Thursday, 15 April 2010

Neuroradiology reporting in Abuja

A few doctors and I are seriously concerned about the quality of reporting of Neuro CT and MRI scans. This is sometimes of such poor quality that it directly affects the management of the patient and increases morbidity and mortality.
One understands that perhaps none of our local radiologists are specifically neuroradiologically trained and have taken on this burden as a public service.
We also appreciate that there is a learning curve with CT and MRI scans as these have only recently become available in Nigeria. While appreciating the service rendered by the radiologists in this subspeciality, the impact of such reports cannot be ignored. There are a few suggestions that may help improve the current situation.

  • Regular neuroradiology meetings to include all radiologists with an interest, neurologists, neurosurgeons, oncologists and pathologists and general physicians especially those managing stroke and raised intracranial pressure medically. This can take place at any of the facilities with a CT or MRI scanner on a rotational basis. These facilities are Zankli hospital, Abuja Clinics, National Hospital, Echo scan, State House Medical Centre and Medicaid.
  • Subspecialization and training in neuroradiology should be encouraged.
  • Radiologists who notice significant pathology on a scan should seek a second opinion from or ask that the patient be referred ASAP or urgently to the care of a neurosurgeon or neurologist.
  • In certain regards, reports should be written clearly and boldly state the following, "REFERRAL TO A NEUROSURGEON IS ADVISED"
  • Qualify the referral as URGENT if brain shift or herniation is apparent. Patients with raised intracranial pressure could lose their vision or rapidly deteriorate while waiting for the radiology report.
  • Direct telephone call to a neurologist or a neurosurgeon may be advisable in the interest of the patient.
  • Resident radiologists should seek a consultant opinion as a matter of urgency and not submit an unconfirmed report where significant pathology is seen.

This is open to discussion and your thoughts on the issue will be appreciated. I suppose and assume that similar problems exist in other parts of the country.

Kind regards

Biodun Ogungbo
Consultant neurosurgeon