Nordgren Rogberg Anna, Nyrén Sven, Westerlund Eli, Lindholm Peter
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Thoracic Radiology, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden.
Acta Radiol Open. 2017 Sep 27;6(9):2058460117734244. doi: 10.1177/2058460117734244. eCollection 2017 Sep.
In recent years, magnetic resonance imaging (MRI) has been suggested as an alternative to computed tomography angiography (CTA) to diagnose pulmonary embolism (PE). In previous studies, only senior radiologists have been evaluated as reviewers.
To investigate if radiology residents can be trained to review MRI regarding PE and to determine the learning curve effects.
Four residents independently went through a training program consisting of 70 participants that had undergone steady-state free precession MRI. The individuals were randomized into ten training sessions. For each exam, the review time and presence or absence of embolus was recorded. After completing each session, the residents received feedback on diagnostic accuracy compared to a consensus reading by two specialists. The residents were also presented with the corresponding CTA.
The review time was nearly halved ( = 0.0002) during the training program. Comparing the first three sessions with the last three sessions for all residents, the review time decreased from 5:22 min to 2:51 min. The inter-reader agreement improved for all residents during the training program reaching a clinically acceptable level after seven sessions.
Our study suggests that radiology residents can be trained to independently review MRI investigations regarding PE within a short training program. Similar training programs could be more extensively used as effective teaching method for residents.
近年来，磁共振成像（MRI）已被提议作为计算机断层扫描血管造影（CTA）的替代方法用于诊断肺栓塞（PE）。在以往的研究中，仅评估了资深放射科医生作为阅片者。
研究放射科住院医师是否可以接受培训以对关于PE的MRI进行阅片，并确定学习曲线效应。
四名住院医师独立完成了一个培训项目，该项目包含70名接受了稳态自由进动MRI检查的参与者。这些个体被随机分为十个培训组。对于每次检查，记录阅片时间以及是否存在栓子。在完成每组培训后，将住院医师的诊断准确性与两名专家的一致读片结果进行比较，并给予他们反馈。同时也向住院医师展示了相应的CTA。
在培训项目期间，阅片时间几乎减半（P = 0.0002）。将所有住院医师的前三组培训与后三组培训进行比较，阅片时间从5分22秒降至2分51秒。在培训项目期间，所有住院医师的阅片者间一致性得到改善，七组培训后达到了临床可接受水平。
我们的研究表明，放射科住院医师可以在短时间培训项目中接受培训，以独立对关于PE的MRI检查进行阅片。类似的培训项目可以更广泛地用作住院医师的有效教学方法。
