The effects of misinterpretation of an artefact on multidetector row CT scans in children.
BACKGROUND
Artefacts reflect problems with radiographic technique rather than true pathology. These may be misinterpreted as pathology with serious consequences. An artefact caused such problems in one paediatric imaging department.


OBJECTIVE
To determine the incidence, and consequences of misinterpretation, of a CT artefact in a paediatric imaging department.


METHODS
A retrospective review of images and reports of paediatric CT scans over a set period with a known artefact was performed. Reports were correlated with reviewers' evaluation of the presence of artefact and reviewed for correct identification of artefact, misinterpretation as pathology, and action taken as a result.


RESULTS
A total of 74 CT scans had been performed over the study period and an artefact detected by reviewers on 32 (43%). Six (18.75%) of these were misinterpreted as pathology, of which three (9.4%) were reported as tuberculous granulomas, two (6.2%) as haemorrhages and one (3.1%) as an unknown hyperdensity. Two patients (6.2%) had subsequent MRI studies performed, and treatment for tuberculosis was continued in one patient (3.1%).


CONCLUSIONS
No initial report identified the artefact. One-fifth of the scans with the artefact were misinterpreted as pathology and half of these misinterpretations led to further action. Artefacts result in false diagnoses and unnecessary investigations; vigilance is needed.
du Plessis
Anne-Marie
AM
Radiology Department, Tygerberg Hospital, University of Stellenbosch, Cape Town, 7505, South Africa. docams@iafrica.com
Theron
Salomine
S
Andronikou
Savvas
S
D000293:Adolescent; D016477:Artifacts; D001927:Brain Diseases / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D004453:Echoencephalography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*