Abstract
Approximately 4 % of radiologic interpretation in daily practice contains errors and discrepancies that should occur in 2–20 % of reports. Fortunately, most of them are minor degree errors, or if serious, are found and corrected with sufficient promptness; obviously, diagnostic errors become critical when misinterpretation or misidentification should significantly delay medical or surgical treatments. Errors can be summarized into four main categories: observer errors, errors in interpretation, failure to suggest the next appropriate procedure, failure to communicate in a timely and a clinically appropriate manner. Misdiagnosis/misinterpretation percentage should rise up in emergency setting and in the first moments of the learning curve, as in residency. Para-physiological and pathological pitfalls in neuroradiology include calcification and brain stones, pseudofractures, and enlargement of subarachnoid or epidural spaces, ventricular system abnormalities, vascular system abnormalities, intracranial lesions or pseudolesions, and finally neuroradiological emergencies. In order to minimize the possibility of error, it is important to be aware of various presentations of pathology, obtain clinical information, know current practice guidelines, review after interpreting a diagnostic study, suggest follow-up studies when appropriate, communicate significant abnormal findings appropriately and in a timely fashion directly with the treatment team.
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References
Borgstede JP, Lewis RS, Bhargavan M et al (2004) RADPEER quality assurance program: a multifacility study of interpretive disagreement rates. J Am Coll Radiol 1:59–65
Goddard P, Leslie A, Jones A et al (2001) Error in radiology. Br J Radiol 74:949–951
Berlin L (2007) Radiologic errors and malpractice: a blurry distinction. AJR Am J Roentgenol 189:517–522
Brady A, Laoide RÓ, McCarthy P et al (2012) Discrepancy and error in radiology: concepts, causes and consequences. Ulst Med J 81:3–9
Fitzgerald R (2001) Error in radiology. Clin Radiol 56:938–946
Caranci F, Brunese L, Reginelli A et al (2012) Neck neoplastic conditions in the emergency setting: role of multidetector computed tomography. Semin Ultrasound CT MR 33(5):443–448
Pinto A, Caranci F, Romano L et al (2012) Learning from errors in radiology: a comprehensive review. Semin Ultrasound CT MR 33:379–382
Kundel HL, Nodine CF, Carmody D (1978) Visual scanning, pattern recognition and decision-making in pulmonary nodule detection. Invest Radiol 13:175–181
Harrigal CL, Erly WK (2007) On-call radiology: community standards and current trends. Semin Ultrasound CT MR 28:85–93
Renfrew DL, Franken EA, Berbaum KS et al (1992) Error in radiology: classification and lessons in 182 cases presented at a problem case conference. Radiology 183:145–150
Cervo A, Cocozza S, Saccà F et al (2015) The combined use of conventional MRI and MR spectroscopic imaging increases the diagnostic accuracy in amyotrophic lateral sclerosis. Eur J Radiol 84:151–157
McCarron MO, Wade C, McCarron P (2014) Optimising neuroimaging effectiveness in a district general hospital. J R Coll Physicians Edinb 44:14–19
Cooper VF, Goodhartz LA, Nemcek AA Jr et al (2008) Radiology resident interpretations of on-call imaging studies: the incidence of major discrepancies. Acad Radiol 15:1198–1204
Viertel VG, Babiarz LS, Carone M et al (2012) Quality control in neuroradiology: impact of trainees on discrepancy rates. AJNR Am J Neuroradiol 33:1032–1036
Babiarz LS, Yousem DM (2012) Quality control in neuroradiology: discrepancies in image interpretation among academic neuroradiologists. AJNR Am J Neuroradiol 33:37–42
Yaniv G, Mozes O, Greenberg G et al (2013) Common sites and etiologies of residents’ misinterpretation of head CT scans in the emergency department of a level I trauma center. Isr Med Assoc J 15:221–225
Walls J, Hunter N, Brasher PM et al (2009) The DePICTORS Study: discrepancies in preliminary interpretation of CT scans between on-call residents and staff. Emerg Radiol 16:303–308
Erly WK, Berger WG, Krupinski E et al (2002) Radiology resident evaluation of head CT scan orders in the emergency department. AJNR Am J Neuroradiol 23:103–107
Stevens KJ, Griffiths KL, Rosenberg J et al (2008) Discordance rates between preliminary and final radiology reports on cross-sectional imaging studies at a level 1 trauma center. Acad Radiol 15:1217–1226
Filippi CG, Schneider B, Burbank HN et al (2008) Discrepancy rates of radiology resident interpretations of on-call neuroradiology MR imaging studies. Radiology 249:972–979
Osborn A (2012) Brain imaging, pathology, anatomy. Lippincott Williams & Wilkins, Philadelphia
Celzo FG, Venstermans C, De Belder F et al. (2013) Brain stones revisited—between a rock and a hard place. Insights Imaging 4(5):625–635
Hoe JW (1989) Computed tomography of nasopharyngeal carcinoma. A review of CT appearances in 56 patients. Eur J Radiol 9:83–90
Adachi M, Hosoya T, Haku T et al (1998) Dilated Virchow-Robin spaces: MRI pathological study. Neuroradiology 40:27–31
Bernard JP, Moscoso G, Renier D et al (2001) Cystic malformations of the posterior fossa. Prenat Diagn 21:1064–1069
Dimmick SJ, Faulder KC (2009) Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 29:1027–1043
Castillo M (2014) Hystory and evolution of brain tumor imaging: insights through radiology. Radiology 273(2 Suppl):S111–S125
Ambrosetto P, Nicolini F, Zoli M et al (2014) Ophthalmoplegic migraine: from questions to answers. Cephalalgia 34(11):914–919
Muccio CF, Di Blasi A, Esposito G et al (2013) Perfusion and spectroscopy magnetic resonance imaging in a case of lymphocytic vasculitis mimicking brain tumor. Pol J Radiol 78:66–69
Caranci F, Cirillo M, Piccolo D et al (2012) A rare case of intraosseous lipoma involving the sphenoclival region. Neuroradiol J 25:680–683
Smimiotopoulos JG, Murphy FM, Rushing EJ et al (2007) Patterns of contrast enhancement in the brain and meninges. Radiographics 27:525–551
Kramer RA (1977) Vermian pseudotumor: a potential pitfall of CT brain scanning with contrast enhancement. Neuroradiology 13(5):229–230
Cirillo L, Leonardi M, Dall’Olio M et al (2012) Complications in the treatment of intracranial aneurysms with silk stents: an analysis of 30 consecutive patients. Interv Neuroradiol 18(4):413–425
van Wessem KJ, Meijer JM, Leenen LP et al (2011) Blunt traumatic carotid artery dissection: still a pitfall? The rationale for aggressive screening. Eur J Trauma Emerg Surg 37:147–154
Pinto A, Brunese L, Pinto F et al (2012) The concept of error and malpractice in radiology. Semin Ultrasound CT MR 33(4):275–279
Caranci F, Briganti F, La Porta M et al (2013) Magnetic resonance imaging in brachial plexus injury. Musculoskelet Surg 97:181–190
Daffner RH, Wippold FJ II, Bennett DL et al (2009) ACR appropriateness criteria suspected spine trauma. http://www.guideline.gov/content.aspx
Grassi R, Rea G, Scaglione M, Brunese L, Scialpi M (2000) Imaging of tracheocele: report of three cases and review of the literature. Radiol Med 100:285–287
Lian K, Bharatha A, Aviv RI et al (2011) Interpretation errors in CT angiography of the head and neck and the benefit of double reading. AJNR Am J Neuroradiol 32:2132–2135
Halsted MJ (2004) Radiology peer review as an opportunity to reduce errors and improve patient care. J Am Coll Radiol 1:984–987
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Caranci, F., Tedeschi, E., Leone, G. et al. Errors in neuroradiology. Radiol med 120, 795–801 (2015). https://doi.org/10.1007/s11547-015-0564-7
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DOI: https://doi.org/10.1007/s11547-015-0564-7