Zeynep Nazlı SIR, Yeşim İŞLER, Halil KAYA

Beyin Tomografi Yorumlamada Acil Tıp Asistan ve Uzmanları ile Radyologların Karşılaştırılması

Çalışmanın amacı, hastanemiz acil servisine başvuran kafa travmalı çocuk hastalara çekilen kranial bilgisayarlı tomografi (BT) görüntülerinin, acil tıp asistan (ATA) ve acil tıp uzman (ATU) hekimlerinin yaptığı yorumun, radyoloji uzmanı (RU) tarafından yapılan yorum ile uyumluluğunu karşılaştırmaktır. 2 aylık dönemde Yüksek İhtisas Eğitim ve Araştırma Hastanesi acil servisine kafa travması ile başvuran ve kranial BT görüntülemesi yapılıp, bir radyoloji uzman hekimi tarafından raporlanmış kranial BT görüntüleri kullanılarak yapıldı. Çalışmaya 10 ATU ve 2 yılını doldurmuş 10 ATA gönüllü oldu. 126 hastanın kranial BT’si randomize olarak dağıtılarak ayrı ayrı değerlendirmesi istendi. RU hekiminin sonuç raporları altın standart kabul edildi. Fraktür bölgelerinde ATU ve ATA’nın RU ile uyumlu olduğu görülmektedir (κ=0,58 κ=0,68). Fraktür tipinde ATU ve ATA’nın RU ile uyumlu olduğu görülmektedir ( κ=0,58 κ=0,68). Kanama bölgesinde ATU ve ATA’ların RU ile uyumunun orta düzeyde olduğu görülmektedir (κ=0,41 κ=0,47). Kanama tipinde, ATU ve ATA’nın RU ile uyumlu olduğu görülmektedir (κ=0,54 κ=0,60). Genel olarak acil tıp asistan ve uzmanlarının kanama, fraktür ve diğer bulguları saptamada radyoloji ile uyumunun iyi düzeyde olduğu görüldü. Kanama, fraktür tipi ve lokalizasyonunda uyuma bakıldığında orta-iyi derecede olduğu görüldü. Acil tıp asistanlarının uzmanlara göre uyumunun daha yüksek olduğu görüldü.

Anahtar Kelimeler:

pediatrik kafa travması, kranial BT, ATA, ATU VE RU yorumu

Comparison of Cranial Tomography Interpretations between Radiologists and Emergency Medicine Specialists.

The aim of the study is to compare the compatibility of the interpretation made by the emergency medicine assistant (EMA) and emergency medicine specialist (EMS) physicians of the cranial computed tomography (CT) images taken in pediatric patients with head trauma who applied to the emergency department of our hospital with the interpretation made by the radiologist (RS). Cranial CT imaging was performed using cranial CT images reported by a radiology specialist who applied to the Emergency Department of Yüksek İhtisas Training and Research Hospital with head trauma in a 2-month period. 10 EMSs and 10 EMA who have completed 2 years volunteered for the study. Cranial CT scans of 126 patients were randomly distributed and asked to be evaluated separately. The outcome reports of the RS physician were accepted as the gold standard. It is seen that EMS and EMA are compatible with RS in the fracture regions (κ=0.58 κ=0.68). It is seen that EMS and EMA are compatible with RS in the fracture type (κ=0.58 κ=0.68). In the hemorrhage region, the agreement of EMS and EMA with RS is seen to be moderate (κ=0.41 κ=0.47). In the hemorrhage region, the agreement of EMS and EMA with RS is seen to be moderate (κ=0.41 κ=0.47). In the bleeding type, EMS and EMA seem to be compatible with RS (κ=0.54 κ=0.60). In general, it was observed that the compliance of emergency medicine residents and specialists with radiology in detecting bleeding, fracture and other findings was at a good level. Bleeding, fracture type and localization were found to be moderate to good. It was observed that the compliance of emergency medicine residents was higher than the specialists.

Keywords:

pediatric head travma, cranial CT, EMA, EMS AND RS compliance,

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