title: Interpretation of magnetic resonance imaging in the chronic phase of traumatic brain injury: what is missed in the original reports?
abstract: OBJECTIVE
  To find eventual differences in detecting the late stage TBI findings in MRI between two neuroradiologists and to compare the results with the original reports.
  
  
  METHODS
  Two neuroradiologists with different levels of experience (R1 and R2) reviewed 89 cranial 1.5 T MRI examinations of patients with clinically evident TBI. They recorded the nature, location and side of the finding and stated their view of traumatic axonal injury (TAI). The original reports were reviewed accordingly.
  
  
  RESULTS
  TAI was reported as being evident or possible in 51 patients with TBI. However, only 30 (76%) of these concerned the same patients. R1 reported more contusion findings, but both found the same number of spot-like haemorrhages. The most striking difference was in the reporting of localized atrophy. R1 reported atrophy in 51/178 (29%) frontal lobes, whereas R2 in 14/178 (8%). Many of the findings were missed in the original reports.
  
  
  CONCLUSIONS
  The interpretation of TBI findings in late stage MRI yields significant variability between neuroradiologists. This may endanger diagnostics and lead to false treatment decisions and medico-legal problems. Standardized quantitative imaging analysis programs and advances in MRI technology should be utilized to improve radiological TBI diagnosis.
authors: Suomen Terveystalo Medical Imaging , Turku , Finland .
authors: Jussi P
authors: JP
authors: Laalo
authors: Timo J
authors: TJ
authors: Kurki
authors: Olli S
authors: OS
authors: Tenovuo
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000473:pathology*; D003627:Data Interpretation, Statistical; D020833:Diffuse Axonal Injury / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009485:Neuroradiography; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results