HEAD TRAUMA - CT SCAN INTERPRETATION BY RADIOLOGY RESIDENTS VERSUS STAFF RADIOLOGISTS

PURPOSE: To determine the rate and clinical outcome of discrepancies i n interpretation by radiology residents and staff neuroradiologists of posttraumatic cranial computed tomographic (CT) scans. MATERIALS AND METHODS: Prospective evaluation was performed for 419 consecutive emer gency posttraumatic cranial CT studies that has been interpreted by ra diology residents on call over a 16-month period. Discrepancies betwee n the interpretations made by residents and those made by staff radiol ogists were divided into two groups; failure to recognize an abnormall y (false-negative finding) and interpretation of normal as abnormal (f alse-positive finding). Discrepancies were considered major if they co uld affect patient care in the emergency setting and minor if they cou ld not. RESULTS: Major and minor discrepancies were 1.7% and 2.6%, res pectively, among interpretations made by residents and those by staff radiologists. Major discrepancies were four subdural hematomas, one pn eumocephalus, one hemorrhagic contusion, and one subarachnoid hemorrha ge. Minor discrepancies included six skull and five facial fractures. The discrepancy rate was statistically significantly higher (12.2%) wh en CT findings were abnormal than when they were normal (1.5%). No cha nge in treatment was attributed to the delay in diagnosis. CONCLUSION: A low discrepancy rate was found between interpretations made by radi ology residents and those made by staff neuroradiologists of posttraum atic cranial CT scans. There were no adverse clinical outcome.