急诊医学专家与放射科医生和神经科医生对疑似急性缺血性脑卒中患者脑MRI解释的准确性；诊断准确性研究

IF 0.4 Q4 NEUROSCIENCES

Archives of Neuroscience Pub Date : 2021-04-30 DOI:10.5812/ans.112166

A. Abdollahi, Sepide Aarabi, Arash Safaie, A. Naser Moghadasi, Mohammad Sadegh Vahedi, Ramin Pourghorban

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引用次数: 0

摘要

背景：尽管在急诊科使用了大量的脑磁共振成像（MRI），但单凭成像是不够的，有必要由在这方面有足够技能的医生进行正确的解释。目的：在这里，我们决定与放射科医生和神经学家相比，研究急诊医生（EMP）对疑似急性缺血性中风（AIS）患者进行的脑MRI解释的准确性。方法：这项诊断准确性研究于2019年4月至11月在伊朗德黑兰进行。一个主要教育、医疗中心的所有参加EMP的人、一名放射科医生和一名神经学家也参加了。随机选择了一组与疑似AIS患者相关的大脑MRI刻板印象。通过回顾EMP的大脑MRI解释，一次与放射科医生比较，一次和神经学家比较，提取了误解（是否存在与AIS诊断相一致的发现）。结果：对287例疑似AIS患者的脑MRI刻板印象进行了解释，其中160例（55.7%）为男性。研究患者的平均年龄为65.0±14.1岁（18至98岁）。EMPs和神经科医生诊断一致性值为0.684（95%CI:0.580-0.787）。考虑神经科医生为金标准，EMPs诊断AIS的准确率为0.85%（95%CI:79.3-89.6）。EMPs和放射科医生诊断一致值为0.673（95%CI:0.553-0.794）。考虑放射科医生为金标准，EMPs诊断AIS的准确率为86.3%（95%CI:79.8至91.3）。这两组的诊断一致值为0.752（95%CI:0.627至0.877）。

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Accuracy of Brain MRI Interpretation of Emergency Medicine Specialists Versus Radiologist and Neurologist in Suspected Acute Ischemic Stroke Patients; a Diagnostic Accuracy Study

Background: Despite numerous brain magnetic resonance imaging (MRI) utilization in the emergency department (ED), certainly, imaging alone is not enough, and it is necessary to have a correct interpretation by a physician who has sufficient skills in this regard. Objectives: Here, we decided to investigate the accuracy of interpreting brain MRI of suspected acute ischemic stroke (AIS) patients conducted by emergency medicine physicians (EMPs) in comparison with a radiologist and a neurologist. Methods: This diagnostic accuracy study was conducted from April to November 2019 in Tehran, Iran. All attending EMPs of one major educational, medical center, a radiologist, and a neurologist also participated. A set of brain MRI stereotypes related to patients suspected of having a AIS was randomly selected. By reviewing the brain MRI interpretation of EMPs, once in comparison with the radiologist and once in comparison with the neurologist, misinterpretations (presence or absence of findings compatible with the diagnosis of AIS) were extracted. Results: Brain MRI stereotypes of 287 suspected AIS patients were interpreted of these patients, 160 cases (55.7%) were male. The mean age of the study patients was 65.0 ± 14.1 (range of 18 to 98) years. The value of the agreement for diagnosis between EMPs and neurologists was 0.684 (95% CI: 0.580 to 0.787). Considering the neurologist as the gold standard, the accuracy of AIS diagnosis by the EMPs was 0.85% (95% CI: 79.3 to 89.6). The agreement value for diagnosis between EMPs and radiologist was 0.673 (95% CI: 0.553 to 0.794). Considering the radiologist as the gold standard, the accuracy of AIS diagnosis by the EMPs was 86.3% (95% CI: 79.8 to 91.3). The agreement value for diagnosis in these two groups was 0.752 (95% CI: 0.627 to 0.877). Conclusions: The findings of the current study revealed that the accuracy of brain MRI interpretation performed by the EMPs, compared with both neurologist and radiologist was proper.

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Archives of Neuroscience NEUROSCIENCES-

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期刊介绍： Archives of neuroscience is a clinical and basic journal which is informative to all practitioners like Neurosurgeons, Neurologists, Psychiatrists, Neuroscientists. It is the official journal of Brain and Spinal Injury Research Center. The Major theme of this journal is to follow the path of scientific collaboration, spontaneity, and goodwill for the future, by providing up-to-date knowledge for the readers. The journal aims at covering different fields, as the name implies, ranging from research in basic and clinical sciences to core topics such as patient care, education, procuring and correct utilization of resources and bringing to limelight the cherished goals of the institute in providing a standard care for the physically disabled patients. This quarterly journal offers a venue for our researchers and scientists to vent their innovative and constructive research works. The scope of the journal is as far wide as the universe as being declared by the name of the journal, but our aim is to pursue our sacred goals in providing a panacea for the intractable ailments, which leave a psychological element in the daily life of such patients. This authoritative clinical and basic journal was founded by Professor Madjid Samii in 2012.