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首页> 外文期刊>Academic radiology >Residents' Performance in the Interpretation of On-Call 'Triple-Rule-Out' CT Studies in Patients with Acute Chest Pain
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Residents' Performance in the Interpretation of On-Call 'Triple-Rule-Out' CT Studies in Patients with Acute Chest Pain

机译：居民对急性胸痛患者应召唤的“三重规则” CT研究的解释

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摘要

Rationaie and Objectives: To evaluate the performance of radiology residents in the interpretation of on-call, emergency "triple-rule-out" (TRO) computed tomographic (CT) studies in patients with acute chest pain.Materials and Methods: The study was institutionai review board-approved and Health Insurance Portability and Accountability Act compliant. Data from 617 on-call TRO studies were analyzed. Dedicated software enables subspecialty attendings to grade discrepancies in interpretation between preliminary trainee reports and their final interpretation as "unlikely to be significant" (minor discrepancies) or "likely to be significant" for patient management (major discrepancies). The frequency of minor, major and all discrepancies in resident's TRO interpretations was compared to 609 emergent non-electrocardiography (ECG)-synchronized chest CT studies using Pearson x2 test.Results: Minor discrepancies occurred more oten in the TRO group (9.1% vs. 3.9%, P < .001), but there was no difference in the frequency of major discrepancies (2.1 % vs. 2.8%, P = .55). Minor discrepancies in the TRO group most commonly resulted from missed extrathoracic findings with missed liver lesions being the most frequent. Major discrepancies mostly encompassed cardiac and extracar-diac vascular findings but did not result in unnecessary interventions, significant immediate changes in management, or adverse patient outcomes.Conclusions: On-call resident interpretation of TRO CT studies in patients with acute chest pain is congruent with final subspecialty attending interpretation in the overwhelming majority of cases. The rate of discrepancies likely to affect patient management in this domain is not different from emergent non-ECG-synchronized chest CT.
机译：比率和目的：评价放射科住院医师在解释急性胸痛患者的紧急，“三重排除”（TRO）计算机断层扫描（CT）研究中的表现。材料与方法：机构审查委员会批准，并符合《健康保险流通与责任法案》。分析了来自617个待命TRO研究的数据。专用软件可以使专科医师就初步实习报告和最终解释之间的解释差异分类为对于患者管理而言“不太可能是重大的”（轻微差异）或“可能是重大的”（重大差异）。使用Pearson x2检验比较了居民TRO解释中轻微，主要和所有差异的发生率与609例紧急非心电图（ECG）同步胸部CT研究的结果。结果：TRO组中轻微差异的发生率更高（9.1％vs.差异为3.9％，P <.001），但主要差异出现的频率没有差异（2.1％与2.8％，P = .55）。 TRO组的轻微差异最常见的原因是胸外发现遗漏，而肝部病变遗漏最常见。主要差异主要包括心脏和心外血管的发现，但并未导致不必要的干预，管理上的重大立即变化或患者预后不良。结论：对急性胸痛患者进行TRO CT研究的待命患者解释与在绝大多数情况下，最终的专科医师都会参加解释。在此领域中可能影响患者管理的差异率与非ECG同步胸部CT出现率没有差异。

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