Outcome of examinations self-referred as a result of spiral CT of the abdomen.

Journal Article (Journal Article)

RATIONALE AND OBJECTIVES: The interpretation of an abdominal computed tomographic (CT) scan is occasionally inconclusive. In many of these cases, the radiologist suggests an additional imaging test for further confirmation or clarification. The purpose of this study was to evaluate the outcome of self-referral by the radiologist after abdominal CT scanning. MATERIALS AND METHODS: Reports from 545 consecutive abdominal CT scans were reviewed to track recommendations for additional imaging. In patients who underwent the additional work-up, a determination of the effect of the study was attempted. In patients who did not, explanations were sought. Wording of the recommendations was also recorded. RESULTS: Recommendations were made for additional imaging studies in 105 (19.3%) patients. Of these, 32 (30.5%) were performed and 31 (96.9%) were helpful by confirming malignancy (n = 5), confirming a benign process (n = 24), or being therapeutic (n = 2). In one, no information was added. There were 63 (60.0%) patients who did not undergo the recommended studies. Reasons included "no clinical indication" (n = 51), alternative study performed (n = 9), or study previously performed (n = 3). In eight (7.6%) patients the chart provided insufficient information about whether the patient underwent the study, and in two (1.9%) the chart was unavailable. Wording of the recommendation had no effect on whether the study was performed (P > .05). CONCLUSION: Although interpretation of abdominal CT scans leads to recommendations for additional imaging in a minority of cases, these recommendations were infrequently followed. When followed, however, the findings from the recommended studies were usually helpful. Better clinical information is perhaps the best way to reduce self-referral by radiologists.

Full Text

Duke Authors

Cited Authors

  • Baumgarten, DA; Nelson, RC

Published Date

  • December 1997

Published In

Volume / Issue

  • 4 / 12

Start / End Page

  • 802 - 805

PubMed ID

  • 9412692

International Standard Serial Number (ISSN)

  • 1076-6332

Digital Object Identifier (DOI)

  • 10.1016/s1076-6332(97)80257-7


  • eng

Conference Location

  • United States