Cranial diffusion-MRI interpretation: comparison of emergency medicine and radiology residents

Abstract

INTRODUCTION: Today diagnosis and treatment of ischaemic stroke is based on cranial CT and MR. The aim of this study is to measure the ability of emergency medical and radiology resident physicians to evaluate brain diffusion MRI and to provide better and faster recognition of the vital condition of acute ischaemic cerebrovascular infarct patients. MATERIAL AND METHODS: 10 radiology and 10 emergency medicine residents were enrolled in the study. Of the 50 brain diffusion MRIs interpreted by trainees, 3 were normal, 13 had cerebral infarct, 27 had lacunar infarct, 3 had brain mass, 2 had hypoxic-ischaemic encephalopathy, 1 had MS and 1 had dermoid cyst. Each participant evaluated 50 digital diffusion MR images sequentially. They were asked to indicate whether there was a pathological lesion on the images, if the lesion was acute or chronic, what was the localization of the lesion, and ultimately the possible preliminary diagnosis. RESULTS: Experienced radiology resident physicians are found to be more accurate in determining MR results in comparison to their inexperienced colleagues in cerebral and lacunar infarcts (p < 0.01) but for noninfarct images, no difference was found between two groups (p > 0.05). Radiology residents outperformed emergency residents in both cerebral and lacunar infarct and non-infarct images (p < 0.01). CONCLUSIONS: In the study authors’ opinion training and education is a must for MRI interpretation for emergency residents which might be vital for ischaemic cerebrovascular patients.