Retrospective analysis of the effect of limited english proficiency on abdominal MRI image quality

Purpose

To evaluate the effect of English proficiency on abdominal MRI imaging quality.

Methods

Three equal-sized cohorts of patients undergoing 3T abdominal MRI were identified based on English proficiency as documented in the EMR: Primary language of English; English as a second language (ESL)/no translator needed; or ESL, translator needed (42 patients per cohort for total study size of 126 patients). Three radiologists independently used a 1–5 Likert scale to assess respiratory motion and image quality on turbo spin-echo T2WI and post-contrast T1WI. Groups were compared using Kruskal–Wallis tests.

Results

For T2WI respiratory motion, all three readers scored the Translator group significantly worse than the English and ESL/no-Translator groups (mean scores across readers of 2.98 vs. 3.58 and 3.51; p values < 0.001–0.008). For T2WI overall image quality, all three readers also scored the Translator group significantly worse than the English and ESL/no-Translator groups (2.77 vs. 3.28 and 3.31; p values 0.002–0.005). For T1WI respiratory motion, mean scores were not significantly different between groups (English: 4.14, ESL/no-Translator: 4.02, Translator: 3.94; p values 0.398–0.597). For T1WI overall image quality, mean scores also were not significantly different (4.09, 3.99, and 3.95, respectively; p values 0.369–0.831).

Conclusion

Abdominal MR examinations show significantly worse T2WI respiratory motion and overall image quality when requiring a translator, even compared with non-translator exams in non-English primary language patients. Strategies are warranted to improve coordination among MR technologists, translators, and non-English speaking patients undergoing abdominal MR, to ensure robust image quality in this vulnerable patient population.