Department of Medicine, Institute of Radiology, University of Udine, Udine, Italy.
Department of Medicine, Rheumatology Clinic, University of Udine, Udine, Italy.
Diagn Interv Radiol. 2022 Nov;28(6):569-575. doi: 10.5152/dir.2022.21488.
PURPOSE To evaluate the performance of radiology residents (RRs) when using a dedicated structured report (SR) template for chest HRCT in patients with suspected connective tissue disease-interstitial lung disease (CTD-ILD), compared to the traditional narrative report (NR). METHODS We retrospectively evaluated 50 HRCT exams in patients with suspected CTD-ILD. A chest-devoted radiologist reported all the HRCT exams as the reference standard, pointing out pulmonary fibrosis findings (i.e., honeycombing, traction bronchiectasis, reticulation, and volume loss), presence and pattern of ILD, and possible other diagnoses. We divided four RRs into two groups according to their expertise level. In each group, RRs reported all HRCT examinations alternatively with NR or SR, noting each report's reporting time. The Cohen's Kappa, Wilcoxon, and McNemar tests were used for statistical analysis. RESULTS Regarding the pulmonary fibrosis findings, we found higher agreement between RRs and the reference standard reader when using SR than NR, regardless of their expertise level, except for volume loss.RRs' accuracy for "other diagnosis" was higher when using SR than NR, moving from 0.48 to 0.66 in the novel group (p = 0.035) and from 0.44 to 0.80 in the expertise group (p < 0.001). No differences in accuracy were found between ILD presence and ILD pattern. The reporting time was significantly lower (p = 0.001) when using SR than NR. CONCLUSION SR is of value in increasing the reporting of critical chest HRCT findings in the complex CTD-ILD scenario and should be used early and systematically during the residency.
目的 评估放射科住院医师（RR）在疑似结缔组织病-间质性肺病（CTD-ILD）患者中使用专用结构化报告（SR）模板进行胸部高分辨率 CT（HRCT）检查时的表现，与传统的叙述性报告（NR）相比。
方法 我们回顾性评估了 50 例疑似 CTD-ILD 患者的 HRCT 检查。一位专注于胸部的放射科医生报告了所有的 HRCT 检查，作为参考标准，指出肺纤维化的发现（即蜂窝状、牵引性支气管扩张、网状和容积损失）、ILD 的存在和模式，以及可能的其他诊断。我们根据专业水平将 4 名 RR 分为两组。在每组中，RR 交替使用 NR 或 SR 报告所有 HRCT 检查，并记录每份报告的报告时间。采用 Cohen's Kappa、Wilcoxon 和 McNemar 检验进行统计学分析。
结果 关于肺纤维化的发现，无论 RR 的专业水平如何，使用 SR 时，RR 与参考标准读者之间的一致性均高于 NR，除了容积损失。使用 SR 时，RR 对“其他诊断”的准确性高于 NR，在新组从 0.48 提高到 0.66（p=0.035），在专家组从 0.44 提高到 0.80（p<0.001）。ILD 存在和ILD 模式的准确性没有差异。使用 SR 的报告时间明显低于 NR（p=0.001）。
结论 SR 在提高复杂 CTD-ILD 情况下对关键胸部 HRCT 发现的报告能力方面具有价值，应在住院医师培训期间尽早系统地使用。
