Liu Mengwen, Wen Xin, Li Meng, Huang Qiang, Jiang Chengyi, Jiang Jiuming, Zhang Li, Zhang Hongmei
Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Radiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Quant Imaging Med Surg. 2025 Jan 2;15(1):1023-1039. doi: 10.21037/qims-24-1270. Epub 2024 Dec 30.
Currently, radiologists must interpret large quantities of images and identify diseases on a daily basis. The minimization of errors is crucial for high-quality diagnostic imaging and optimal patient care. Brain imaging is frequently used in clinical practice; however, radiologists are prone to overlook some regions in brain imaging and make perceptual errors, thus leading to missed diagnoses. These regions, also known as "blind spots", comprise a number of intricate areas, including the posterior fossa, cerebral sulci and pia mater, cranial nerves (CNs), intracranial arteries, dural sinuses, sella and parasellar region, Meckel's cave, skull base, scalp, orbit, and pterygopalatine fossa (PPF). Therefore, the knowledge of normal computed tomography (CT) and magnetic resonance imaging (MRI) manifestations and common lesions in these blind spots is imperative to avoid false-negative results. This article graphically discusses and analyzes these common blind spots of brain imaging using real representative cases. It also provides comprehensive strategies to address missed diagnostic errors in radiology, including enhancing the selection of imaging protocols, implementing a multi-reviewer reporting system, adopting structured reporting templates, employing error measurement or detection strategies, and promoting the use, development, and refinement of artificial intelligence (AI) to improve diagnostic accuracy and efficiency. This article may also increase junior doctors' awareness of these blind spots and assist them in their daily work, and thus has continuing education implications.
目前,放射科医生每天都必须解读大量图像并识别疾病。将错误最小化对于高质量的诊断成像和最佳的患者护理至关重要。脑部成像在临床实践中经常使用;然而,放射科医生在脑部成像中容易忽略一些区域并出现感知错误,从而导致漏诊。这些区域,也被称为“盲点”,包括许多复杂的部位,如后颅窝、脑沟和软脑膜、颅神经、颅内动脉、硬脑膜窦、鞍区和鞍旁区域、 Meckel腔、颅底、头皮、眼眶和翼腭窝。因此,了解这些盲点的正常计算机断层扫描(CT)和磁共振成像(MRI)表现以及常见病变对于避免假阴性结果至关重要。本文使用真实的典型病例以图文并茂的方式讨论和分析了脑部成像的这些常见盲点。它还提供了全面的策略来解决放射学中的漏诊错误,包括加强成像方案的选择、实施多审阅者报告系统、采用结构化报告模板、采用误差测量或检测策略,以及推广人工智能(AI)的使用、开发和完善以提高诊断准确性和效率。本文还可能提高初级医生对这些盲点的认识并在日常工作中帮助他们,因此具有继续教育意义。