open access

Vol 4, No 3 (2019)
ORIGINAL ARTICLES
Published online: 2019-10-08
Get Citation

Cranial diffusion-MRI interpretation: comparison of emergency medicine and radiology residents

Ferdi Kala, Kurtulus Aciksari
DOI: 10.5603/DEMJ.2019.0020
·
Disaster Emerg Med J 2019;4(3):98-101.

open access

Vol 4, No 3 (2019)
ORIGINAL ARTICLES
Published online: 2019-10-08

Abstract

INTRODUCTION: Today diagnosis and treatment of ischaemic stroke is based on cranial CT and MR. The aim of this study is to measure the ability of emergency medical and radiology resident physicians to evaluate brain diffusion MRI and to provide better and faster recognition of the vital condition of acute ischaemic cerebrovascular infarct patients. 

MATERIAL AND METHODS: 10 radiology and 10 emergency medicine residents were enrolled in the study. Of the 50 brain diffusion MRIs interpreted by trainees, 3 were normal, 13 had cerebral infarct, 27 had lacunar infarct, 3 had brain mass, 2 had hypoxic-ischaemic encephalopathy, 1 had MS and 1 had dermoid cyst. Each participant evaluated 50 digital diffusion MR images sequentially. They were asked to indicate whether there was a pathological lesion on the images, if the lesion was acute or chronic, what was the localization of the lesion, and ultimately the possible preliminary diagnosis. 

RESULTS: Experienced radiology resident physicians are found to be more accurate in determining MR results in comparison to their inexperienced colleagues in cerebral and lacunar infarcts (p < 0.01) but for noninfarct images, no difference was found between two groups (p > 0.05). Radiology residents outperformed emergency residents in both cerebral and lacunar infarct and non-infarct images (p < 0.01). 

CONCLUSIONS: In the study authors’ opinion training and education is a must for MRI interpretation for emergency residents which might be vital for ischaemic cerebrovascular patients.

Abstract

INTRODUCTION: Today diagnosis and treatment of ischaemic stroke is based on cranial CT and MR. The aim of this study is to measure the ability of emergency medical and radiology resident physicians to evaluate brain diffusion MRI and to provide better and faster recognition of the vital condition of acute ischaemic cerebrovascular infarct patients. 

MATERIAL AND METHODS: 10 radiology and 10 emergency medicine residents were enrolled in the study. Of the 50 brain diffusion MRIs interpreted by trainees, 3 were normal, 13 had cerebral infarct, 27 had lacunar infarct, 3 had brain mass, 2 had hypoxic-ischaemic encephalopathy, 1 had MS and 1 had dermoid cyst. Each participant evaluated 50 digital diffusion MR images sequentially. They were asked to indicate whether there was a pathological lesion on the images, if the lesion was acute or chronic, what was the localization of the lesion, and ultimately the possible preliminary diagnosis. 

RESULTS: Experienced radiology resident physicians are found to be more accurate in determining MR results in comparison to their inexperienced colleagues in cerebral and lacunar infarcts (p < 0.01) but for noninfarct images, no difference was found between two groups (p > 0.05). Radiology residents outperformed emergency residents in both cerebral and lacunar infarct and non-infarct images (p < 0.01). 

CONCLUSIONS: In the study authors’ opinion training and education is a must for MRI interpretation for emergency residents which might be vital for ischaemic cerebrovascular patients.

Get Citation

Keywords

magnetic resonance imaging; emergency medicine; medical education

About this article
Title

Cranial diffusion-MRI interpretation: comparison of emergency medicine and radiology residents

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 4, No 3 (2019)

Pages

98-101

Published online

2019-10-08

DOI

10.5603/DEMJ.2019.0020

Bibliographic record

Disaster Emerg Med J 2019;4(3):98-101.

Keywords

magnetic resonance imaging
emergency medicine
medical education

Authors

Ferdi Kala
Kurtulus Aciksari

References (10)
  1. Ferro JM, Pinto AN, Falcão I, et al. Diagnosis of stroke by the nonneurologist. A validation study. Stroke. 1998; 29(6): 1106–1109.
  2. Powers W, Derdeyn C, Biller J, et al. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment. Stroke. 2015; 46(10): 3020–3035.
  3. Savitz SI, Caplan LR, Edlow JA. Pitfalls in the diagnosis of cerebellar infarction. Acad Emerg Med. 2007; 14(1): 63–68.
  4. Evans LR, Fitzgerald MC, Mitra B, et al. Emergency department interpretation of CT of the brain: a systematic review. Postgrad Med J. 2017; 93(1102): 454–459.
  5. Khoo NC, Duffy M. Out of hours non-contrast head CT scan interpretation by senior emergency department medical staff. Emerg Med Australas. 2007; 19(2): 122–128.
  6. Alfaro D, Levitt MA, English DK, et al. Accuracy of interpretation of cranial computed tomography scans in an emergency medicine residency program. Ann Emerg Med. 1995; 25(2): 169–174.
  7. Al-Reesi A, Stiell IG, Al-Zadjali N, et al. Comparison of CT head interpretation between emergency physicians and neuroradiologists. Eur J Emerg Med. 2010; 17(5): 280–282.
  8. Arendts G, Manovel A, Chai A. Cranial CT interpretation by senior emergency department staff. Australas Radiol. 2003; 47(4): 368–374.
  9. Dolatabadi A, Baratloo A, Rouhipour A, et al. Interpretation of Computed Tomography of the Head: Emergency Physicians versus Radiologists. Trauma Monthly. 2013; 18(2): 86–89.
  10. Oray D, Limon O, Ertan C, et al. Inter-Observer Agreement on Diffusion-Weighted Magnetic Resonance Imaging Interpretation for Diagnosis of Acute Ischemic Stroke Among Emergency Physicians. Turk J Emerg Med. 2015; 15(2): 64–68.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl