Geijer Mats, Ivarsson Liz, Göthlin Jan H
Center for Medical Imaging and Physiology, Lund University and Skåne University Hospital, 221 85 Lund, Sweden.
Radiol Res Pract. 2012;2012:862198. doi: 10.1155/2012/862198. Epub 2012 Dec 20.
Objective. Between one-third and half of all radiology examinations worldwide are probably chest studies. The aim of the current study was to retrospectively evaluate the clinical influence of chest radiography. Methods. In a tertiary referral hospital, 939 consecutive daytime chest radiography examinations were evaluated. The outcome was classified as normal, incidental, or pathologic. The referring physician's reaction to radiologic outcome was classified as highly expected, moderately expected, or unexpected. The influence on the patients' treatment was divided into four groups from major to no influence. Results. In all, 71.6% of the studies had a highly expected outcome. Moderately expected or unexpected outcomes were noted in 36.6% of 500 pathologic examinations. Unexpected outcome was noted in 11.6% of all studies. The radiologic outcome influenced treatment in 65.4% of patients where pathology was demonstrated. Patients with normal or incidental findings had treatment influenced in 1/3 of the cases. Unexpected findings influenced treatment more than moderately expected findings. When radiological findings were highly expected, treatment was influenced in less than half of the cases. Surprisingly few chest radiology examinations were commented upon in the medical records.
目的。全球范围内所有放射学检查中，大概三分之一到一半是胸部检查。本研究的目的是回顾性评估胸部X线摄影的临床影响。方法。在一家三级转诊医院，对939例连续的日间胸部X线摄影检查进行评估。结果分为正常、偶然发现或病理性。转诊医生对放射学结果的反应分为高度预期、中度预期或意外。对患者治疗的影响分为从重大影响到无影响的四组。结果。总体而言，71.6%的检查结果为高度预期。在500例病理性检查中，36.6%的结果为中度预期或意外。在所有检查中，11.6%的结果为意外。在65.4%有病理表现的患者中，放射学结果影响了治疗。正常或偶然发现的患者中，三分之一的病例治疗受到影响。意外发现比中度预期发现对治疗的影响更大。当放射学结果为高度预期时，不到一半的病例治疗受到影响。令人惊讶的是，病历中对胸部放射学检查的评论很少。
