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解读腹部和盆腔计算机断层扫描时常见的住院医师错误:类型、陷阱及改进策略综述

Common Resident Errors When Interpreting Computed Tomography of the Abdomen and Pelvis: A Review of Types, Pitfalls, and Strategies for Improvement.

作者信息

Wildman-Tobriner Benjamin, Allen Brian C, Maxfield Charles M

机构信息

Department of Radiology, Duke University Hospital, Durham, NC.

Department of Radiology, Duke University Hospital, Durham, NC.

出版信息

Curr Probl Diagn Radiol. 2019 Jan;48(1):4-9. doi: 10.1067/j.cpradiol.2017.12.010. Epub 2018 Jan 6.

Abstract

OBJECTIVE

The purpose of this study was to identify common errors that radiology residents make when interpreting abdominopelvic (AP) computed tomography (CT) while on call, to review the typical imaging findings of these cases, and to discuss strategies for improvement.

MATERIALS AND METHODS

AP (or chest, abdomen, pelvis) CTs from 518 weekend senior call shifts (R3 or R4) were retrospectively reviewed. Discrepancies between preliminary and final reports were identified and then rated by whether the miss could impact short-term management. The imaging findings from the cases were reviewed.

RESULTS

A total of 4695 CTs were reviewed, revealing a total of 145 discrepancies that could affect short-term clinical management (miss rate 3.1%). The most common misses were related to blood clots (13.8%), colitis (8.3%), misplaced lines or tubes (6.9%), or pyelonephritis (5.5%). Common pitfalls and strategies from improved detection are discussed using image examples.

CONCLUSIONS

Through increased attention to the vasculature, colon, devices, and kidneys, trainees may improve their discrepancy rates and improve on-call reporting.

摘要

目的

本研究旨在确定放射科住院医师在值班时解读腹部盆腔计算机断层扫描(CT)时常见的错误,回顾这些病例的典型影像学表现,并讨论改进策略。

材料与方法

回顾性分析518次周末高级值班(R3或R4)期间的腹部盆腔(或胸部、腹部、盆腔)CT。确定初步报告和最终报告之间的差异,然后根据漏诊是否会影响短期管理进行评级。回顾这些病例的影像学表现。

结果

共回顾了4695例CT,发现共有145处差异可能影响短期临床管理(漏诊率3.1%)。最常见的漏诊与血凝块(13.8%)、结肠炎(8.3%)、管路位置不当(6.9%)或肾盂肾炎(5.5%)有关。使用图像示例讨论了改进检测的常见陷阱和策略。

结论

通过更多地关注血管系统、结肠、器械和肾脏,实习生可能会提高其差异率并改进值班报告。

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