Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
Department of Computer Science, Emory University(,) Atlanta, GA.
Curr Probl Diagn Radiol. 2022 Jul-Aug;51(4):529-533. doi: 10.1067/j.cpradiol.2021.11.001. Epub 2021 Dec 2.
We aimed to assess early COVID-19 pandemic-associated changes in brain MRI examination frequency and acuity of imaging findings acuity.
Using a natural language processing model, we retrospectively categorized reported findings of 12,346 brain MRI examinations performed during 6-month pre-pandemic and early pandemic time periods across a large metropolitan health system into 3 acuity levels: (1) normal or near normal; (2) incidental or chronic findings not requiring a management change; and (3) new or progressive findings requiring a management change. Brain MRI frequency and imaging finding acuity level were compared over time.
Between March and August of 2019 (pre-pandemic) and 2020 (early pandemic), our health system brain MRI examination volumes decreased 17.0% (6745 vs 5601). Comparing calendar-matched 6-month periods, the proportion of higher acuity findings increased significantly (P< 0.001) from pre-pandemic (22.5%, 43.6% and 34.0% in acuity level 1, 2, and 3, respectively) to early pandemic periods (19.1%, 40.9%, and 40.1%). During the second 3 months of the early pandemic period, as MRI volumes recovered to near baseline, the proportion of higher acuity findings remained high (42.6% vs 34.1%) compared with a similar pre-pandemic period. In a multivariable analysis, Black (B coefficient, 0.16) and underinsured population (B coefficient, 0.33) presented with higher acuity findings (P< 0.05).
As the volume of brain MRI examinations decreased during the early COVID-19 pandemic, the relative proportion of examinations with higher acuity findings increased significantly. Pandemic-related changes in patient outcomes related to reduced imaging access merits further attention.
我们旨在评估 COVID-19 大流行早期与脑 MRI 检查频率变化相关的内容，以及成像发现的敏锐度。
我们使用自然语言处理模型，将大型都市医疗系统在大流行前和大流行早期 6 个月期间进行的 12346 次脑部 MRI 检查的报告结果分类为 3 种敏锐度水平：（1）正常或接近正常；（2）不需要管理变更的偶发性或慢性发现；以及（3）需要管理变更的新发现或进展性发现。比较了不同时间段内脑 MRI 检查的频率和成像发现敏锐度水平。
在 2019 年 3 月至 8 月（大流行前）和 2020 年（大流行早期）期间，我们的医疗系统脑部 MRI 检查量下降了 17.0%（6745 次与 5601 次）。比较日历匹配的 6 个月期间，高敏锐度发现的比例显著增加（P<0.001），从大流行前（敏锐度水平 1、2 和 3 的比例分别为 22.5%、43.6%和 34.0%）到大流行早期（比例分别为 19.1%、40.9%和 40.1%）。在大流行早期的第二个 3 个月期间，当 MRI 量恢复到接近基线时，与类似的大流行前时期相比，高敏锐度发现的比例仍然很高（42.6%比 34.1%）。在多变量分析中，黑人（B 系数，0.16）和保险不足的人群（B 系数，0.33）呈现出更高的敏锐度发现（P<0.05）。
在 COVID-19 大流行早期，当脑 MRI 检查量减少时，具有更高敏锐度发现的检查比例显著增加。与减少影像学检查机会相关的大流行相关的患者结局变化值得进一步关注。
