Congenital Urogenital Tract Anomalies are Associated with a Higher Rate of Radiologic Interpretation Error

Abstract

Objective: Congenital Urogenital Tract Anomalies (CUTA) are complex and proper diagnosis is important for competent patient care. We set out to investigate whether there is an increased rate of radiologic image interpretation error in patients with CUTA. Methods: We utilized a case-control study design to compare each CUTA case (n=30) with 6 age-matched controls (n=180). We evaluated electronic medical records obtained from EPIC of patients who were referred to our tertiary care center for a higher level of care. We compared imaging results from MRI, CT, and US to intraoperative findings to look for any discrepancies in four key anatomical areas (vagina, uterus, ovaries, and urologic-kidney/ureter/bladder). Error was determined using a standardized scoring system for adjudicating imaging discrepancies in each anatomic area. Results: Cases and controls were similar across all demographic variables except for weight, (controls had a higher BMI). The rate of radiologic interpretation error was higher in patients with congenital urogenital tract anomalies when compared to age-matched controls (OR=51.65; 95% CI (6.39, 417.42)). Conclusion: CUTA are associated with a high rate of radiologic interpretation error. Although radiologic scans are helpful in the work up of CUTA, imaging results may not be definitively diagnostic.