Introduction Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist's review is required in cases reported as normal by the sonographer. Methods This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition. Results The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients’ age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1–21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant. Conclusion Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.
Intussusception is typically considered an acute emergency; however, the increased utilisation of medical imaging has revealed that intussusceptions can also be transient, asymptomatic and possibly physiologic. Sonographers should be aware of three categories of intussusceptions: (i) persistent intussusceptions resulting in acute abdomen and requiring urgent intervention, (ii) transient symptomatic intussusceptions which may be amenable to a ‘wait‐and‐see’ strategy and (iii) transient asymptomatic intussusceptions which almost always involve the small bowel. In particular, the incidental discovery of enteroenteric intussusceptions in children should not be confused with acute pathology. In adults, sonographers should be mindful of the frequent presence of pathological lead points and further investigations may be warranted. In this literature review, we provide an overview of transient intussusceptions, highlight important differences between children and adults and describe sonographic appearances of various intussusceptions and their mimics.
Introduction:The aim of this study was to compare the ultrasound (US) findings independently reported by sonographers with final reports issued by radiologists in a complex working environment of an acute and inpatient US service in a large tertiary teaching hospital.Methods: This study was a prospective review of 1000 unique hospital patients who received 1142 US examinations. Sonographers performed the requested examinations and reported their findings independently before consulting with radiologists. Radiologists reviewed the sonographers' findings, consulted with sonographers, and issued their final reports. Any disagreements between the findings of the sonographer and radiologist were captured, analysed and separated into errors or discrepancies according to commonly accepted definitions. Patient outcomes were determined from electronic clinical records.Results: Examinations were performed by a team of 11 sonographers with a median of 9.5 years of experience and standard US qualifications. Sonographers independently reported 1484 abnormal findings in 268 categories. Radiologists were in complete agreement in 93.6% of cases, 5.3% cases included minor discrepancies and 1.1% of cases contained errors of which sonographers were responsible for 9 and radiologists 7. The severity of errors was comparable between sonographers and radiologists. Conclusion:Sonographers and radiologists demonstrate a high degree of agreement in reporting abnormal US findings. Sonographers and radiologists committed a comparable number of errors, and the error severity scores were also comparable. The customary, routine involvement of a radiologist in the second reading and reporting of all US examinations is unnecessary.
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