Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA.
College of Medicine, University of Florida, Gainesville, FL, USA.
Emerg Radiol. 2024 Apr;31(2):187-192. doi: 10.1007/s10140-024-02210-8. Epub 2024 Feb 10.
Suppurative retropharyngeal lymphadenitis is a retropharyngeal space infection almost exclusively seen in the young (4-8 years old) pediatric population. It can be misdiagnosed as a retropharyngeal abscess, leading to unnecessary invasive treatment procedures. This retrospective study aims to assess radiology residents' ability to independently identify CT imaging findings and make a definitive diagnosis of suppurative retropharyngeal lymphadenitis in a simulated call environment.
The Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM) is a computer-aided emergency imaging simulation proven to be a reliable method for assessing resident preparedness for independent radiology call. The simulation included 65 cases across various imaging modalities of varying complexity, including normal studies, with one case specifically targeting suppurative retropharyngeal adenitis identification. Residents' free text responses were manually scored by faculty members using a standardized grading rubric, with errors subsequently classified by type.
A total of 543 radiology residents were tested in three separate years on the imaging findings of suppurative retropharyngeal lymphadenitis using the Wisdom in Diagnostic Imaging simulation web-based testing platform. Suppurative retropharyngeal lymphadenitis was consistently underdiagnosed by radiology residents being tested for call readiness irrespective of the numbers of years in training. On average, only 3.5% of radiology residents were able to correctly identify suppurative retropharyngeal lymphadenitis on a contrast-enhanced computed tomography (CT).
Our findings underscore a potential gap in radiology residency training related to the accurate identification of suppurative retropharyngeal lymphadenitis, highlighting the potential need for enhanced educational efforts in this area.
化脓性咽后淋巴结炎是一种咽后间隙感染，几乎仅见于儿童（4-8 岁）。它可能被误诊为咽后脓肿，导致不必要的侵入性治疗。本回顾性研究旨在评估放射科住院医师在模拟呼叫环境中独立识别 CT 影像学表现并做出化脓性咽后淋巴结炎明确诊断的能力。
智慧诊断影像学紧急/重症放射学模拟（WIDI SIM）是一种计算机辅助急诊成像模拟，已被证明是评估住院医师独立放射科呼叫准备情况的可靠方法。该模拟包括 65 例不同成像方式的病例，包括正常研究，其中一个病例专门针对化脓性咽后淋巴结炎的识别。住院医师的自由文本回答由教师使用标准化评分表手动评分，随后按类型对错误进行分类。
共有 543 名放射科住院医师在三年的时间里，使用智慧诊断影像学模拟网络测试平台，对化脓性咽后淋巴结炎的影像学表现进行了测试。在为呼叫准备而接受测试的放射科住院医师中，无论受训年限如何，化脓性咽后淋巴结炎的诊断均始终不足。平均而言，只有 3.5%的放射科住院医师能够在增强 CT 上正确识别化脓性咽后淋巴结炎。
我们的研究结果强调了放射科住院医师培训中可能存在的一个潜在差距，即准确识别化脓性咽后淋巴结炎，这突出表明在该领域可能需要加强教育努力。
