BACKGROUND: Recent studies have demonstrated that gradient echo (GRE) MRI sequences are as accurate as CT for the detection of intracerebral hemorrhage (ICH) in the context of acute stroke. However, many physicians who currently read acute stroke imaging studies may be unfamiliar with interpretation of GRE images. METHODS: An NIH Web-based training program was developed including a pretest, tutorial, and posttest. Physicians involved in the care of acute stroke patients were encouraged to participate. The tutorial covered acute, chronic, and mimic hemorrhages as they appear on CT, diffusion-weighted imaging, and GRE sequences. Ability of users to identify ICH presence, type, and age on GRE was compared from the pretest to posttest timepoint. RESULTS: A total of 104 users completed the tutorial. Specialties represented included general radiology (42%), general neurology (16%), neuroradiology (15%), stroke neurology (14%), emergency medicine (1%), and other (12%). Median overall score improved pretest to posttest from 66.7% to 83.3%, p < 0.001. Improvement by category was as follows: acute ICH, 66.7%-100%, p < 0.001; chronic ICH, 33.3%-66.7%, p < 0.001; ICH negatives/mimics, 100%-100%, p = 0.787. Sensitivity for identification of acute hemorrhage improved from 68.2% to 96.4%. CONCLUSIONS: Physicians involved in acute stroke care achieved significant improvement in gradient echo (GRE) hemorrhage interpretation after completing the NIH GRE MRI tutorial. This indicates that a Web-based tutorial may be a viable option for the widespread education of physicians to achieve an acceptable level of diagnostic accuracy at reading GRE MRI, thus enabling confident acute stroke treatment decisions.
BACKGROUND: Recent studies have demonstrated that gradient echo (GRE) MRI sequences are as accurate as CT for the detection of intracerebral hemorrhage (ICH) in the context of acute stroke. However, many physicians who currently read acute stroke imaging studies may be unfamiliar with interpretation of GRE images. METHODS: An NIH Web-based training program was developed including a pretest, tutorial, and posttest. Physicians involved in the care of acute strokepatients were encouraged to participate. The tutorial covered acute, chronic, and mimic hemorrhages as they appear on CT, diffusion-weighted imaging, and GRE sequences. Ability of users to identify ICH presence, type, and age on GRE was compared from the pretest to posttest timepoint. RESULTS: A total of 104 users completed the tutorial. Specialties represented included general radiology (42%), general neurology (16%), neuroradiology (15%), stroke neurology (14%), emergency medicine (1%), and other (12%). Median overall score improved pretest to posttest from 66.7% to 83.3%, p < 0.001. Improvement by category was as follows: acute ICH, 66.7%-100%, p < 0.001; chronic ICH, 33.3%-66.7%, p < 0.001; ICH negatives/mimics, 100%-100%, p = 0.787. Sensitivity for identification of acute hemorrhage improved from 68.2% to 96.4%. CONCLUSIONS: Physicians involved in acute stroke care achieved significant improvement in gradient echo (GRE) hemorrhage interpretation after completing the NIH GRE MRI tutorial. This indicates that a Web-based tutorial may be a viable option for the widespread education of physicians to achieve an acceptable level of diagnostic accuracy at reading GRE MRI, thus enabling confident acute stroke treatment decisions.
Authors: Julio A Chalela; Chelsea S Kidwell; Lauren M Nentwich; Marie Luby; John A Butman; Andrew M Demchuk; Michael D Hill; Nicholas Patronas; Lawrence Latour; Steven Warach Journal: Lancet Date: 2007-01-27 Impact factor: 79.321
Authors: Chelsea S Kidwell; Julio A Chalela; Jeffrey L Saver; Sidney Starkman; Michael D Hill; Andrew M Demchuk; John A Butman; Nicholas Patronas; Jeffry R Alger; Lawrence L Latour; Marie L Luby; Alison E Baird; Megan C Leary; Margaret Tremwel; Bruce Ovbiagele; Andre Fredieu; Shuichi Suzuki; J Pablo Villablanca; Stephen Davis; Billy Dunn; Jason W Todd; Mustapha A Ezzeddine; Joseph Haymore; John K Lynch; Lisa Davis; Steven Warach Journal: JAMA Date: 2004-10-20 Impact factor: 56.272
Authors: Peter D Schellinger; Götz Thomalla; Jens Fiehler; Martin Köhrmann; Carlos A Molina; Tobias Neumann-Haefelin; Marc Ribo; Oliver C Singer; Olivier Zaro-Weber; Jan Sobesky Journal: Stroke Date: 2007-08-16 Impact factor: 7.914
Authors: Harold P Adams; Gregory del Zoppo; Mark J Alberts; Deepak L Bhatt; Lawrence Brass; Anthony Furlan; Robert L Grubb; Randall T Higashida; Edward C Jauch; Chelsea Kidwell; Patrick D Lyden; Lewis B Morgenstern; Adnan I Qureshi; Robert H Rosenwasser; Phillip A Scott; Eelco F M Wijdicks Journal: Circulation Date: 2007-05-22 Impact factor: 29.690