Rationale and Objectives
At our institution, on-call radiology residents perform emergent ultrasounds (US)
outside of departmental working hours. The aim of the study was to evaluate radiology
resident-performed US for clinically suspected acute appendicitis in women under the
age of 40.
Materials and Methods
Retrospective review of 104 consecutive US scans outside of departmental working hours
by radiology residents, and 104 consecutive US studies scanned during departmental
working hours by sonographers, in women under the age of 40 for clinically suspected
appendicitis .
Results
Appendix visualization rate was 27% for the resident group (sonographer group: 30%,
p = 0.759). The sensitivity and specificity of US for appendicitis were 63% (95% confidence
interval: 41%–81%) and 98% (95% CI: 91%–100%), respectively for the resident group
(sonographer group: 69% [95% CI: 41%–89 %] and 98% [95% CI: 92%–100%], respectively).
An alternative cause for right lower quadrant pain was offered in 17% of resident
group cases (sonographer group: 21%, p = 0.598). Follow-up CT or MRI was performed in 47% of resident cases (sonographer
group: 44%, p = 0.781). Residents performed more focused US (i.e. not imaging the pelvic organs),
at 34% (sonographer group: 1%, p < 0.001). When only focused scanning was performed by residents, there was a trend
toward increased downstream imaging (CT or MRI), odds ratio = 2.76 (95% CI: 0.99–7.70).
Conclusions
Out-of-hours US scans performed by radiology residents had similar performance characteristics
compared to departmental sonographers. We discovered an increased rate of downstream
imaging in cases in which residents performed limited scans and did not document visualization
of the pelvic organs.
Key Words
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Article Info
Publication History
Published online: August 14, 2020
Accepted:
July 16,
2020
Received in revised form:
July 7,
2020
Received:
May 12,
2020
Footnotes
Declarations of interest: None.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
