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The ‘bulky female pelvis’ : An  audit into the appropriateness of Ultrasound requests following incidental CT findings
EP34404
Poster Title: The ‘bulky female pelvis’ : An audit into the appropriateness of Ultrasound requests following incidental CT findings
Submitted on 30 Oct 2020
Author(s): Dr Mahrukh Rehman Khan, Dr Nida Mushtaq,Dr Rameesha Anwar,Dr Ola Stankiewicz
Affiliations:
This poster was presented at BIR Annual Congress 2020
Poster Views: 674
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Poster Information
Abstract: Background

With an increasing ultrasound backlog following the COVID-19 lockdown, we wanted to explore any areas of unnecessary workload1. The aim of this audit is to evaluate the appropriateness of ultrasound requests which occur following a radiologist’s recommendation as a result of incidental CT findings within the female pelvis.

Method

Data from 85 patients from Jan 2018 - 2020 who had a pelvic ultrasound following CT was analysed. Both the ultrasound reports and requests were reviewed and whether the ultrasound was performed following a radiologist’s recommendation. The findings on CT were examined and whether these correlated with the ultrasound.

Results

Out of 85 patients, 78% (66/85) had a subsequent ultrasound recommended by the reporting radiologist in a prior CT report. 34 CT reports mentioned ‘adnexal cysts’ with two stating ‘bulky adnexa’. Furthermore, 17 reports mentioned ‘bulky endometrium’ and a further 6 reported both ‘bulky uterus and adnexa’. Following ultrasound, 1 patient was found to have endometrial cancer. 87% of ‘bulky uterus’ findings were found to be fibroids on ultrasound. 97% of ‘adnexal cysts’ were found to be haemorrhagic or simple cysts on ultrasound.

Conclusion

We found that a significant proportion of subsequent ultrasounds following CT showed benign pathology. A lack of clear guidance on when ultrasound follow up is required is resulting in unnecessary imaging. We will be working with our GU radiology team to formulate guidance based on research on which pelvic findings require ultrasound follow up. A re-audit will be performed following this to assess improvements to the service.
Summary:
The aim of this audit is to evaluate the appropriateness of ultrasound requests which occur following a radiologist’s recommendation as a result of incidental CT findings within the female pelvis.
References: 1. RCR. Interim Recovery Guidance COVID 19. https://www.rcr.ac.uk/sites/default/files/covid-19-interim-recovery-guidance.pdf [accessed 25 August 2020)
2. Fig 1: case courtesy of Dr Dalia Ibrahim Radiopaedia.org, rID: 29791
3. Fig 2: case courtesy of Dr David Ceuta, Radiopaedia.org, rID: 22853
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