Abstract
Introduction: Neuroimaging plays an important role in assessing patients referred to a memory assessment service. CT scans are a cost-effective option and are useful to identify other causes of cognitive impairment and provide valuable information regarding the subtype of dementia. In our trust, there is no standardised request proforma for CT head scans and not all relevant criteria have been included that are in line with the guidance from the British Society of Neuroradiologists (BSNR) proposed structure dementia template for routine clinical practice. This audit aims to assess CT head scan reports of patients with cognitive impairment referred for a memory assessment to determine whether information from the request has been addressed in the report.
Methods: Retrospective review of CT head scan reports from an outpatient memory assessment clinic between July and September 2022. Data was collected from Cito, Rio. 58 scans were reviewed against CT request proforma which requested to comment on evidence of different atrophy in medial temporal lobe, hippocampus, amygdala; evidence of ischaemia, infarction, and small cerebral vessel disease; rule out Space Occupying Lesion (SOL).
Results: CT scans were reviewed against the CT request. 67% commented on the medial temporal lobe, 31% on the hippocampus, and 0% on the amygdala. 21 out of 58 reports commented on the Medial Temporal Atrophy score. In terms of ischaemia/infarcts all 58 reports mentioned this, while 78% commented on evidence of small vessel disease and 95% on SOL.
Conclusion: Reviewing the criteria against each CT report, not all information was commented on by the radiologists. The CT request proforma overlaps with some of the proposed BSNR guidelines; however, it could be improved to include relevant information that will aid the referrer with the diagnosis. Action plan: discuss with local old age psychiatry to refine the CT request proforma.