radiologist

放射科医生
  • 文章类型: Journal Article
    居民通常在夜间和周末轮班,在大学医院发布放射学研究的初步读数。这对于独立面对复杂案件时加强决策技能至关重要。然而,病人的安全和学术经验之间应该有一个平衡,因为有人对学员的解释的准确性表示了一些担忧。这项工作旨在评估和表征放射科居民发布的初步报告中的差异。
    放射科医生填写了一份调查问卷,以评估考虑诊断的学员的初步报告,发现描述,临床方法的改变,和重要的发现。考虑模态进行分析,成像类型,身体部位,和居民学年。采用显著性水平α为0.05的卡方检验进行组间比较。
    共审查了9072项研究。主要和次要整体差异率分别为1.7%和8.3%,分别。轻微差异率,发现描述,关键发现的识别随着学年的增加而提高,总体和模态。CT的差异率低于MR,神经影像学的差异率低于身体影像学研究。腹部/骨盆CT和腰椎MR的主要和次要差异率最高,分别。百分之二的报告存在差异,可能会导致医疗方法发生变化。
    差异率很低,与文献报道的差异相当。随着居民学年的增加,这些比率往往会提高。我们的结果表明,放射科居民对夜班和周末的覆盖是一种有益于教育过程而不会对患者安全产生负面影响的做法。
    UNASSIGNED: Residents usually cover night and weekend shifts issuing the preliminary reading of radiological studies in university hospitals. This is essential to strengthening decision-making skills when facing complex cases independently. However, there should be a balance between patient safety and academic experience since some concern has been expressed about the accuracy of the interpretations generated by trainees. This work aims to evaluate and characterize the discrepancies in preliminary reports issued by radiology residents.
    UNASSIGNED: Radiologists filled out a questionnaire to evaluate preliminary reports of trainees considering diagnosis, findings description, clinical approach changes, and critical findings. Analysis was performed considering modality, imaging type, body part, and resident academic year. A Chi-square test with a significance level α of 0.05 was used to make group comparisons.
    UNASSIGNED: A total of 9072 studies were reviewed. Major and minor overall discrepancy rates were 1.7% and 8.3%, respectively. Minor discrepancy rate, findings description, and critical findings identification improved with increasing academic year, both overall and by modality. Discrepancy rates were lower for CT than MR and neuroimaging than for body-imaging studies. The highest major and minor discrepancy rates as abdomen/pelvis CT and lumbar-spine MR, respectively. Two percent of reports presented discrepancies that could generate a medical approach change.
    UNASSIGNED: Discrepancy rates are low and comparable with those reported in the literature. These rates tend to improve as the resident\'s academic year increases. Our results suggest that radiology residents\' coverage of night shifts and weekends is a practice that benefits the educational process without negatively impacting patient safety.
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  • 文章类型: Journal Article
    UNASSIGNED: The aim of this study was to better understand the usefulness of retrospective inspection of radiology reports of CT (computed tomography) or MRI (magnetic resonance imaging) by emergency doctors in the emergency room.
    UNASSIGNED: Between April 2018 and March 2019, patients who went home after CT or MRI who needed to change their treatment plans and subsequent corresponding procedures after inspection of radiology reports by emergency doctors were reviewed.
    UNASSIGNED: Among 7,661 CT or MRIs performed on 5,917 patients, there were 131 patients (133 CT or MRI or 1.7% among 7,661 examinations) who required a change in their treatment plans after inspection of radiology reports. Of the 133 CT or MRI performed, there were 51 (38.3% among 133 CT or MRI, 0.7% among 7,661 examinations) CT or MRI performed, which indicated findings to suspect a tumor (11.8% in the head, 41.2% in the chest, 35.3% in the abdomen, and 11.8% in others). With the need to make important changes in treatment plans, making appointments for outpatient clinics was necessary for 52 CT or MRI findings, and requiring the patients to return to the clinic or be admitted was necessary for 9 (totally 61; 0.8% among 7,661 examinations).
    UNASSIGNED: Data from this study suggest that inspection of radiology reports of CT or MRI by emergency doctors after patients went home is useful in finding characteristics suggestive of tumors in 0.7% of all radiology reports and is necessary to identify important changes that should be made in treatment plans in 0.8% of all radiology reports.
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  • 文章类型: Case Reports
    在肝脏中的结核分枝杆菌杆菌感染的主要传播后,疾病进展和体内免疫功能的变化。各种形式的结核病,包括肉芽肿,干酪样坏死,液化坏死,纤维化,钙化,可能出现在不同阶段的情况,影像学检查显示与这些阶段一致的发现。并不是所有的肝结核患者都适合肝切除术,术前影像学检查和病理免疫组织化学结果可用于确定结核病是否活跃,避免不必要的肝切除,并防止结核病术后扩散。这里,我们报道了一例粟粒性肺结核,盆腔结核,一名51岁男子肝病灶切除后大腿肌肉结核性脓肿。肝脏病变经手术病理证实为结核,这是罕见的,以前没有报道过。此病例报告的目的是提醒放射科医生花状增强的重要性,并估计肝结核是否活跃。这将有助于指导临床医生确定手术时机,避免不必要的肝切除,并避免血源性传播。
    After primary dissemination of Mycobacterium tuberculosis bacillus infection that is localized in liver, disease progression and changes to immune function in the body occur. Various forms of tuberculosis, including granuloma, caseous necrosis, liquefactive necrosis, fibrosis, and calcification, occur that could be presented at different stages, and imaging examination shows findings that are consistent with these stages. Not all liver tuberculosis patients are suitable for liver resection, and preoperative imaging examination and pathological immunohistochemical results could be used to determine whether tuberculosis was active, avoid unnecessary liver resection, and prevent the postoperative spread of tuberculosis. Here, we reported a case of miliary tuberculosis, pelvic tuberculosis, and tuberculous abscess of the thigh muscle in a 51-year-old man after liver lesion resection. The liver lesion was confirmed to be tuberculosis by surgical pathology, which is rare and has not been previously reported. The purpose of this case report is to remind radiologists of the importance of the floral-like enhancement and to estimate whether liver tuberculosis is active. This will help to guide clinicians to determine the timing of surgery, avoid unnecessary liver resection, and avoid hematogenous transmission.
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  • 文章类型: Journal Article
    The aim of this prospective, survey study was to assess the opinions of specialist surgeons as to the preferred content, nomenclature, and classification of extrahepatic portosystemic shunts for inclusion in radiology reports. A link to an online survey was sent by email to members of the European College of Veterinary Surgeons and the Association of Veterinary Soft Tissue Surgeons, and was made available on the American College of Veterinary Surgeons web forum and Facebook page. There were 93 respondents (survey sent to over 2500 email addresses and made available in two online locations). Most respondents agreed that they both review the images themselves (87/92, 95%) and read the radiology report (82/92, 89%) prior to surgery. Most respondents believed that the radiology report should contain a detailed anatomic description of the insertion (83/92, 90%), origin (54/91, 59%), and course (70/92, 76%) of the shunt, as well as a measure of the diameter of the shunting vessel at its insertion (54/92, 59%). Most respondents (70/90, 78%) disagreed that a brief description of shunt type, such as portocaval or portophrenic, was sufficient. Respondents were undecided regarding the use of an alphanumeric classification system (36/92, 39% agree; 32/92, 35% disagree). There was agreement that details of the presence or absence of urolithiasis (91/93, 98%), renomegaly (54/93, 58%), and peritoneal fluid (72/92, 78%) should be included in the report. The results of this study will help to guide reporting radiologists in providing descriptions of extrahepatic portosystemic shunts that include information most preferred by the recipient surgeons.
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  • 文章类型: Journal Article
    OBJECTIVE: To investigate how frequently and when referring physicians follow the recommendation in an 18F-fluoro-2-deoxy-D-glucose PET/CT (FDG-PET/CT) report and to determine the diagnostic yield of these recommendations.
    METHODS: This retrospective study included 2,496 clinical FDG-PET/CT scans that were performed at a tertiary care academic medical center in a 1.5-year period. The following variables were extracted from each report that contained a recommendation: patient age, patient gender, hospital status (inpatient versus outpatient), indication for FDG-PET/CT scanning, descriptive clarity of the recommendation, type of recommendation (additional imaging versus other), and compliance of the referring physician with the recommendation.
    RESULTS: The 2,496 FDG-PET/CT reports contained 193 recommendations (7.7%), of which 120 (62.2%) were followed by the referring physicians. Only the strength of the recommendation (strong versus weak wording) was significantly associated (P = .019) with the referring physicians\' compliance with the recommendations in the FDG-PET/CT reports (odds ratio of 2.14 [95% confidence interval: 1.13-4.05]). Of 120 recommendations that were followed, 21 (17.5%) led to a malignancy diagnosis, whereas 3 of the 73 (7.2%) recommendations that were not followed proved to have led to a malignancy diagnosis based on follow-up examinations not related to the recommendation; these proportions were significantly different (P = .006).
    CONCLUSIONS: In a nonprofit academic medical center, recommendations for additional radiological and nonradiological examinations in clinical FDG-PET/CT reports are relatively low. Recommendations are mostly followed and lead to a malignant diagnosis in a substantial number of cases. Compliance of the referring physician is influenced by the strength of the recommendation.
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  • 文章类型: Journal Article
    OBJECTIVE: To identify factors associated with the patient experience in radiology based on patient feedback reports from a single institution.
    METHODS: In a departmental patient experience committee initiative, all imaging outpatients are provided names and roles of all departmental employees with whom they interact, along with contact information for providing feedback after their appointment. All resulting feedback was recorded in a web-based database. A total of 3,675 patient comments over a 3-year period were assessed in terms of major themes. Roles of employees recognized within the patient comments were also assessed.
    RESULTS: Patient feedback comments most commonly related to professional staff behavior (74.5%) and wait times (11.9%), and less commonly related to a spectrum of other issues (comfort during the exam, quality of the facilities, access to information regarding the exam, patient privacy, medical records, the radiology report, billing). The most common attributes relating to staff behavior involved patients\' perceptions of staff caring, professionalism, pleasantness, helpfulness, and efficiency. Employees most commonly recognized by the comments were the technologist (50.2%) and receptionist (31.6%) and much less often the radiologist (2.2%). No radiologist was in the top 10% of employees in terms of the number of comments received.
    CONCLUSIONS: Patients\' comments regarding their experiences in undergoing radiologic imaging were largely influenced by staff behavior and communication (particularly relating to technologists and receptionists), as well as wait times, with radiologists having a far lesser immediate impact. Radiologists are encouraged to engage in activities that promote direct visibility to their patients and thereby combat risks of the perceived \"invisible\" radiologist.
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