Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Levine, D.
Right arrow Articles by Robertson, R. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Levine, D.
Right arrow Articles by Robertson, R. L.
(Radiology 2008;247:516-527.)
© RSNA, 2008

Obstetric Imaging

Frequency and Cause of Disagreements in Diagnoses for Fetuses Referred for Ventriculomegaly1

Deborah Levine, MD, Henry A. Feldman, PhD, João F. Kazan Tannus, MD, PhD, Judy A. Estroff, MD, Melissa Magnino, BA, Caroline D. Robson, MD, Tina Y. Poussaint, MD, Carol E. Barnewolt, MD, Tejas S. Mehta, MD, MPH, and Richard L. Robertson, MD

1 From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 (D.L., J.F.K.T., M.M., T.S.M.); and Clinical Research Program (H.A.F.) and Department of Radiology (J.A.E., C.D.R., T.Y.P., C.E.B., R.L.R.), Children's Hospital Boston, Boston, Mass. From the 2006 RSNA Annual Meeting. Received June 18, 2007; revision requested August 16; revision received August 29; accepted September 27; final version accepted October 12. Supported by National Institutes of Health, National Institute of Biomedical Imaging and Bioengineering grant 01998. Address correspondence to D.L. (e-mail: dlevine{at}caregroup.harvard.edu).

Purpose: To prospectively assess the frequency and cause of disagreements in diagnoses at ultrasonography (US) and magnetic resonance (MR) imaging for fetuses referred for ventriculomegaly (VM).

Materials and Methods: One hundred ninety-five women, aged 18–44 years, with 200 fetal referrals for VM, were recruited in a prospective IRB-approved, HIPAA-compliant study. Written informed consent was obtained. US scans were prospectively interpreted by three obstetric radiologists and MR examinations were read by one obstetric radiologist and three pediatric neuroradiologists. Final diagnosis was reached by consensus (198 US, 198 MR, and 196 US-MR comparisons). Gestational age, ventricular size, types of disagreements, and reasons for disagreements were recorded. Interreader agreement was assessed with {kappa} statistics. Ventricular diameter, gestational age, and confidence scores were analyzed by using mixed-model analysis of variance, accounting for correlation within reader and fetus.

Results: There was prospective agreement on 118 (60%) of 198 US and 104 (53%) of 198 MR readings. Consensus was more likely when the final diagnosis was isolated VM (83 of 104, 80% at US; 82 of 109, 75% at MR) than when the final diagnosis included other anomalies as well (14 of 63, 22% at US; seven of 68, 10% at MR; P < .001). There was disagreement on 19 (10%) of 196 and 31 (16%) of 196 fetuses about the presence of VM at US and MR, respectively, and on 29 (15%) of 198 and 39 (20%) of 198 fetuses regarding the presence of major findings at US and MR, respectively. Reasons for discrepancies in reporting major findings included errors of observation, lack of real-time US scanning, lack of neuroradiology experience, as well as modality differences in helping depict abnormalities.

Conclusion: Of radiologists who read high-risk obstetric US and fetal MR images for VM, there is considerable variability in central nervous system diagnosis.

© RSNA, 2008




This article has been cited by other articles:


Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
K Melchiorre, M Liberati, C Celentano, S Domizio, C Puglielli, S Buoni, M Strambi, and R Zannolli
Neurological outcome following isolated 10-12 mm fetal ventriculomegaly
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2009; 94(4): F311 - F312.
[Full Text] [PDF]