Singh Rahul B, Ahmed Ahmed K, Virador Gabriel M, Alami Idrissi Yassine, Bhatt Alok A, Lakhani Dhairya A, Oei Merrie W, Gopal Neethu, Overfield Cameron, Rowell Colin, Rao Dinesh, Vibhute Prasanna, Watson Robert E, Sandhu Sukhwinder J S
Department of Internal Medicine, New York City Health and Hospitals, South Brooklyn Health, Brooklyn, NY, USA.
Radiology Department, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
Emerg Radiol. 2025 Feb;32(1):41-50. doi: 10.1007/s10140-024-02282-6. Epub 2024 Sep 21.
For acute stroke patients requiring MR examination and unable to provide a reliable history, screening for potentially MRI-incompatible objects (PMIOs) typically necessitates the use of plain-film radiographs (PFRs). However, using a whole body CT scout at the time of non-contrast head CT scans can preclude critical delays. Here, we aim to compare the effectiveness of PFRs and CT scouts in detecting PMIOs.
A case-control study was conducted at a tertiary care institution, involving 408 imaging studies from 200 patients, half of which contained PMIOs. The diagnostic performances of CT scouts and PFRs were evaluated by six blinded readers, including two board-certified neuroradiologists, one neuroradiology fellow, and three radiology residents.
2448 interpretations from the 6 readers were analyzed. The diagnostic performance of combined CT scout images (full-body and regional) was not significantly different from that of PFRs for all six readers (p = 0.06). However, PFRs outperformed full-body CT scouts in PMIO detection (p = 0.01), with no significant differences observed between PFRs and regional CT scouts (p = 0.4). Notably, the diagnostic accuracy of the radiology residents was found to be equivalent to radiologists across all imaging techniques.
Integrating CT scouts in acute stroke protocols may help expedite MRI screening. The scouts should include the head, neck, chest, upper arms, abdomen, pelvis, and thighs. Including radiology residents in the screening process for PMIOs may be an avenue for resource optimization in acute care settings.
对于需要进行磁共振成像（MR）检查但无法提供可靠病史的急性中风患者，筛查潜在的磁共振成像不兼容物体（PMIOs）通常需要使用平片放射摄影（PFRs）。然而，在进行非增强头部CT扫描时使用全身CT定位像可以避免严重延误。在此，我们旨在比较PFRs和CT定位像在检测PMIOs方面的有效性。
在一家三级医疗机构进行了一项病例对照研究，涉及来自200名患者的408项成像研究，其中一半包含PMIOs。由六位不知情的阅片者评估CT定位像和PFRs的诊断性能，其中包括两名获得委员会认证的神经放射科医生、一名神经放射科住院医师和三名放射科住院医生。
分析了6位阅片者的2448份解读结果。对于所有6位阅片者，联合CT定位像图像（全身和局部）的诊断性能与PFRs没有显著差异（p = 0.06）。然而，在PMIO检测方面，PFRs优于全身CT定位像（p = 0.01），PFRs与局部CT定位像之间未观察到显著差异（p = 0.4）。值得注意的是，发现放射科住院医生在所有成像技术中的诊断准确性与放射科医生相当。
在急性中风方案中整合CT定位像可能有助于加快MRI筛查。定位像应包括头部、颈部、胸部、上臂、腹部、骨盆和大腿。让放射科住院医生参与PMIOs的筛查过程可能是急性护理环境中优化资源的一条途径。
