Abstract:
Objective To evaluate the effectiveness of CT-ultrasound comparison as a quality control method for the missed diagnosis of focal liver lesions by ultrasound.
Methods The study subjects were patients who underwent imaging examinations at Peking University Shenzhen Hospital from December 2022 to April 2023. Using the CT examination results as the "gold standard", cases were divided into three groups based on the maximum diameter of the focal lesions suggested by CT: "≤1.0 cm", "1.1-2.0 cm", and "＞2.0 cm". The lesion locations and maximum diameters were analyzed, and the CT-ultrasound comparison results were classified as "weakly inconsistent (≤1.0 cm)", "moderately inconsistent (1.1-2.0 cm)", "strongly inconsistent (＞2.0 cm)", and "possibly consistent". Statistical analysis was then conducted. Based on the chronological order of CT and ultrasound reports, the paired records were categorized into "pre-examination quality control" (CT report before ultrasound report) and "post-examination quality control" (CT report after ultrasound report), and the quantity of records in each category was recorded. Records of "strongly inconsistent" were reviewed, followed by data analysis and quality control feedback.
Results Among the 2397 cases of CT-ultrasound paired focal liver lesions, the "inconsistency rate" was 24.53% (588/2397); the inconsistency rate of the "≤1.0 cm" group was the highest (42.62%, 430/1009), and that of the "＞2.0 cm" group was the lowest (7.66%, 49/640). The proportions of "weakly inconsistent", "moderately inconsistent", and "strongly inconsistent" categories were 17.94% (430/2397), 4.55% (109/2397), and 2.04% (49/2397), respectively. Cases of "strongly inconsistent" were mainly concentrated near the capsule of the left outer lobe of the liver and the diaphragmatic top of the right lobe. Among all inconsistent cases, 47.96% (282/588) were in the "pre-examination quality control" category.
Conclusion The method of CT-ultrasound comparison can serve as a practical quality control strategy to improve the missed diagnosis of focal liver lesions in ultrasound examinations.
Key words:
Computed tomography,
Ultrasound,
Liver,
Missed diagnosis,
Quality control
Heng Lyu, Licong Dong, Haiqin Xie, Zhuofei Zhao, Li Liu, Desheng Sun. CT-ultrasound comparison for evaluating missed diagnosis of focal liver lesions by ultrasound: a single-center cross-sectional quality control survey[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 712-716.