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응급센터 CT 및 MRI 영상 판독 모니터링 시스템의 임상적 유용성: 미인지 소견의 분석

The clinical usefulness of radiologic report monitoring system of CT and MRI in emergency department: analysis of missed and incidental findings

대한응급의학회지 2020년 31권 4호 p.391 ~ 400
이지훈, 서준석, 이승철, 이정훈, 도한호, 이상헌, 김용원, 김재승,
소속 상세정보
이지훈 ( Lee Ji-Hoon ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
서준석 ( Seo Jun-Seok ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
이승철 ( Lee Seung-Chul ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
이정훈 ( Lee Jeong-Hun ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
도한호 ( Do Han-Ho ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
이상헌 ( Lee Sang-Hun ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
김용원 ( Kim Yong-Won ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Emergency Medicine
김재승 ( Kim Jae-Seong ) - Mediplex Sejong Hospital Department of Emergency Medicine

Abstract


Objective: This study was undertaken to establish a radiologic report monitoring system (RRMS) for missed and incidental findings (MIFs) in computed tomography (CT) and magnetic resonance imaging (MRI) reports, to help determine the clinical significance of MIFs in the emergency department (ED).

Method: Patients presenting to our ED in 2017 were subjected to RRMS. Preliminary reports and final reports were subsequently compared based on the clinical significance of the MIFs. If required, the patient was contacted and instructed to revisit the ED.

Results: Totally, 12,132 CT and MRI exams were performed during the study period, and 321 cases (2.6%) encompassed MIFs. We attempted to contact 228 cases (1.9%) who had clinically significant MIF findings; 9 patients were instructed to return to the ED, whereas 105 cases were instructed to report to the outpatient department. Hospitalization was required for 12 patients: 2 cases required surgical intervention, 2 cases had an additional procedure, and 8 cases required medical hospitalization.

Conclusion: This study applied RRMS for a timely assessment of MIFs, determine rearrangements required, and present an active response to the MIFs determined in the ED. To improve patient care and safety, we hereby propose monitoring MIFs using the RRMS or similar methods.

키워드

Emergency departments; Incidental findings; Reports; Radiology information systems

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