Wadhwa Vibhor, Weissman Eric, Hayashi Daichi, Xi Yin, Chhabra Avneesh
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
BMC Musculoskelet Disord. 2017 Dec 15;18(1):530. doi: 10.1186/s12891-017-1876-7.
Majority of musculoskeletal cross-sectional imaging requests have a non-revealing and non-specific clinical history of pain. However, the location of pain is very relevant towards arriving at a specific orthopedic diagnosis. The purpose of this research was to study the impact of skin marker placement and training of technologists prior to knee MRI in detection of clinically important findings.
Total 200 consecutive left knee MRIs were evaluated before and after technologist training with regards to marker placement at the site of clinical symptoms or palpable finding. Marker location in relation to the knee was recorded and important findings were classified as correlated important finding, non-correlated important finding, other compartment important finding in non-correlated cases, and diffuse abnormality, i.e. tri-compartmental cartilage defects in both correlated and non-correlated cases. Differences among scans before and after technologist training were analyzed.
The marker placement was observed in higher proportion of patients in post-training scans (78% vs 60%, p = 0.00). The most common location of the marker was in anterior or anterolateral knee (32% and 34% cases, respectively). The marker-important finding correlation was also higher post training, but not statistically significant (53% versus 38%, p = 0.57). Important findings correlated with the marker in more than 50% of the scans in the post-training set.
Marker placement can aid in detection of clinically important imaging finding and technologist training aids in increased rates of marker placement and improved correlation.
大多数肌肉骨骼横断面成像检查的临床病史无明显特征且不具特异性。然而，疼痛部位对于做出具体的骨科诊断非常重要。本研究的目的是探讨在膝关节磁共振成像（MRI）检查前皮肤标记放置以及技术人员培训对检测临床重要发现的影响。
对连续200例左膝关节MRI检查进行评估，在技术人员接受关于在临床症状部位或可触及发现处放置标记的培训前后各进行一次评估。记录标记相对于膝关节的位置，并将重要发现分类为相关重要发现、不相关重要发现、不相关病例中的其他关节间室重要发现以及弥漫性异常，即在相关和不相关病例中的三关节间室软骨缺损。分析技术人员培训前后扫描结果的差异。
在培训后的扫描中，观察到更多患者放置了标记（78%对60%，p = 0.00）。标记最常见的位置是在膝关节前方或前外侧（分别为32%和34%的病例）。培训后标记与重要发现的相关性也更高，但无统计学意义（53%对38%，p = 0.57）。在培训后组中，超过50%的扫描中重要发现与标记相关。
标记放置有助于检测临床重要的影像学发现，技术人员培训有助于提高标记放置率并改善相关性。
