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ECR 2019 / C-2347
Certificate of Merit
Normal looking abnormal brain: Review areas in routine practice.
Congress: ECR 2019
Poster No.: C-2347
Type: Educational Exhibit
Keywords: Anatomy, Emergency, Neuroradiology brain, CT, MR, PACS, Audit and standards, Comparative studies, Observer performance, Ischaemia / Infarction, Trauma, Education and training
Authors: P. Hota, H. C. Chadaga, S. Patwari, S. Kanumukullakshminarayana; Bangalore/IN
DOI:10.26044/ecr2019/C-2347

Background

Radiologists are prone to make perceptual or cognitive errors 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).

 

Table 1: "Blind spots" in Brain imaging
References: Bahrami, S., & Yim, C. M. (2009). Quality Initiatives: Blind Spots at Brain Imaging. RadioGraphics, 29(7), 1877–1896.

 

Fig. 41: Midsagittal section of MRI Brain showing "BLIND SPOTS"
References: Radiology, COLUMBIA ASIA REFERRAL HOSPITAL, YESHWANTPUR, BANGALORE, COLUMBIA ASIA REFERRAL HOSPITAL, YESHWANTPUR, BANGALORE - Bangalore/IN

 

Fig. 42: Sagittal MRI highlighting basal cisterns(light blue),the ventricles (teal blue), and a variety of cerebral structures including the midbrain (mb) pons, medulla (med) and cerebellum.
References: http://www.imagingdomain.com

In this exhibit we have provided pictorial review of most commonly missed pathologies by the reporting junior radiologistc and residents.

 

Knowledge of anatomical features of these blind spots, use of appropriate window width while evaluating CT images, use of appropriate imaging sequence while evaluating MR images and inclusion of a comprehensive checklist are crucial for avoiding false negative results.

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