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腹部和盆腔计算机断层扫描(CT)解读:经验丰富的放射科医生之间的差异率。

Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists.

机构信息

Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

出版信息

Eur Radiol. 2010 Aug;20(8):1952-7. doi: 10.1007/s00330-010-1763-1. Epub 2010 Mar 25.

Abstract

OBJECTIVE

To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists.

METHODS

Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated.

RESULTS

CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation.

CONCLUSIONS

Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations.

摘要

目的

评估经验丰富的放射科医生在解读腹部和盆腔 CT 检查结果方面的解释差异率。

方法

从放射学数据库中随机抽取三位擅长腹部成像的经验丰富的放射科医生报告的 90 例腹部和盆腔 CT 检查。这些放射科医生在不知道先前解释的情况下,要求重新解释 60 次检查:其中 30 次是他们先前的解释,30 次是由其他人解释的。根据三级评分系统评估初始和重复解释之间的差异程度:无差异、轻微差异或主要差异。评估了读者间和读者内的差异率和原因。

结果

调查中包括的 CT 检查是为以下适应证对 90 名患者(男 43 名,平均年龄 59 岁,标准差 14 岁,范围 19-88 岁)进行的:恶性肿瘤的随访/评估(69/90,77%)、胰腺炎(5/90,6%)、尿路结石(4/90,4%)或其他(12/90,13%)。观察者间和观察者内的主要差异率分别为 26%和 32%。主要差异是由于漏诊、对有临床意义的发现的间隔变化的不同意见以及存在推荐建议。

结论

在解读腹部和盆腔 CT 检查结果方面,观察到 26%至 32%的主要差异。

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