Neuroradiology Department, IRCCS C. Mondino Foundation, Pavia, Italy.
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Radiol Med. 2019 Jul;124(7):628-635. doi: 10.1007/s11547-019-01012-0. Epub 2019 Mar 9.
To assess whether structured reports (SRs) of MRI in patients with inherited neuromuscular disorders (IND) provide more clinically relevant information than non-structured reports (NSRs) and whether neuroradiologists' expertise affects completeness of reports.
Lower limbs' MRI reports of patients with IND produced by neuroradiologists with different level of expertise (> 15 years vs. < 15 years of experience in reading IND-MRI) before and after implementation of a SR template were included. Reports were assessed for the presence of 9 key features relevant for IND management. Reports and images were evaluated by neurologists who assessed: disease-specific muscular involvement pattern; presence of sufficient information to order the appropriate genetic/diagnostic tests; presence of sufficient information to make therapeutic decision/perform biopsy and necessity to review MRI images. Mann-Whitney and Fisher's exact tests were used to compare the number of key features for NSR and SR and neurologists' answers for reports produced by neuroradiologists with different experience.
Thirty-one SRs and 101 NSRs were reviewed. A median of 8 and 6 key features was present in SR and NSR, respectively (p value < 0.0001). When reports were produced by less expert neuroradiologists, neurologists recognized muscular involvement pattern, had sufficient information for clinical decision-making/perform biopsy more often with SR than NSR (p values: < 0.0001), and needed to evaluate images less often with SR (p value: 0.0001). When reports produced by expert neuroradiologists were evaluated, no significant difference in neurologists' answers was observed.
SR of IND-MRI contained more often clinically relevant information considered important for disease management than NSR. Radiologist's expertise affects completeness of NSR reports.
评估遗传性神经肌肉疾病（IND）患者的磁共振成像（MRI）结构化报告（SR）是否比非结构化报告（NSR）提供了更具临床相关性的信息，以及神经放射科医生的专业知识是否影响报告的完整性。
纳入了经验丰富（> 15 年）和经验不足（< 15 年）的神经放射科医生在实施 SR 模板前后为 IND 患者进行的下肢 MRI 报告。报告中评估了 9 个与 IND 管理相关的关键特征。由神经科医生评估报告和图像，评估内容包括疾病特异性肌肉受累模式、是否有足够的信息来安排适当的基因/诊断测试、是否有足够的信息做出治疗决策/进行活检以及是否需要重新评估 MRI 图像。使用 Mann-Whitney 和 Fisher 精确检验比较 NSR 和 SR 中的关键特征数量，以及不同经验的神经放射科医生报告的神经科医生的答案。
共审查了 31 份 SR 和 101 份 NSR。SR 和 NSR 分别存在中位数为 8 和 6 个关键特征（p 值< 0.0001）。当由经验不足的神经放射科医生生成报告时，神经科医生更频繁地通过 SR 而不是 NSR 识别肌肉受累模式、具有足够的临床决策/进行活检信息（p 值：< 0.0001），并且更频繁地不需要评估图像（p 值：0.0001）。当评估由专家神经放射科医生生成的报告时，神经科医生的答案没有显著差异。
与 NSR 相比，IND-MRI 的 SR 更常包含被认为对疾病管理重要的临床相关信息。放射科医生的专业知识影响 NSR 报告的完整性。
