Computed Tomography Pulmonary Angiography: An Assessment of the Radiology Report
Computed Tomography Pulmonary Angiography: An Assessment of the Radiology Report
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DOI：
10.1016/j.acra.2009.06.012
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发表时间：
2009-11-01
影响因子：
4.8
通讯作者：
Shepard, Jo-Anne O.
中科院分区：
文献类型：
--
作者：
Abujudeh, Hani H.;Kaewlai, Rathachai;Shepard, Jo-Anne O.
理据和目标。本研究的目的是评估CT肺血管造影术(CTPA)放射学报告中的不确定度，其表现为对报告的局限性和图像质量的描述。回顾了2004-2006年间CTPA报告中的患者人口统计数据(年龄、性别、怀孕状态)、放射科医生数据(多年经验、专科、主治医师与住院医师的最终口述)、肺血栓(PE)的存在以及描述检查质量和局限性的关键词。CTPA报告2151份。CTPA在影像部分的报告类型如下：(1)PE阳性(10%)，(2)PE阴性(29%)，(3)节段动脉PE阴性(27%)，(4)PE阴性(21%)，(5)PE阴性但不理想的检查(8%)，(6)非诊断性检查(5%)。在最后三种类型中，有七种PE最初没有被诊断出来，但在随后的影像检查中被发现。图像质量的限制、呼吸运动伪影和对比度增强是最常被提及的图像质量限制(分别占所有报告的62%和28%)。如果放射科医生是胸部放射科专科医生，有10年的工作经验，或独立工作(P<；.001)，他们倾向于报告图像质量方面的局限性。不同的CTPA报告模式因放射科医师的专科、经验以及他们是独立工作还是与住院医师一起工作而有所不同。关于体育存在的某些措辞可能错误地暗示在有限的检查中体育是否定的。
Rationale and Objective. The aim of this study was to evaluate the uncertainty in computed tomographic pulmonary angiography (CTPA) radiology reports, manifested by descriptions of report limitations and image quality.Materials and Methods. CTPA reports between 2004 and 2006 were reviewed for patient demographic data (age, gender, pregnancy state), radiologist data (years of experience, subspecialty, final dictation by an attending radiologist vs a resident being present and dictating the report), the presence of pulmonary embolism (PE), and key words describing examination quality and limitations.Results. There were 2151 CTPA reports. Patterns of reporting CTPA in the impression sections of radiology reports were as follows: (1) PE conclusively positive (10%), (2) PE conclusively negative (29%), (3) PE negative to segmental arteries (27%), (4) PE negative to central Pulmonary arteries (21%), (5) PE negative but suboptimal examination (8%), and (6) nondiagnostic examination (5%). Among the last three categories, seven PEs were not initially diagnosed but were found on subsequent imaging examinations. Limitations in image quality, respiratory motion artifact, and contrast enhancement were most frequently mentioned as limitations in image quality (62% and 28% of all reports, respectively). Radiologists tended to report limitations in image quality if they were thoracic radiology subspecialists, had >10 years of experience, or worked independently (P < .001).Conclusion. Different patterns of reporting CTPA exist and vary on the basis of individual radiologists' subspecialties, experience, and whether they work independently or with residents. Certain wording regarding the presence of PE may falsely imply negativity of PE in a limited examination.