Radiology reports can feel overwhelming, but they’re easier to understand when you know what to focus on. These reports summarise findings from imaging tests like X-rays, CT scans, MRIs, and ultrasounds, helping doctors diagnose conditions and plan treatments. In New Zealand, radiology reports are structured into key sections: patient details, imaging techniques, findings, and impressions. The "Impression" is the most important part, offering a summary of results and next steps. While some terms may seem technical, recognising common phrases like "unremarkable" or "no acute abnormality" can help you make sense of your report. Always discuss the results with your doctor for accurate interpretation and advice.
How to Read a Radiology Report: Key Sections Guide
10 – How to Read your Radiology Reports by Dr. Carla Harmath
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Main Parts of a Radiology Report
Radiology reports in New Zealand follow a consistent structure, making them easier to understand once you’re familiar with the format. Knowing these key sections can help you discuss your results with your healthcare provider and prepare any questions for your GP or specialist.
Patient Details and Clinical History
Often titled "Indication", "Clinical Information", "History", or "Reason for Exam", this section explains why the imaging was requested. It includes essential details like your age, gender, symptoms (e.g., "new onset abdominal pain"), and the medical reasoning behind the test. This context guides the radiologist in focusing their analysis on the areas most relevant to your condition.
Type of Imaging Used
The imaging method is described under the "Type of Exam" and "Technique" sections. The "Type of Exam" notes the procedure performed (e.g., "CT of the abdomen and pelvis with contrast") and the date it was conducted. The "Technique" section provides more technical details, such as the imaging views, use of contrast agents, and equipment specifications. For instance, a brain MRI might specify the use of a "3.0 Tesla scanner" with sequences like "Sagittal T1, axial T2, axial FLAIR", along with the injection of "15 cc Clariscan".
"The technique section describes how the exam was done, giving more details than the type of exam section. It is intended for documentation purposes… as this can be helpful for a radiologist when future exams may become necessary to prevent duplication of imaging techniques." – Chad Hutchison, Founder and CEO, Maven Imaging
This section primarily serves as a record, ensuring consistency if repeat imaging is required.
Findings, Impressions, and Next Steps
After the technical details, the report moves on to the observations. The "Findings" section lists all structures examined, highlighting both normal and abnormal features. For example, it may mention that an organ is "unremarkable" or "intact" to indicate normalcy.
The "Impression" section is where you should focus first. It summarises the key findings and provides the radiologist’s interpretation. This section often includes recommendations for next steps, such as further tests, follow-ups, biopsies, or instructions for "clinical correlation" – where your doctor compares imaging results with your symptoms to determine their relevance.
"The Impression section is the most important part of your report. … The radiologist has reviewed your findings and synthesized all that data to come up with a conclusion…essentially his or her opinion about what your test shows." – Dr. Bonnie O’Hayon, Radiologist, North York General Hospital
Medical Terms You’ll See in Radiology Reports
Radiology reports often include specialised terms that might seem confusing at first glance. However, many of these phrases are used repeatedly and follow predictable patterns. Getting familiar with them can help you better understand what the radiologist observed and whether any findings need further investigation.
What Common Terms Mean
"Unremarkable" is a term that signals positive findings. It means the radiologist didn’t identify any significant abnormalities in the area examined. Dr. Bonnie O’Hayon, a radiologist at North York General Hospital, explains: "At the conclusion of the report, your kidney may be categorised as ‘unremarkable’ instead of ‘normal’, signalling that while technically not 100% ‘normal’, there’s nothing significant going on that requires extra attention or investigation".
"No acute abnormality" indicates there’s no evidence of a recent injury or sudden issue, such as a new fracture or infection. Essentially, it rules out urgent problems.
Radiologists often describe tissue appearance using terms like "density" and "opacity". For instance, structures that absorb more X-rays, such as bones or calcifications, appear lighter or white (sometimes called "hyperdense"). On the other hand, areas absorbing fewer X-rays, like air or fat, appear darker, referred to as "hypodense" or "lucent." For CT scans, these measurements are based on the Hounsfield scale, where water equals 0, air measures –1000, and bone starts around 300 and can exceed 1000.
"Lesion" is a general term for any abnormal area of tissue, which could include a cyst, tumour, scar, or infection. Similarly, a "nodule" is a small, typically round growth, while a "mass" refers to a larger, more complex abnormality. These terms don’t automatically mean cancer – many lesions and nodules are harmless – but they often warrant follow-up imaging to monitor changes.
An "incidental finding" refers to an abnormality discovered unintentionally during a scan that wasn’t related to the original reason for the test. According to RadiologyInfo.org, "Many findings that a radiologist sees on your scan are incidental and will cause you no harm".
Additional terms you might encounter include:
- "Effusion": An abnormal fluid collection in a body cavity, such as the lungs or joints.
- "Stenosis": Narrowing of a passageway, like a blood vessel.
- "Oedema": Swelling caused by fluid buildup.
- "Enhancement": Areas that appear more visible after contrast dye is used, often pointing to inflammation or tumours.
Understanding the difference between "acute" and "chronic" is also essential. Acute refers to sudden or recent conditions, while chronic describes issues lasting three months or more. Knowing these terms can help you interpret updates about your health more confidently.
Phrasing Used in New Zealand
Familiarity with these terms also helps you navigate the standardised language used in New Zealand’s radiology reports. Radiology practices here follow guidelines set by the Royal Australian and New Zealand College of Radiologists (RANZCR), which introduced standardised terminology for eReferrals in May 2022. This ensures consistent phrasing across major providers like Bay Radiology, Auckland Radiology, and Pacific Radiology.
Reports in New Zealand use metric measurements, and dates are formatted as DD/MM/YYYY. When discussing prior scans, radiologists will note whether findings are "stable" (unchanged) or "new", helping distinguish harmless, long-standing features from potential concerns.
If you access your report through electronic health records before your GP has reviewed it, don’t let unfamiliar terms cause unnecessary worry. Many findings that sound concerning are routine observations requiring professional interpretation within the context of your medical history and symptoms.
How to Read Findings and Impressions
Understanding Descriptive Findings
The Findings section of a radiology report provides a detailed account of what the radiologist observes during your scan. It covers each organ or structure, describing aspects like size, shape, location, and density. Normal features are often labelled as "normal" or "unremarkable."
This section is essentially a technical checklist, systematically noting each organ system. You might encounter terms like "1.2 cm lesion in the liver" or "bilateral lung fields are clear." If there are previous scans available, comparisons may also be included to highlight changes over time.
However, the Findings section is purely observational. The radiologist documents what they see but does not interpret what these observations mean for your health. That’s why the Impression section plays such a crucial role.
What the Impression Section Tells You
The Impression section, often referred to as the "Conclusion" or "Summary", is where the radiologist connects the dots. It condenses the detailed observations from the Findings section into a concise interpretation, highlighting any key abnormalities and offering potential diagnoses. This is the part of the report your doctor will rely on to guide your care.
"Think of the Impression as the report’s bottom line – the key takeaways your doctor will use to guide your care." – Jeff Langmaid, DC
For example, a normal brain scan might state: "No acute intracranial abnormality. Brain parenchyma, ventricles, and vasculature are within normal limits." This indicates no signs of stroke, tumours, or bleeding. On the other hand, an abnormal chest scan could read: "3 cm mass in the right upper lobe concerning primary lung neoplasm. Recommend CT-guided biopsy." This would point to a potentially cancerous mass that requires further testing.
Pay attention to any follow-up recommendations, such as additional tests or specialist referrals. If the report mentions "clinical correlation", it means your doctor should compare the imaging findings with your symptoms to determine their relevance. In cases where a single diagnosis isn’t apparent, the report might provide a differential diagnosis – a list of possible causes ranked by likelihood.
Talking to Your Healthcare Provider About Your Report
Questions to Ask Your Doctor
Once you’ve gone through your radiology report, it’s a good idea to prepare specific questions for your next appointment. To make the conversation more productive, group your questions into three main areas: exam findings, the radiologist’s impression, and recommended next steps.
Start by clarifying whether the results are definitive, inconclusive, or if they include incidental findings – these are abnormalities that might not relate to the reason for your scan. You should also ask if the radiologist’s conclusion supports the initial diagnosis or suggests a list of alternative possibilities (known as a differential diagnosis).
If your report mentions "recommend clinical correlation", it’s worth asking how the imaging results tie into your symptoms and medical history. Double-check the Clinical History section of your report to ensure the information is accurate, as this plays a key role in how the images are interpreted. Radiologist Dr. Brett Mollard highlights the importance of this:
"An accurate and detailed history is our metal detector. Ignorance is not always bliss. In medicine, ignorance is frequently dangerous."
Additionally, ask your doctor to compare your current imaging results with any previous scans. This can help determine if your condition is stable, getting better, or worsening. If your doctor isn’t able to answer more technical questions, don’t hesitate to request a discussion with the radiologist who interpreted the images.
These types of questions can help you better understand your results and decide whether further imaging or treatment is necessary.
Finding Follow-Up Services with Radiology Clinics NZ
If your report suggests additional imaging or specialised procedures, Radiology Clinics NZ can simplify the process of finding follow-up care. Their directory allows you to search for clinics across New Zealand by location. Each listing provides detailed profiles, including contact details and patient reviews, so you can make an informed choice.
The platform also features an integrated map to help you navigate to the clinic you select. Whether you need a repeat scan, advanced imaging, or image-guided procedures, this tool makes it easy to locate the services you need close to home.
Conclusion
Understanding your radiology report gives you the tools to take an active role in your healthcare. By focusing on the key sections – especially the Impression – you can approach your next appointment with specific questions and a clearer understanding of your results. As Chad Hutchison, Founder and CEO of Maven Imaging, puts it: "Understanding how to read a radiology report is critical for ensuring quality patient care". This knowledge not only helps interpret your results but also builds confidence for future discussions.
Having access to and interpreting your report opens the door to informed conversations with your doctor, sharing records with specialists, and deciding whether follow-up imaging or treatment is necessary. As RadiologyInfo.org highlights: "Online access to your health records may help you make more informed decisions about your healthcare… This may increase the safety, quality, and efficiency of your care".
Start with the Impression section to grasp the main findings and recommendations, then turn to the detailed Findings section for further explanation. However, avoid self-diagnosing – always combine the report’s insights with a clinical exam and your doctor’s expertise.
This understanding ensures a smoother path to any next steps in your healthcare. If further imaging or specialised procedures are suggested, Radiology Clinics NZ offers resources to find services across New Zealand. Their platform provides clinic profiles, patient reviews, and maps to help you locate follow-up care nearby.
With this guide in hand, you’re better equipped to read your radiology report, ask the right questions, and make informed decisions about your health. Use these insights to lead meaningful discussions and stay in control of your care.
FAQs
Should I worry about an “incidental finding”?
An incidental finding refers to an unexpected abnormality discovered during an imaging test, unrelated to the reason the test was initially performed. These findings happen quite often and are usually harmless, though some may need further evaluation.
If you come across an incidental finding, make sure to discuss it with your doctor. They can help you understand its importance based on your overall health and medical history. While many of these findings don’t pose a risk, it’s crucial to follow your doctor’s recommendations to ensure nothing critical is overlooked.
What does “clinical correlation recommended” mean?
When a radiologist states, “clinical correlation recommended,” they’re suggesting that the imaging results should be evaluated alongside the patient’s medical history, symptoms, and other clinical details. This approach ensures the findings are properly understood and aids in making an accurate diagnosis.
When do I need follow-up imaging or a biopsy?
If your radiology report highlights findings that need closer examination, your doctor might recommend follow-up imaging or a biopsy. This step may be necessary for cases such as unclear results, suspicious masses, or areas that require a more detailed look. To decide if additional tests are needed, your doctor will carefully evaluate these findings in the context of your symptoms and medical history, ensuring the most accurate diagnosis and treatment plan.
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