Optimising neuroimaging effectiveness in a district general hospital
| Autor: | McCarron P, Wade C, McCarron Mo |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology Neuroimaging Neuroradiologist Hospitals General Education medicine Humans Medical diagnosis General hospital Observer Variation Hippocampal sclerosis medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine Middle Aged medicine.disease Hospitals District Magnetic Resonance Imaging United Kingdom Neuroradiography Female Radiology Abnormality Nervous System Diseases business Tomography X-Ray Computed |
| Zdroj: | The journal of the Royal College of Physicians of Edinburgh. 44(1) |
| ISSN: | 2042-8189 |
| Popis: | Background: Diagnostic accuracy in neurology frequently depends on clinical assessment and neuroimaging interpretation. We assessed neuroimaging discrepancy rates in reported findings between general radiologists and neuroradiologists among patients from a district general hospital (DGH). Methods: A neuroradiologist’s report was sought on selected DGH patients over 28 months. Pre-planned outcomes included comparisons of primary findings (main diagnosis or abnormality), secondary findings (differential diagnoses and incidental findings) and advice from neuroradiologists for further investigations. Results: A total of 233 patients (119 men and 114 women), mean age 47.2 (SD 17.8) years were studied: 43 had a computed tomography (CT) brain scan only, 37 had CT and magnetic resonance imaging (MRI) scans and 153 had only MRI scans. Discrepancies in the primary diagnosis/abnormality were identified in 33 patients (14.2%). This included 7 of 43 patients (16.3%) who had a CT brain scan as their only neuroimaging. Secondary outcomes differed in 50 patients (21.5%). Neuroradiologists recommended further neuroimaging for 29 patients (12.4%). The most common discrepancies in the primary diagnosis/abnormality were misinterpreting normal for hippocampal sclerosis and missed posterior fossa lesions. There was no evidence of temporal changes in discrepancy rates. Conclusions: Selecting CT and MR neuroimaging studies from general hospitals for reviewing by neuroradiologists is an important and effective way of optimising management of neurological patients. |
| Databáze: | OpenAIRE |
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