European Journal of Radiography最新文献

Although various rates of sonographic detection of foetal anomalies abound, no available data exist on the prevalence and patterns of anomalies in the South–South (Niger Delta) region of Nigeria. A retrospective analysis of the records of 10,440 prenatal sonograms and anomaly register over a two year period was performed. 72 foetuses were identified with a total of 88 anomalies.

Anencephaly was the most common anomaly representing 23.99% (22), and achondroplasia with limb length discrepancy/dwarfism 7.95% (7). Systemic classification was as follows; CNS (42, 47.7%), urogenital (20, 22.7%), skeletal (11, 12%), GIT (9, 3.41%), others (12, 13.64%).

The mean age for majority of anomalies was 25 years. A Chi-square test of significance, showed this is significantly lower than the mean age of 35 years earlier documented in literature.

The study recommends a prospective screening program, use of a detailed anomaly protocol and guidelines, compulsory screening at 18–20 weeks gestational window, improved training of sonographers and use of 3D and more sophisticated equipment to improve detection rates.

The aim of this study was to calculate the absorbed dose of 22 patients that were diagnosed for neuroendocrine tumours in liver and had received therapeutic dose of ¹¹¹In octreotide. In-111 Octreotide infusion, via intrahepatic catheterization is well established technique in our Institution in hepatocellular carcinoma and neuroendocrine tumours treatments. The patient specific dosimetry calculations, for this way of treatment, were based on anterior and posterior scintigraphy images that were acquired immediately after radiopharmaceutical infusion, through hepatic arterial port and at 24 and 48 h post-infusion. Gamma – camera was calibrated in order to estimate source organ activity considering count rate, patient’s body diameter and source organ size. The results showed that the tumour absorbed dose ranged from 2.5 to 18.4 mGy/MBq, depending on the lesion size. Patient specific dosimetry calculations helps the physician to optimize the planning of the treatment, avoid side effects to healthy tissue and assign administered dose to treatment results.

Medical literature and the number of patients diagnosed with head and neck angiosarcomas are very limited. Our case report presents clinical history, imaging procedures, treatment (surgery) and histological findings of angiosarcoma in non-irradiated parotid gland.

Aim

The purpose of this article is to describe and discuss the development and challenges faced by radiography science as a new academic discipline.

Background

New academic disciplines develop continually from different circumstances and for different purposes. As they develop, they are faced with the challenge of justifying their status as independent academic disciplines in various ways. Radiography science is one of the youngest disciplines among health sciences in Finland, challenged by the academic community, society and clinical practice.

Conclusions

Radiography science in Finland has already shown considerable development and achieved many substantial and structural criteria set for independent academic disciplines. However, resources are still very limited and the profile of radiography science needs to be clarified. Challenges should be considered as inspirational opportunities and takeoff for the development of radiography science nationally and internationally.

The aims of the study are to measure the performance of radiographers in detecting the presence of a distal wrist fracture; to determine whether the number of years clinical service impacts on radiographers' performance and progresses further to compare the performance of the radiographer, untrained in reporting, to that of published data on the performance of consultant radiologists.

Method

A Free-response Receiver Operating Characteristic (FROC) study was carried out on radiographers to assess their performance. 19 experienced radiographers untrained in image interpretation were shown 30 wrist radiographs, 15 of which had distal radial fractures, 15 did not. The results of the FROC, false positive and false negative data were assessed.

Results

The study showed that for AUC values radiographers scored 0.877 (0.087) on average. A trend of increased performance with increased experience was seen amongst the radiographers.

Conclusions

Radiographers AUC scores of 0.87 demonstrates that there is potential for radiographers to recognise fractures with some accuracy. There is a trend of increasing performance with increasing experience. When this was compared to published data it is seen that radiologists outscored radiographers and a difference in performance exists between the groups. The radiologists as a whole and the MSK specialists scored a significantly higher than the radiographers with and AUC value of 0.92 (p ≤ 0.05) and 0.96 (p ≤ 0.001) respectively. Radiologists had fewer false positives than radiographers (P ≤ 0.007), however there was no difference was found in the false negatives (p ≤ 0.11). Further image interpretation training of radiographers should now be carried out and this experiment should be repeated

The purpose of this review is to discuss the difficulties in interpreting paediatric dual energy X-ray absorptiometry (DXA) scans and examine the methods used to overcome these problems. There are several approaches to aid interpretation of DXA results, however despite agreement that a method should be employed; there is currently no consensus as to which method is the most appropriate.

Introduction

With technological advancement sonographers work with increasing independence and expertise, forming intimate relationships and engaging in extended communication during breast ultrasound. However the nature and extent of any current communication is unknown. This study set out to examine sonographer's attitudes, beliefs, fears and the constraints that determined the communication of differential diagnosis.

Method

A survey was sent to a purposive sample of sonographers. Questions relating to demographics, experience and employment were included. Comments on communication, non-verbal cues, restraints, communication skills and fears of disclosure were asked. Following collation descriptive statistics were developed.

Results

82% of the surveys were returned. 89% of sonographers agreed patients were aware of non-verbal cues. 83% communicated normal and abnormal findings to the patient. 32% reported using cryptic language to answer patient's questions. 65% worked in practices that placed no constraints on what or how much information was communicated. Fear of medico-legal issues and loss of credibility with medical practitioners rated highly as an influence in the decision to impart a differential diagnosis.

Conclusion

The study demonstrated varied approaches to the provision of differential diagnosis during breast ultrasound. This study has provided evidence for the development of specific guidelines for sonographers wanting to impart differential diagnosis. The provision of communication skills workshops to guide and provide strategies to deal with the emotional needs of the patient and sonographer when “bad news” is to be given is also recommended.

Magnetic Resonance Imaging (MRI) is an important diagnostic imaging tool that has seen rapid expansion in recent years with a commensurate increase in the number of radiographers undertaking MRI scans. This imaging modality is a complex one and the strong magnetic fields associated with MRI scanners pose a very serious risk to patients and staff. Therefore it is essential that MR radiographers receive appropriate training in the correct operation and safe use of MRI. The education of radiographers undertaking MRI examinations is largely provided “in-house” by radiographers or applications specialists. This training is usually informal and focuses on essential safety training and the use of scanner software. This learning is not usually formally assessed and therefore its value is not properly evaluated.

In 2007 the authors, acting as independent consultants, developed a number of assessment tools to enable quick and effective evaluation of theoretical knowledge and skills related to the clinical use of MRI in a group of individuals with a range of MRI experience. A total of 47 individuals with a range of MRI experience were tested using an Objective Structured Clinical Examination (OSCE). Some were also given a viva voce.

Our results show that the majority of radiographers in our sample could not answer more than half the OSCE questions correctly and a significant and unacceptable number did not convince us they could practice MRI safely. Very few of the examinees had adequate knowledge of image quality issues and parameter manipulation. A few also raised concerns over their radiographic credentials.

Purpose

To assess whether radiographic findings were documented in the clinical notes by the referring medical team.

Standard

All radiographs should be checked by the referring medical team, and documented in the clinical records.

Sample

All adult inpatients at City Hospital Birmingham, UK.

Design

Prospective spot audit of medical records.

Method

We established which plain radiographs had been performed during that admission using PACS (picture archiving and communication system). This was reconciled against the patients' notes to determine if findings were documented by the referring medical team, and the delay in documenting their findings. A baseline audit was performed in September 2007, and re-audited in August 2008.

Intervention

A letter highlighting the importance of documenting findings was circulated. Stickers were affixed to clinical notes to act as a reminder for the referring medical team.

Results

For the baseline audit we assessed 388 radiographs of 164 adult inpatients. 147 (37.9%) showed no evidence of being checked by the referring medical team. Of the 241 radiographs which were documented, 230 (95.8%) were documented within 2 days of being performed.

For the re-audit in August 2008, we assessed 687 radiographs of 279 adult inpatients. 492 radiographs were documented, of which 467 (94.9%) were reported within 2 days. The absolute reduction in the proportion of undocumented radiographs was 9.6% which represents a 25% improvement (p < 0.002).

Conclusion

This audit demonstrates that many inpatient radiographs have no evidence documented in clinical notes of being checked or acted upon by the referring medical teams. Affixing a reminder sticker to medical notes improves reporting rates.