title: Standardising reporting of cervical lymphadenopathy in paediatric neck ultrasound: a pilot study using an evidence-based reporting protocol.
abstract: OBJECTIVE
  Cervical lymphadenopathy is common in children and can arise from a wide range of aetiologies. Ultrasound can be a useful imaging tool for initial investigation but is known to be operator dependent. We aimed to compare the content of ultrasound reporting in this clinical scenario before and after the introduction of an evidence-based reporting protocol.
  
  
  METHODS
  We performed a prospective 8-month pilot study assessing the content of ultrasound reports generated from scans to investigate suspected cervical lymphadenopathy in children referred to our tertiary referral otolaryngology service. We found wide variation in report content and inconsistent reporting of certain radiological features. In response to this we performed a literature search to identify key, clinically relevant ultrasonographic features for cervical lymphadenopathy and then in consultation with our radiology colleagues, devised a protocol to facilitate the reporting of these key features. Content of reports was then prospectively re-audited over a further 8-month period.
  
  
  RESULTS
  23 reports were assessed before and 26 after introduction of the reporting protocol. Fisher's exact test was used to analyse the data. We found a statistically significant (p < 0.05) improvement in the frequency of reporting of various key features such as nodal distribution, shape, echogenicity, calcification, necrosis and vascular pattern.
  
  
  CONCLUSIONS
  The introduction of a standardised protocol has helped to streamline the reporting of ultrasounds to investigate cervical lymphadenopathy within our department. In the absence of any national guidelines on the reporting of paediatric neck ultrasound in this scenario, we propose that our protocol could be used by other departments to improve standardisation and as a teaching aid.
authors.affiliation: Departments of Otolaryngology, Royal Hospital for Sick Children, Dalnair St, Glasgow G3 8SJ, United Kingdom. LyndsayFraser@doctors.org.uk
authors.forename: Lyndsay
authors.initials: L
authors.lastname: Fraser
authors.forename: Katie
authors.initials: K
authors.lastname: O'Neill
authors.forename: Richard
authors.initials: R
authors.lastname: Locke
authors.forename: Morag
authors.initials: M
authors.lastname: Attaie
authors.forename: Greg
authors.initials: G
authors.lastname: Irwin
authors.forename: Haytham
authors.initials: H
authors.lastname: Kubba
authors.forename: Fiona B
authors.initials: FB
authors.lastname: MacGregor
mesh_terms: D000367:Age Factors; D002648:Child; D002985:Clinical Protocols / Q000592:standards*; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D009333:Neck; D010865:Pilot Projects; D011446:Prospective Studies; D012017:Referral and Consultation; D058028:Research Report / Q000592:standards*; D014463:Ultrasonography
keywords: Audit; Cervical lymphadenopathy; Radiology reporting; Ultrasonography