Resident interpretation of emergency CT scans in the evaluation of acute appendicitis

Purpose. Radiology resident interpretation of computed tomographic (CT) sca ns at academic institutions often guides management of cases of suspected a cute appendicitis in the emergency department. The purpose of this study wa s to compare resident and faculty interpretation of CT scans obtained for a cute appendicitis. Materials and Methods. From December 16, 1999, to July 13, 2000, CT was per formed in 103 consecutive patients between the hours of 9:00 PM and 8:00 AM who were suspected of having acute appendicitis. The authors compared the residents' preliminary written interpretations with both the final reports written by the faculty and the surgical findings. The faculty interpreting the CT scans were aware of resident interpretations but were not aware that a study was being conducted. Results. The final faculty interpretation and the preliminary resident inte rpretation were identical in 96 of the 103 patients (93%; 95% confidence in terval: 87.8%, 97.2%). In only one patient was a scan originally interprete d as negative interpreted as positive by the faculty member. Clinically, th e patient did not have acute appendicitis, and surgery was not performed. Conclusion. In the diagnosis of acute appendicitis, image interpretations m ade by adequately trained radiology residents can be expected to closely ma tch those of the radiology faculty, and the practice of after-hours interpr etation of such studies by radiology residents is safe.