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Mammography: Current practice in Australia for the selection of bucky angle in the mediolateral oblique view of the breast 乳房x线摄影:目前在澳大利亚的实践中,在乳房的中外侧斜位视图中选择巴克角
Pub Date : 2009-12-01 DOI: 10.1016/J.EJRADI.2010.02.001
K. Spuur, A. Poulos
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引用次数: 3
Morphological and kinetic characteristics of dynamic contrast-enhanced MRI (DCE-MRI) correlated with histopathological factors of breast cancer: A potential prognostic role of breast MRI? 动态对比增强MRI (DCE-MRI)形态学和动力学特征与乳腺癌组织病理因素的相关性:乳腺MRI的潜在预后作用?
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.02.002
Katerina Vassiou , Theodora Kanavou , Marianna Vlychou , Antigoni Poultsidi , Maria Ioannou , Eleftherios Lavdas , Dimitris L. Arvanitis , Ioannis V. Fezoulidis

Purpose

To explore the correlation of morphological and kinetic DCE-MRI features with histopathological prognostic factors of invasive breast cancer.

Material and methods

Fifty-one women with 57 cancerous lesions underwent DCE-MRI prior to surgery. DCE-MRI findings were interpreted with a multifactorial classification system that included morphological (shape, margins and pattern of enhancement) and kinetic characteristics (initial signal increase and post-initial behaviour of the time-signal intensity curve). Each morphological and kinetic parameter was scored with 0, 1 or 2 points and the total score was estimated. Finally each lesion was classified into one of the five categories that correspond to the five ACR BI-RADS categories. Statistical analysis was performed to correlate DCE-MR imaging parameters and histopathological findings using Fisher's exact test and stepwise multiple regression analysis.

Results

Increase of the signal intensity at the initial phase >100% was strongly correlated with positive lymph nodes (p = 0.008, OR 0.054). Types I and II time-signal intensity curves at the post-initial phase were associated with a fourfold increase in the likelihood of progesterone receptors positivity (p = 0.022, OR 4). Finally, high total score was positively correlated with affected lymph nodes (p = 0.033, OR 0.29).

There was a trend regarding ill-defined margins of the tumor (p = 0.08) and vascular infiltration and also high score and neural infiltration (p = 0.072).

Conclusion

A multivariate interpretation model for DCE-MRI that includes morphological and kinetic characteristics has prognostic value for invasive breast cancer. Early initial contrast agent uptake and a high overall score are associated with poor prognostic factors.

目的探讨浸润性乳腺癌DCE-MRI形态学和动力学特征与组织病理学预后因素的相关性。材料与方法51例女性57个癌灶术前行DCE-MRI检查。DCE-MRI结果用多因素分类系统进行解释,包括形态学(形状、边缘和增强模式)和动力学特征(初始信号增强和时间-信号强度曲线的初始行为)。以0分、1分或2分对各形态和动力学参数进行评分,并计算总分。最后,每个病变被分为五个类别中的一个,对应于五个ACR BI-RADS类别。采用Fisher精确检验和逐步多元回归分析,统计分析DCE-MR成像参数与组织病理学结果的相关性。结果初发期信号强度增加>100%与淋巴结阳性呈正相关(p = 0.008, OR 0.054)。初始期后I型和II型时间信号强度曲线与孕酮受体阳性可能性增加4倍相关(p = 0.022, OR 4)。最后,高总分与受影响淋巴结呈正相关(p = 0.033, OR 0.29)。肿瘤边缘不清(p = 0.08)、血管浸润、高评分和神经浸润(p = 0.072)均有增加趋势。结论DCE-MRI包括形态学和动力学特征的多变量解释模型对浸润性乳腺癌具有预后价值。早期初始造影剂摄取和高总分与预后不良因素相关。
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引用次数: 6
The radiation therapist’s role in real-time EPI interpretation and decision-making 放射治疗师在实时EPI解释和决策中的作用
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.04.001
Jennifer Cox, Yobelli Jimenez

Purpose

To determine whether radiation therapists (RTT) can correctly identify field placement errors and recommend appropriate isocentre moves using electronic portal imaging.

Methods

A systematic review of the literature was made using the keywords: “radiation therapy OR radiotherapy AND electronic portal imaging”; radiation therapist OR radiographer OR radiologic technologist AND electronic portal imaging”; “electronic portal imaging”; “verification AND electronic portal imaging”; “verification AND radiation therapist”; “verification films”; “image approval”; “radiation therapist AND role expansion”; and “radiation therapist experience”.

Results

Eighteen relevant articles were found. These were collated into three topic areas: 1) current practice, 2) ability to assess EPIs, and 3) experience/education needed. It is common practice for RTTs to review EPIs in Canada, Australia and New Zealand. Education is carried out in the clinic. Concordance between RTTs and radiation oncologists (ROs) in error detection and iso-move decisions was between 90.1% and 97.3%. RTT inter-observer variability was 0.7–1.4 mm and intra-observer variability was 0.4–0.7 mm.

Conclusions

RTTs provide acceptable alternatives to ROs for rapid review of EPIs, enabling prompt corrections to be made with the patient on the treatment couch. It is recommended that RTTs take on this role, using an internal accrediting program and ongoing continual professional education.

目的确定放射治疗师(RTT)是否能够正确识别野位置错误,并使用电子门静脉成像推荐适当的等心移动。方法以“放射治疗或放疗与电子门静脉成像”为关键词,对相关文献进行系统回顾;放射治疗师或放射技师或放射技术专家和电子门静脉成像”;“电子门静脉成像”;“验证和电子门户成像”;“验证和放射治疗师”;“验证电影”;“批准”形象;“放射治疗师与角色拓展”;还有“放射治疗经验”。结果共检索到相关文献18篇。这些被整理成三个主题领域:1)当前的实践,2)评估epi的能力,以及3)所需的经验/教育。在加拿大、澳大利亚和新西兰,rtt审查EPIs是常见的做法。教育是在诊所进行的。rtt与放射肿瘤学家(ROs)在错误检测和等移决策方面的一致性在90.1%至97.3%之间。RTT观察者间变异性为0.7-1.4 mm,观察者内变异性为0.4-0.7 mm。结论srtt为快速评估epi提供了可接受的替代方案,能够在患者躺在治疗台上时及时纠正。建议rtt承担这一角色,使用内部认证程序和持续的专业教育。
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引用次数: 5
A small scale qualitative study to investigate the interaction between psychiatric patients and diagnostic radiographers in one Irish hospital 一项小规模的定性研究,旨在调查爱尔兰一家医院精神病患者与诊断放射技师之间的相互作用
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.10.001
Aoife Farmer, Michaela Davis

Background

A substantial number of patients with psychiatric illnesses present to the Imaging Department across the Irish Republic each year. Patients who have a psychiatric illness may present difficulties for the radiographer during a radiographic examination. These difficulties may include communication difficulties, and an increased prevalence to become violent due to their illness.

Aims

To investigate if radiographers feel confident interacting with psychiatric patients. To ascertain if radiographers need more training in this area of patient interaction.

Method

A qualitative approach was used drawing upon six radiographers working in a regional hospital with a psychiatric unit attached. The radiographers were interviewed individually and the results were thematically analysed.

Results

The results indicated that the level of the radiographers own confidence in relation to interacting with psychiatric patients was influenced by the number of years since qualification. The majority of radiographers in the study displayed a poor knowledge of psychiatric conditions and how they affect patients.

Conclusion

Based upon this small study, the results suggest that newly qualified radiographers do not feel confident in their own abilities when interacting with psychiatric patients and would welcome and benefit from specific training with regards to strategies to deal with psychiatric patients. The radiographers reported that particular areas which may be improved upon are more information on psychiatric illnesses, manifestations of different types of psychiatric illness and the subsequent effect on patients. A larger study encompassing the whole of the Republic of Ireland would be valuable as a precursor to a European comparative study in order to investigate this phenomenon at a deeper level. Additionally it is recommended that further research is conducted within a wider European context on student radiographers and lecturers teaching on undergraduate radiography courses to ascertain if this topic is addressed at undergraduate level.

背景:爱尔兰共和国每年都有相当数量的精神疾病患者到影像科就诊。患有精神疾病的患者在放射检查时可能会给放射技师带来困难。这些困难可能包括沟通困难,以及由于疾病而变得越来越暴力。目的调查放射技师与精神病患者互动时是否自信。确定放射技师是否需要在与病人互动方面进行更多的培训。方法采用定性分析的方法,对6名在某精神科附属地区医院工作的放射技师进行分析。对放射技师进行个别访谈,并对访谈结果进行专题分析。结果放射技师在与精神病人接触方面的自信程度受从业年限的影响。在这项研究中,大多数放射技师对精神疾病及其对患者的影响知之甚少。结论:基于这项小型研究,结果表明,新获得资格的放射技师在与精神病患者互动时对自己的能力缺乏信心,他们欢迎并受益于与精神病患者打交道的策略方面的特殊培训。放射技师报告说,可以改善的具体领域是更多关于精神疾病的信息、不同类型精神疾病的表现以及对病人的后续影响。一项涵盖整个爱尔兰共和国的更大的研究将是有价值的,可以作为一项欧洲比较研究的先驱,以便在更深层次上调查这一现象。此外,建议在更广泛的欧洲背景下对学生放射技师和教授本科放射学课程的讲师进行进一步的研究,以确定该主题是否在本科水平上得到解决。
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引用次数: 1
The role of central DXA measurements in the evaluation of bone mineral density 中央DXA测量在评估骨矿物质密度中的作用
Pub Date : 2009-12-01 DOI: 10.1016/J.EJRADI.2010.05.003
M. L. Nogueira, I. Ramos
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引用次数: 1
Job satisfaction of the radiological departments' staff 放射科工作人员工作满意度
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.03.001
Eija Grönroos , Arja Pajukari

Job satisfaction is an important issue both because of its meaning as a staff well being factor as well as because of its associations with central implications of health care quality and productivity e.g. quality of care, organizational commitment, and health care staff's intention to leave.

The aim of the study was to explore factors associated with the job satisfaction of the radiological departments' staff. It was studied associations of job satisfaction and 1) personal, 2) work and organization related and 3) psychosocial work environment factors and 4) intention to stay in their work.

The study was performed in co-operation with the imaging units of two Finnish municipalities in spring 2007. The sample comprised two specialised care radiological departments facilities and eight primary care radiological departments. The data was collected via Internet in the spring 2007 from the personnel of the radiological departments. The response rate was 49% (n = 73/150). The data was analysed by using Spearman correlation and univariate and multivariate logistic regression.

The best predictors for the job satisfaction were work control and goal commitment. Correlation between job satisfaction and intention to stay at the radiological department person was working in was 0.68 (p = 0.001). The article suggests several means for enchancing job satisfaction and retention of the imaging units staff.

工作满意度是一个重要的问题,因为它作为员工福祉因素的意义,也因为它与卫生保健质量和生产力的核心含义(如卫生保健质量、组织承诺和卫生保健人员的离职意图)有关。本研究旨在探讨影响放射科员工工作满意度的相关因素。研究了工作满意度与1)个人因素、2)工作与组织相关因素、3)社会心理工作环境因素和4)留任意愿的关系。这项研究是在2007年春季与两个芬兰城市的成像单位合作进行的。样本包括两个专门护理放射科设施和八个初级保健放射科。数据于2007年春季通过互联网从放射科人员处收集。有效率为49% (n = 73/150)。采用Spearman相关及单因素和多因素logistic回归对数据进行分析。工作满意度的最佳预测因子是工作控制和目标承诺。工作满意度与留在放射科意愿的相关系数为0.68 (p = 0.001)。本文提出了提高影像单位工作满意度和挽留员工的几种方法。
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引用次数: 6
Title Page / Editorial Board 标题页/编委会
Pub Date : 2009-12-01 DOI: 10.1016/S1756-1175(10)00037-6
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引用次数: 0
Good radiographic practice: The Nigerian experience and the CEC recommendations 良好的放射学实践:尼日利亚的经验和CEC的建议
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.04.002
N.O. Egbe , G.B. Inah , W.E. Azogor , N.O. Chiaghanam , V.C. Ikamaise

A survey of 25 hospitals in Nigeria has been conducted to assess the level of compliance to the Commission for European Communities (CEC) criteria for good radiographic practice in four adult radiographic examinations. Chest, skull, abdominal and lumbar spine radiographic examinations were assessed. Using a simple scoring system of ‘0’ for unfulfilled and ‘1’ for fulfilled criteria, the results show an average compliance level of 50 ± 8% for chest, 57 ± 8% for skull, 56 ± 10% for abdomen and 51 ± 7% for lumbar spine radiography. Findings show that the level of compliance could be corrected by the adoption of quality control programmes in the country.

对尼日利亚的25家医院进行了调查,以评估在四项成人放射检查中遵守欧洲共同体委员会(CEC)良好放射检查规范标准的程度。评估胸部、颅骨、腹部和腰椎影像学检查。采用简单的评分系统,0为未达到标准,1为达到标准,结果显示胸片的平均依从性为50±8%,颅骨为57±8%,腹部为56±10%,腰椎为51±7%。调查结果表明,可以通过在该国采用质量控制方案来纠正遵守的程度。
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引用次数: 7
Evidence based medical imaging practice in Nigeria: A paradigm or a placebo? 尼日利亚循证医学成像实践:一种范例还是安慰剂?
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.07.001
Anthony Chukwuka Ugwu , E. Udo Benjamin , M. Ifenatuora Jennifer , Erondu Okechukwu Felix

Background

Any Medical imaging practice or education which is not based on current best evidence is unscientific and lacks the capability for sustainable quality and improvement. From literature search, there has not been any structured or empirical research to determine the knowledge attitudes and perceptions of radiographers to evidence based medical imaging in Nigeria.

Purpose

The purpose of this study was to assess the knowledge and attitudes towards the use of evidence based medical imaging among medical imaging scientists (radiographers) in south eastern Nigeria.

Methods

Quantitative research methods were employed. A questionnaire was sent to all radiographers working in hospitals in south eastern Nigeria for whom contact could be established (n = 60). The questionnaire included questions seeking information on radiographer’s definition of EBMI, attendance at EBMI courses, beliefs regarding patients’ willingness and capability to participate in EBMI and their perceived barriers to use of EBMI. Data analysis involved descriptive statistics and theme analysis of suggestions made by radiographers. SPSS (11.0) was used.

Results

Fifty out of the sixty questionnaires were returned. None of the respondents have ever attended an EBMI course, reads regularly or subscribes to a journal. 88% of respondents ticked the correct definition of EBMI. 62% of radiographers commented that EBMI is new to them. Analysis of barriers to the use of EBMI showed that no access to EBMI resources was the dominant barrier (36%). 15 (30%) of radiographers believe that 10% of patients can participate in EBMI, while 4 (8%) of radiographers believe that 100% of patients can participate. The majority of respondents (48%) believe that mass education of radiographers will improve the practice of EBMI.

Conclusions

We conclude that there is poor knowledge and attitude towards the use of EBMI by most radiographers (medical imaging scientists) in the south east Nigeria. Individual and organizational barriers to the use of evidence based medical imaging were identified. Mass education and better organizational platforms are needed to improve the practice of EBMI in Nigeria. A broad-based approach that integrates EBMI into practical clinical, teaching, administration and research domains is canvassed for Nigerian radiographers.

任何没有基于当前最佳证据的医学影像学实践或教育都是不科学的,缺乏可持续质量和改进的能力。从文献检索来看,没有任何结构化或实证研究来确定尼日利亚放射技师对循证医学成像的知识态度和看法。目的本研究的目的是评估尼日利亚东南部医学成像科学家(放射技师)对使用循证医学成像的知识和态度。方法采用定量研究方法。向在尼日利亚东南部医院工作的所有放射技师发送了一份调查问卷,可以与他们建立联系(n = 60)。调查问卷的问题包括放射技师对EBMI的定义、参加EBMI课程的情况、患者参与EBMI的意愿和能力以及他们认为使用EBMI的障碍。数据分析包括描述性统计和放射技师建议的主题分析。采用SPSS(11.0)统计软件。结果60份问卷中有50份被回收。没有一个受访者参加过EBMI课程,定期阅读或订阅期刊。88%的受访者选择了EBMI的正确定义。62%的放射技师认为EBMI对他们来说是全新的。对EBMI利用障碍的分析表明,无法获得EBMI资源是主要障碍(36%)。15名(30%)放射技师认为10%的病人可以参加EBMI, 4名(8%)放射技师认为100%的病人可以参加。大多数受访者(48%)相信对放射技师进行大众教育,可改善放射技师的循证照护工作。结论:在尼日利亚东南部,大多数放射技师(医学成像科学家)对EBMI的使用缺乏知识和态度。确定了使用循证医学成像的个人和组织障碍。需要大众教育和更好的组织平台来改善尼日利亚的EBMI实践。将EBMI整合到实际临床,教学,管理和研究领域的广泛方法为尼日利亚放射技师进行了调查。
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引用次数: 9
Saphenous varix – A pitfall in ultrasound imaging of femoral hernia: A case report 大隐静脉曲张-股疝超声成像中的一个缺陷:1例报告
Pub Date : 2009-12-01 DOI: 10.1016/j.ejradi.2010.09.003
Chyke Ihechikara Ohuegbe , Emmanuel Ehiwe , Malhotra Vivek , Felix Okechukwu Erondu

Saphenous varix is a rare vascular malformation occurring in the groin and its recognition may pose a diagnostic challenge.

This paper highlights the importance of differentiating saphenous varix from femoral hernia amongst a wide range of possible groin masses, using ultrasound as a front-line imaging modality which clinical examination could not diagnose.

We present a case report of a 39 year old male patient with saphenous varix, a sacculated varix of the greater saphenous vein closely simulating femoral hernia.

Our report highlights the key points to note in correctly diagnosing this rare condition and the role of ultrasound as a cheap, non-invasive and readily available modality.

隐静脉曲张是一种罕见的血管畸形发生在腹股沟和它的识别可能会造成诊断挑战。本文强调了在各种可能的腹股沟肿块中,将超声作为临床检查无法诊断的一线成像方式来鉴别大静脉曲张与股疝的重要性。我们报告一例39岁男性患者的大隐静脉曲张,一个囊状静脉曲张的大隐静脉接近模拟股疝。我们的报告强调了正确诊断这种罕见疾病的要点,以及超声作为一种廉价、非侵入性和容易获得的方法的作用。
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引用次数: 1
期刊
European Journal of Radiography
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