Lockwood P, Dolbear G
Clinical and Medical Sciences Research Hub, School of Allied Health Professions, Canterbury Christ Church University, Kent, UK.
Clinical and Medical Sciences Research Hub, School of Allied Health Professions, Canterbury Christ Church University, Kent, UK.
Radiography (Lond). 2018 Nov;24(4):370-375. doi: 10.1016/j.radi.2018.05.009. Epub 2018 Jun 7.
The aim of the study was to evaluate the performance of radiographers in image interpretation of magnetic resonance imaging (MRI) brain, spine and knee examinations following a nine-month work based postgraduate MRI module.
Twenty-seven participants each submitted 60 image commentaries taken from prospective clinical workloads. The image interpretations (n = 1620) comprised brain, spine, and knee MRI examinations. Prevalence of abnormal examinations approximated 53% (brain), 74% (spine), and 73% (knee), and included acute and chronic pathology, normal variants and incidental findings. Each image interpretation was graded against reference standard consultant radiologist definitive report.
The radiographer's performance on brain image interpretations demonstrated mean accuracy at 86.7% (95% CI 83.4-89.3) with sensitivity and specificity of 84% (95% CI 80.9-86.4) and 89.7% (95% CI 86.2-92.6) respectively. For spinal interpretations the mean accuracy was 86.4% (95% CI 83.4-89.0), sensitivity was 90.2% (95% CI 88.2-92), mean specificity was 75.3% (95% CI 69.4-80.4). The mean results for knee interpretation accuracy were 80.9% (95% CI 77.3-84.1), sensitivity was 83.3% (95% CI 80.8-85.5), with 74.3% specificity (95% CI 67.4-80.4).
The radiographer's demonstrated skills in brain, spine and knee MRI examination image interpretation. These skills are not to replace radiologist reporting but to meet regulating body standards of proficiency, and to assist decision making in communicating unexpected serious findings, and/or extend scan range and sequences. Further research is required to investigate the impact of these skills on adjusting scan protocols or flagging urgent findings in clinical practice.
本研究的目的是评估放射技师在完成为期九个月的基于工作的研究生磁共振成像(MRI)模块后,对脑部、脊柱和膝盖MRI检查图像解读的表现。
27名参与者每人提交了60份取自前瞻性临床工作量的图像注释。图像解读(n = 1620)包括脑部、脊柱和膝盖MRI检查。异常检查的患病率约为53%(脑部)、74%(脊柱)和73%(膝盖),包括急性和慢性病变、正常变异和偶然发现。每个图像解读都根据参考标准放射科顾问医生的最终报告进行评分。
放射技师在脑部图像解读方面的表现显示,平均准确率为86.7%(95%可信区间83.4 - 89.3),敏感性和特异性分别为84%(95%可信区间80.9 - 86.4)和89.7%(95%可信区间86.2 - 92.6)。对于脊柱解读,平均准确率为86.4%(95%可信区间83.4 - 89.0),敏感性为90.2%(95%可信区间88.2 - 92),平均特异性为75.3%(95%可信区间69.4 - 80.4)。膝盖解读准确率的平均结果为80.9%(95%可信区间77.3 - 84.1),敏感性为83.3%(95%可信区间80.8 - 85.5),特异性为74.3%(95%可信区间67.4 - 80.4)。
放射技师在脑部、脊柱和膝盖MRI检查图像解读方面展现出了技能。这些技能并非要取代放射科医生的报告,而是为了达到监管机构的熟练标准,并在传达意外严重发现和/或扩展扫描范围及序列方面协助决策。需要进一步研究来调查这些技能对调整扫描方案或在临床实践中标记紧急发现的影响。