. METHODS: During a single academic year, both students and faculty preceptors were surveyed anonymously following a senior radiology elective. The survey was based on an established theoretical framework for studying the educational environment which takes into account domains: (1) goal orientation, (2) organization/regulation, and (3) relationships. Mann-Whitney tests were performed to determine if there was any difference between the overall satisfaction of students and preceptors, responses from the different elective sites and students' ratings of the domains. Statistical significance was set at P < .05. Thematic analysis was performed on the narrative comments to identify specific challenges. RESULTS: The response rate was 82.0% for students (95/116) and 19.5% (31/159) for radiologists. There was no difference in responses based on elective site. Overall, the elective was viewed positively by both groups however students rated their experience as significantly better than their preceptors (P = .0012). Students viewed the relationships domain more positively than both the other two (goal orientation, P = .0001; organization/regulation, P = .0038). Thematic analysis identified that the student challenges were lack of autonomy, structured teaching, and preceptor continuity and the preceptor challenges were ambiguous learning objectives/expectations and insufficient resources. CONCLUSIONS: The radiology elective challenges identified in this study provide educators with specific areas to target when updating radiology electives. A better elective experience may improve students' radiology knowledge and attitude towards the specialty as well as radiologists' interest in teaching.


Assuntos
Educação de Graduação em Medicina , Radiologistas/psicologia , Radiologia/educação , Estudantes de Medicina/psicologia , Adulto , Feminino , Humanos , Masculino
4.
Br J Radiol ; 92(1104): 20190663, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31559859

RESUMO

OBJECTIVES: To assess whether NHS breast screening programme (NHSBSP) mammogram readers could effectively interpret first post-contrast acquisition subtracted (FAST) MRI, for intended use in screening for breast cancer. METHODS: Eight NHSBSP mammogram readers from a single centre (four who also read breast MRI (Group 1) and four who do not (Group 2)) were given structured FAST MRI reader training (median 4 h: 32 min). They then prospectively interpreted 125 FAST MRIs (250 breasts: 194 normal and 56 cancer) comprising a consecutive series of screening MRIs enriched with additional cancer cases from 2015, providing 2000 interpretations. Readers were blinded to other readers' opinions and to clinical information. Categorisation followed the NHSBSP MRI reporting categorisation, with categories 4 and 5 considered indicative of cancer. Diagnostic accuracy (reference standard: histology or 2 years' follow-up) and agreement between readers were determined. RESULTS: The accuracy achieved by Group 2 (847/1000 (85%; 95% confidence interval (CI) 82-87%)) was 5% less than that of Group 1 (898/1000 (90%; 95% CI 88-92)). Good inter-reader agreement was seen between both Group 1 readers (κ = 0.66; 95% CI 0.61-0.71) and Group 2 readers (κ = 0.63; 95% CI 0.58-0.68). The median time taken to interpret each FAST MRI was Group 1: 34 s (range 3-351) and Group 2: 77 s (range 11-321). CONCLUSION: Brief structured training enabled multiprofessional mammogram readers to achieve similar accuracy at FAST MRI interpretation to consultant radiologists experienced at breast MRI interpretation. ADVANCES IN KNOWLEDGE: FAST MRI could be feasible from a training-the-workforce perspective for screening within NHSBSP.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Confiabilidade dos Dados , Imagem por Ressonância Magnética/métodos , Mamografia , Radiologistas/educação , Intervalos de Confiança , Meios de Contraste , Feminino , Humanos , Estudos Prospectivos , Padrões de Referência , Sensibilidade e Especificidade , Fatores de Tempo
5.
Radiologe ; 59(10): 906-911, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31444511

RESUMO

CONTEXT: Although in recent times more research has been done on interactions of metallic dental objects in magnetic resonance imaging (MRI), radiologists are often uncertain whether the objects should be removed or can be retained prior to an impending examination. On the one hand, they want to avoid unnecessary material removal which is associated with costs and potential damage of the dental object. On the other hand, they fear material-induced susceptibility artefacts will impair the diagnostic workup so that examinations will have to be repeated. The lack of information complicates adequate decision making for radiologists. AIM: The aim of this survey was to evaluate the information that is currently available to radiologists regarding orthodontic appliances of the head and neck region in the MRI and determine how to handle these situations in a radiologist's every day routine. Therefore, this study can reveal the need for further research. MATERIALS AND METHODS: The questionnaire was published in the 9/2017 issue of the journal Der Radiologe and sent as an electronic version by the BDR (Professional Association of German Radiologists) to their approximately 1800 members. In addition, the radiological institutes of 55 German university and maximum care clinics were contacted. RESULTS: In all, 74 evaluable responses were received within a period of 16 weeks, representing a response rate of 3.7%. Altogether, the participants rate the risks of a detachment or heating of orthodontic appliances as too high. The interviewed radiologists categorize the available data as insufficient and they almost unanimously (97.3%) demand a declaration requirement for the manufacturers. There is a clear need for further education (78.3%). Intraoral measurement of the magnetic permeability is considered as a useful tool to determine possible interactions with the MRI by 40.5%.


Assuntos
Imagem por Ressonância Magnética , Metais , Próteses e Implantes , Artefatos , Cabeça/diagnóstico por imagem , Humanos , Pescoço/diagnóstico por imagem , Radiologistas , Inquéritos e Questionários
6.
Orv Hetil ; 160(35): 1395-1402, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31448642

RESUMO

The incidence of endometriosis, including atypical forms of the disease, has been continuously growing, thus increasingly challenging for the imaging specialists as well. We conducted a retrospective study to analyze the results of ultrasound-guided interventions between 2016 and 2018. All interventions were performed in female patients due to uncertain abdominal wall lesions at the University of Szeged, Hungary. The abdominal wall lesions were incidentally detected, one by CT, the others by ultrasound examinations. We identified 12 cases during the study period. The average age of the patients was 59 years (29-79), 8 of them had abdominal surgery in their medical history. The mean diameter of the masses was 34.4 mm (20-49 mm). Since the indication of imaging examinations was the evaluation of a known or suspected malignancy, four patients had undergone an MRI prior to the biopsy. In addition, ultrasound-guided biopsy was not performed in another two patients, and the diagnosis was established by histological examination of the surgically removed specimens. The histological examination revealed malignant primary serous epithelial tumor in one case, metastases in six cases, endometriosis in six patients and abdominal wall abscess was found in one patient. Endometriosis was more frequent in the younger patients. The likelihood of endometriosis as a cause of abdominal wall lesions of younger, premenopausal female patients is rather high, especially with obstetrical or gynaecological operations in the medical history. Ultrasound plays a primary role in the detection and therapy planning of these lesions. Orv Hetil. 2019; 160(35): 1395-1403.


Assuntos
Parede Abdominal/diagnóstico por imagem , Endometriose/diagnóstico por imagem , Parede Abdominal/patologia , Adulto , Idoso , Biópsia , Endometriose/patologia , Feminino , Humanos , Hungria , Pessoa de Meia-Idade , Radiologistas , Estudos Retrospectivos , Ultrassonografia
9.
Radiologe ; 59(9): 791-798, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31410495

RESUMO

BACKGROUND: The radical resection of colorectal liver metastases is the only curative option for affected patients. If properly performed, surgery provides the chance of long-term tumor-free survival. OBJECTIVE: Summary of the critical interaction points between radiology and surgery in the planning and performance of (complex) liver resections. RESULTS: There are many interaction points between radiology and surgery in the treatment of patients with colorectal liver metastases. Radiology supports surgery by providing detailed information of the localization of metastases, information on liver inflow and outflow as well as basic information on liver quality and function. Perioperatively, it provides interventional treatment options for postoperative complications as well as ablation of non-resectable metastases. CONCLUSION: Complex liver resections can only be performed properly and successfully after thorough planning by an interdisciplinary board of surgeons, radiologists and associated disciplines.


Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Hepatectomia , Humanos , Neoplasias Hepáticas/cirurgia , Radiologistas
10.
Medicine (Baltimore) ; 98(32): e16379, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393347

RESUMO

BACKGROUND: More and more automated efficient ultrasound image analysis techniques, such as ultrasound-based computer-aided diagnosis system (CAD), were developed to obtain accurate, reproducible, and more objective diagnosis results for thyroid nodules. So far, whether the diagnostic performance of existing CAD systems can reach the diagnostic level of experienced radiologists is still controversial. The aim of the meta-analysis was to evaluate the accuracy of CAD for thyroid nodules' diagnosis by reviewing current literatures and summarizing the research status. METHODS: A detailed literature search on PubMed, Embase, and Cochrane Libraries for articles published until December 2018 was carried out. The diagnostic performances of CAD systems vs radiologist were evaluated by meta-analysis. We determined the sensitivity and the specificity across studies, calculated positive and negative likelihood ratios and constructed summary receiver-operating characteristic (SROC) curves. Meta-analysis of studies was performed using a mixed-effect, hierarchical logistic regression model. RESULTS: Five studies with 536 patients and 723 thyroid nodules were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) for CAD system were 0.87 (95% confidence interval [CI], 0.73-0.94), 0.79 (95% CI 0.63-0.89), 4.1 (95% CI 2.5-6.9), 0.17 (95% CI 0.09-0.32), and 25 (95% CI 15-42), respectively. The SROC curve indicated that the area under the curve was 0.90 (95% CI 0.87-0.92). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR for experienced radiologists were 0.82 (95% CI 0.69-0.91), 0.83 (95% CI 0.76-0.89), 4.9 (95% CI 3.4-7.0), 0.22 (95% CI 0.12-0.38), and 23 (95% CI 11-46), respectively. The SROC curve indicated that the area under the curve was 0.96 (95% CI 0.94-0.97). CONCLUSION: The sensitivity of the CAD system in the diagnosis of thyroid nodules was similar to that of experienced radiologists. However, the CAD system had lower specificity and DOR than experienced radiologists. The CAD system may play the potential role as a decision-making assistant alongside radiologists in the thyroid nodules' diagnosis. Future technical improvements would be helpful to increase the accuracy as well as diagnostic efficiency.


Assuntos
Diagnóstico por Computador/métodos , Diagnóstico por Computador/normas , Radiologistas/normas , Nódulo da Glândula Tireoide/diagnóstico , Inteligência Artificial , Diagnóstico Diferencial , Humanos , Curva ROC , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia
12.
Br J Radiol ; 92(1102): 20190057, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287719

RESUMO

Breast cancer is the most common cancer among females worldwide and large volumes of breast images are produced and interpreted annually. As long as radiologists interpret these images, the diagnostic accuracy will be limited by human factors and both false-positive and false-negative errors might occur. By understanding visual search in breast images, we may be able to identify causes of diagnostic errors, find ways to reduce them, and also provide a better education to radiology residents. Many visual search studies in breast radiology have been devoted to mammography. These studies showed that 70% of missed lesions on mammograms attract radiologists' visual attention and that a plethora of different reasons, such as satisfaction of search, incorrect background sampling, and incorrect first impression can cause diagnostic errors in the interpretation of mammograms. Recently, highly accurate tools, which rely on both eye-tracking data and the content of the mammogram, have been proposed to provide feedback to the radiologists. Improving these tools and determining the optimal pathway to integrate them in the radiology workflow could be a possible line of future research. Moreover, in the past few years deep learning has led to improving diagnostic accuracy of computerized diagnostic tools and visual search studies will be required to understand how radiologists interact with the prompts from these tools, and to identify the best way to utilize them. Visual search in other breast imaging modalities, such as breast ultrasound and digital breast tomosynthesis, have so far received less attention, probably due to associated complexities of eye-tracking monitoring and analysing the data. For example, in digital breast tomosynthesis, scrolling through the image results in longer trials, adds a new factor to the study's complexity and makes calculation of gaze parameters more difficult. However, considering the wide utilization of three-dimensional imaging modalities, more visual search studies involving reading stack-view examinations are required in the future. To conclude, in the past few decades visual search studies provided extensive understanding about underlying reasons for diagnostic errors in breast radiology and characterized differences between experts' and novices' visual search patterns. Further visual search studies are required to investigate radiologists' interaction with relatively newer imaging modalities and artificial intelligence tools.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Erros de Diagnóstico , Reconhecimento Visual de Modelos/fisiologia , Radiologistas , Atenção/fisiologia , Aprendizado Profundo , Diagnóstico por Computador/métodos , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Mamografia/métodos , Pesquisa , Ultrassonografia Mamária/métodos
13.
Can Assoc Radiol J ; 70(3): 226-232, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255393

RESUMO

In 2017, the Canadian Association of Radiologists issued a clinical practice guideline (CPG) regarding the use of gadolinium-based contrast agents (GBCAs) in patients with acute kidney injury (AKI), chronic kidney disease (CKD), or on dialysis due to mounting evidence indicating that nephrogenic systemic fibrosis (NSF) occurs with extreme rarity or not at all when using Group II GBCAs or the Group III GBCA gadoxetic acid (compared to first generation Group I linear GBCAs). One of the goals of the work group was to re-evaluate the CPG after 24 months to determine the effect of more liberal use of GBCA on reported cases of NSF in patients with AKI, CKD Stage 4 or 5 (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m2), or those that are dialysis-dependent. A comprehensive review of the literature was conducted by a subcommittee of the initial CPG panel between the dates of January 1, 2017-December 31, 2018 to identify new unconfounded cases of NSF linked to Group II or Group III GBCAs and an updated CPG developed. To our knowledge, when using a Group II or Group III GBCA between 2017-2018, only a single unconfounded case report of a fibrosing dermopathy has been reported in a patient who received gadobenate dimeglumine with Stage 2 CKD. No other unconfounded cases of NSF have been reported with Group II or III agents in during this timeframe. The subcommittee concluded that the main recommendations from the 2017 CPG should remain unaltered, but agreed that screening for renal disease in the outpatient setting is no longer justifiable, cost-effective or recommended. Patients on hemodialysis (HD) should, however, be identified prior to GBCA administration to arrange timely HD to optimize gadolinium clearance, although there remains no evidence that HD reduces the risk of NSF. When administering Group II or III GBCAs to patients with AKI, on dialysis or with severe CKD, informed consent relating to NSF is also no longer explicitly recommended.


Assuntos
Meios de Contraste , Gadolínio , Aumento da Imagem/métodos , Nefropatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Canadá , Humanos , Rim/diagnóstico por imagem , Radiologistas , Sociedades Médicas
14.
Can Assoc Radiol J ; 70(3): 292-299, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31300314

RESUMO

Medical professional liability (MPL), also commonly referred to as medical malpractice, is a costly issue in health care today, accounting for roughly 2.4% of total health care expenditure in the United States. Almost all physicians currently in clinical practice will either be subject to a lawsuit themselves or work with someone who has. Given a lack of formal structured education about MPL in medicine for trainees, this review aims to define and discuss the relevant concepts in MPL as a reference for early career interventionalists to understand the current medicolegal environment and learn best practices to avoid litigation.


Assuntos
Responsabilidade Legal , Imperícia/legislação & jurisprudência , Radiologistas/legislação & jurisprudência , Radiologia Intervencionista/legislação & jurisprudência , Humanos
15.
Bull Cancer ; 106(11): 1000-1007, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31351573

RESUMO

INTRODUCTION: Microinvasive in situ ductal carcinomas of the breast are rare and of good prognosis. They are grouped with early stage invasive carcinomas in the TNM 2017 classification. This study assessed practitioners' treatment decisions and their justifications in comparison to the literature. MATERIALS AND METHODS: Three clinical cases were evaluated by anonymous forms regarding sentinel node decisions, tumour bed boost irradiation and hormone therapy. RESULTS: Sentinel lymph node was performed by 93.1%, 100% and 44.4% of the practitioners respectively. Radiation boost was a treatment option chosen by 62.1% and 61.1% of practitioners in both clinical cases. Hormone therapy was advocated for 65.5%, 94.7% and 50.0% patients depending on the clinical case. CONCLUSION: The therapeutic attitude proposed in microinvasive breast carcinomas was heterogeneous in this study, reflecting the absence of specific recommendations. In view of the existing literature, it is not currently possible to propose recommendations for these three therapeutic options. Prospective cohorts and meta-analyses of the microinvasive subgroup could provide answers.


Assuntos
Neoplasias da Mama/terapia , Carcinoma Intraductal não Infiltrante/terapia , Tomada de Decisão Clínica , Biópsia de Linfonodo Sentinela/estatística & dados numéricos , Adulto , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Mastectomia/estatística & dados numéricos , Pessoa de Meia-Idade , Invasividade Neoplásica , Oncologistas/estatística & dados numéricos , Prognóstico , Radiologistas/estatística & dados numéricos , Radioterapia Adjuvante/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos
16.
West J Emerg Med ; 20(4): 626-632, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31316702

RESUMO

Introduction: In many hospitals, off-hours emergency department (ED) radiographs are not read by a radiologist until the following morning and are instead interpreted by the emergency physician (EP) at the time of service. Studies have found conflicting results regarding the radiographic interpretation discrepancies between EPs and trained radiologists. The aim of this study was to identify the number of radiologic interpretation discrepancies between EPs and radiologists in a community ED setting. Methods: Using a pre-existing logbook of radiologic discrepancies as well as our institution's picture archiving and communication system, all off-hours interpretation discrepancies between January 2012 and January 2015 were reviewed and recorded in a de-identified fashion. We recorded the type of radiograph obtained for each patient. Discrepancy grades were recorded based on a pre-existing 1-4 scale defined in the institution's protocol logbook as Grade 1 (no further action needed); Grade 2 (call to the patient or pharmacy); Grade 3 (return to ED for further treatment, e.g., fracture not splinted); Grade 4 (return to ED for serious risk, e.g., pneumothorax, bowel obstruction). We also recorded the total number of radiographs formally interpreted by EPs during the prescribed time-frame to determine overall agreement between EPs and radiologists. Results: There were 1044 discrepancies out of 16,111 EP reads, indicating 93.5% agreement. Patients averaged 48.4 ± 25.0 years of age and 53.3% were female; 25.1% were over-calls by EPs. The majority of discrepancies were minor with 75.8% Grade 1 and 22.3% Grade 2. Only 1.7% were Grade 3, which required return to the ED for further treatment. A small number of discrepancies, 0.2%, were Grade 4. Grade 4 discrepancies accounted for two of the 16,111 total reads, equivalent to 0.01%. A slight disagreement in finding between EP and radiologist accounted for 8.3% of discrepancies. Conclusion: Results suggest that plain radiographic studies can be interpreted by EPs with a very low incidence of clinically significant discrepancies when compared to the radiologist interpretation. Due to rare though significant discrepancies, radiologist interpretation should be performed when available. Further studies are needed to determine the generalizability of this study to EDs with differing volume, patient population, acuity, and physician training.


Assuntos
Erros de Diagnóstico , Serviço Hospitalar de Emergência , Médicos , Radiografia , Radiologistas , Competência Clínica , Feminino , Hospitais Comunitários , Humanos , Masculino , Pessoa de Meia-Idade
17.
Radiologe ; 59(8): 684-691, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31168772

RESUMO

CLINICAL ISSUE: Today's advanced MRI imaging allows for a precise diagnosis and thus better treatment planning of cartilage damage. The phrase "depending on intraoperative findings" is therefore slowly becoming a thing of the past. However, this also increases the demand for an exact interpretation of the imaging, from clinicians and patients alike. This article highlights the importance of a radiologist's role in different constellations. PRACTICAL RECOMMENDATIONS: In the case of acute injuries, it is crucial to recognize osteochondral flakes, cartilage delamination, subchondral bone bruising and fractures as well as concomitant injuries. These findings must be instantly communicated to the practitioner. In the case of chronic cartilage damage, grading the extent and size of the damage is decisive in choosing the appropriate therapy method. Possible causes and accompanying injuries must also be analyzed and, if necessary, addressed. Direct communication with the clinical colleague is also useful in correlating the clinical and radiological findings.


Assuntos
Doenças das Cartilagens , Cartilagem Articular , Fraturas Ósseas , Doenças das Cartilagens/diagnóstico por imagem , Doenças das Cartilagens/fisiopatologia , Cartilagem Articular/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Radiologistas
18.
Radiology ; 291(3): 708-709, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31066625
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