Common Resident Errors When Interpreting Computed Tomography of the Abdomen and Pelvis: A Review of Types,Pitfalls, and Strategies for Improvement

Objective

The purpose of this study was to identify common errors that radiology residents make when interpreting abdominopelvic (AP) computed tomography (CT) while on call, to review the typical imaging findings of these cases, and to discuss strategies for improvement.

Materials and Methods

AP (or chest, abdomen, pelvis) CTs from 518 weekend senior call shifts (R3 or R4) were retrospectively reviewed. Discrepancies between preliminary and final reports were identified and then rated by whether the miss could impact short-term management. The imaging findings from the cases were reviewed.

Results

A total of 4695 CTs were reviewed, revealing a total of 145 discrepancies that could affect short-term clinical management (miss rate 3.1%). The most common misses were related to blood clots (13.8%), colitis (8.3%), misplaced lines or tubes (6.9%), or pyelonephritis (5.5%). Common pitfalls and strategies from improved detection are discussed using image examples.

Conclusions

Through increased attention to the vasculature, colon, devices, and kidneys, trainees may improve their discrepancy rates and improve on-call reporting.