drranjit

2+ Year Member
Oct 5, 2014
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I'm a GS intern, and I have been trying to look at all the CT scans that I can. I seriously lack decent foundations, so honestly I have no idea what I'm looking at 90% of the time. The advice I keep getting is "look at more CTs", but I seem to lack basic understanding, so there's essentially nothing to build on.

Anyone experiencing/has experienced this? Is there a website/resource where I can learn the most basic tips for reading CT abd?

Thank you
 

ThoracicGuy

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Jun 11, 2013
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I'm a GS intern, and I have been trying to look at all the CT scans that I can. I seriously lack decent foundations, so honestly I have no idea what I'm looking at 90% of the time. The advice I keep getting is "look at more CTs", but I seem to lack basic understanding, so there's essentially nothing to build on.

Anyone experiencing/has experienced this? Is there a website/resource where I can learn the most basic tips for reading CT abd?

Thank you
One thing that can help is when you have a patient that gets a scan, go down to radiology and have the resident go over it with you.
 

ACSurgeon

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One thing that can help is when you have a patient that gets a scan, go down to radiology and have the resident go over it with you.
Yup. This. And try to read your own scan as best as you can before going to radiology and have them show you their findings
 
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vhawk

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Here is the approach I found most helpful and what I tell the junior residents. Start by reading every scan of yours, cold. So don't look at the read, don't talk to rads just read the scan. Top to bottom. Try to develop a systematic way of doing it look at lung bases, then look at diaphragm, look for air or fluid, liver, then spleen, etc. Do this and come up with a diagnosis, every time. Whether that's "normal scan" or some pathology, and expect you will be wrong, but it helps to stake something to it so it's important to try to make your dx. Then look at the read and see how wrong you were. Go back through and see the things they commented on. See how they described them. Then go down to rads and ask, politely, if the rads attending will go over a scan with you. You've seen it twice now and know the dx, so spend the time listening to the way he describes what he is looking for and what he sees.

Do this every scan. Eventually you will start to see that you are catching some of the things in the read then most of them. Then you will find you just look at the read to confirm. Then you will start asking the radiologist things like "so the report says normal but the small bowel looks a little funny to me on slices 50 and 51, what am I seeing?" Again, to start with this will just be you being wrong, but eventually you will start catching things they miss.

There are systems for looking through scans like they teach for cxr but it really just matters that you are looking through that whole scan. What it mostly is is pattern recognition so you are just developing your subconscioius model of what normal looks like. Eventually you just sort of get to the point where abnormal things kind of jump out at you.
 

armybound

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Agree with all of the above. Excellent advice.

Reading your own scans is crucial. Look it over yourself, figure out what you see or don't see, read the report and confirm what you saw or didn't see, go over the films with an upper level and/or radiology. Practice.
 
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dmal

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I struggled with this a good deal as an intern and even into 2nd year. I agree with everything everyone said and the methods everyone else have said as it what worked for me. My seniors never went over this with me. I was that one intern that I felt basically couldn't tell s&*t, when I looked at the scan. I tried to read some radiology resources that went over techniques on how to interpret but still couldn't get it. So pretty much did a combination what everyone else said here. Would look at it first and try and figure it out myself. Then I'd look at the read and see if it confirmed what I saw. Then I'd go down to radiology and have one of the residents or their attendings go over it again with me. Did that with EVERY SINGLE scan, xray, ultrasound etc. Some of the rads residents would get irritated with me, but w/e...its the only way that I was able to learn.
 

sievert_fever

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Jan 13, 2015
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These resources are admittedly more than "basic tips," but if you feel so compelled and have some free time on your hands, these are what many first year radiology residents use:
- Fundamentals of Body CT (standard textbook; easy read)
- e-Anatomy (actual CT scans that are labeled in tremendous detail; can toggle various labels)
 

akwho

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A surgeon needs to be able to read his/her own imaging. It is an absolutely critical skill worth developing.
  1. You are the one operating based on imaging findings so you have ultimate responsibility for the patient, and if you operate based on a wrong diagnosis that has the potential to be malpractice.
  2. There will be nights on trauma or other services where it is an R2 radiology resident who doesn't know what they are looking at, and you have to make a middle of the night decision on treatment
  3. In my subspeciality at least 10-20% of the non musculoskeletal-fellowship trained radiology reads are laughably bad, inaccurate or missed and it would be horrible patient care to rely upon these reads for treatment.
  4. Reads may take a while and it will delay patient care to wait for radiologist interpretation.
Agree with the read it yourself first, compare to radiologist read, find section on imaging they discuss in their report and see if you agree, if you are unclear how/why they reached that conclusion, check with co or senior residents, if still unclear go to rads and discuss with the radiologist. Do this enough times and you will be a specialist in the imaging relating to your speciality.
 
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qwerty89

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If you have an iphone/ipad download the app called "Radiology 2.0: One Night in the ED". Its free.

It has around 50 annotated cases. Many might not apply to general surgery, but most do. SBO. Incarcerated hernias. Closed loop obstructions. Appys. Choles.

And as a radiology resident I second e-anatomy. Its 75 bucks for a 1 year subscription but its really amazing and probably worth it. Might even be reimbursable by your program under your educational fund.