Mussmann B R, Milner Robert, Barlow Nicholas, Jensen Janni
Department of Radiology, Odense University Hospital, Denmark; Research and Innovation Unit of Radiology, University of Southern, Denmark; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Department of Clinical Radiology, The Rotherham Foundation NHS Trust, South Yorkshire, UK.
Radiography (Lond). 2023 Jan;29(1):119-123. doi: 10.1016/j.radi.2022.10.013. Epub 2022 Nov 5.
Patient positioning may impact diagnostic quality when obtaining radiographs of the musculoskeletal (MSK) system. Hence, knowledge on patient positioning, as seen in the radiograph, followed by informed adjusted retake if appropriate, is key when undertaking MSK radiographs. Forearm positioning is particularly important in lateral wrist radiographs where rotation impacts anatomic measurements. The purpose was to evaluate the accuracy of MSK and non-MSK radiographers' immediate assessments of wrist positioning including need for retake.
A questionnaire including images of 18 lateral wrist radiographs and questions regarding positioning, i.e. forearm rotation and flexion of the wrist, were developed and distributed to radiographers worldwide via the European Federation of Radiographer Societies (EFRS) and the Research Hub at the European Congress of Radiology (ECR) 2021. Demographic data such as area of expertise, years of experience etc. were collected.
In total, 156 replies were included in the analyses. The inter-observer agreement of radiographers' assessment of the need for a retake was 47% (kappa = .25) and the intra-observer agreement was 81% (kappa = .62). Radiographers working with MSK radiography had more correct positioning assessments than radiographers who did not routinely obtain radiographs of the MSK system (p = 0.0003).
Results indicated that MSK radiographers are more consistent in assessment of the need for a retake in lateral wrist radiographs and more able to correctly judge positioning compared to non-MSK radiographers.
Constant focus on image quality may lead to increased awareness and adherence to image criteria. Improved image quality will in turn improve the diagnostic value for the benefit of the patients potentially leading to better outcomes.
在获取肌肉骨骼（MSK）系统的X光片时，患者体位可能会影响诊断质量。因此，了解X光片中显示的患者体位，并在适当情况下进行明智的调整重拍，是进行MSKX光检查的关键。在前臂X光片中，前臂位置尤为重要，因为旋转会影响解剖测量。本研究的目的是评估MSK和非MSK放射技师对腕部位置的即时评估准确性，包括是否需要重拍。
设计了一份问卷，其中包含18张腕部侧位X光片的图像以及关于体位的问题，即前臂旋转和手腕屈曲情况，并通过欧洲放射技师协会联合会（EFRS）和2021年欧洲放射学大会（ECR）的研究中心分发给全球的放射技师。收集了诸如专业领域、工作年限等人口统计学数据。
分析共纳入156份回复。放射技师对是否需要重拍的评估的观察者间一致性为47%（kappa = 0.25），观察者内一致性为81%（kappa = 0.62）。从事MSK放射摄影的放射技师比不经常进行MSK系统X光片拍摄的放射技师有更准确的体位评估（p = 0.0003）。
结果表明，与非MSK放射技师相比，MSK放射技师在评估腕部侧位X光片是否需要重拍方面更一致，并且更能够正确判断体位。
持续关注图像质量可能会提高对图像标准的认识和遵守程度。提高图像质量反过来将提高诊断价值，从而使患者受益，可能带来更好的治疗结果。
