To understand the anatomy of the review areas where pathological findings are commonly missed. To illustrate the subtle radiological findings commonly misinterpreted by junior doctors and registers. To discuss the appropriate steps in systematic evaluation of CT and MR images of brain to avoid these common misinterpretations.
Radiologists are prone to make perceptual or cognitiveerrors and/or miss the findings in certain areas in the head encountered at routine CT and MR imaging of brain.
Probability of missing findings is much more when the findings are subtle,
especially for an untrained eye! Bahrami et al (1),
defined these areas as “blind spots” (Table 1). In this exhibit we have provided pictorial review of most commonly missed pathologies by the reporting junior radiologistc and residents. Knowledge of...
Findings and procedure details
We reviewed approximately 200 CT scans and 100 MR scans of brain over a period of ~4 years in a tertiary centre and found out the most commonly missed pathologies by the reporting junior radiologists and residents in decreasing order of frequencies were: Traumatic (Subtle subarachnoid hemorrhage,
subacute subdural hemorrhage,
diffuse axonal injury and fractures particularly at the base of the skull,
and orbital blow out) Ischemic ( hyper acute MCA...
Crucial step in avoiding errors is to systematically review the blind spots using comprehensivecheck list.
Knowledge of anatomical features of these blind spots,
use of appropriate window width while evaluating CT images and use of appropriate imaging sequence while evaluating MR images are important for avoiding false negative results.
(2009).Quality Initiatives: Blind Spots at Brain Imaging.
Detection of hyperacute subarachnoid hemorrhage of the brain by using magnetic resonance imaging.
Journal of Neurosurgery,