Diagnostic radiology in acute pediatric abdomen

Acute pediatric abdomen is a very common clinical problem. Clinical and laboratory findings, however, are nonspecific or confusing in many instances. This review article focuses on strategy in diagnosing acute pediatric abdomen. A variety of diseases such as appendicitis, gastroenteritis, mesenteric adenitis, intestinal intussusception, Henoch-Sch?lein purpura, Crohn's disease, Meckel's diverticulitis, duodenal ulcer, congenital biliary dilatation, ovarian torsion, and anomaly of the internal genitalia are discussed in this article. Selection of an appropriate imaging modality is essential to ensure prompt management. In the majority of cases, ultrasound can provide specific diagnoses, whereas in others valuable supplemental information can be obtained. CT will be reserved for selected patients in whom further information is needed. Indications of MR imaging in the management of acute pediatric abdomen are currently limited. MR imaging, however, is indicated on an emergency or semi-emergency basis in selected conditions including anomaly of the internal genitalia, ovarian torsion, and congenital biliary dilatation.     

Diagnostic radiology around the world

The frequency and type of radiographic examinations performed, as well as the type and quantity of radiographic equipment currently available, vary from country to country, depending on the type of screening programs used and on the level of health care available. These factors are a reflection of the country's overall wealth and stage of development. In past years, the annual number of radiologic examinations performed has increased worldwide, and this trend is expected to continue. If less developed countries are unable to increase their radiologic capacity at least as quickly as their population increases, they will fall further behind in their ability to care for their citizens.     

Diagnostic radiology resident perspectives on fellowship training and career interest in emergency radiology

Purpose

(1) Evaluate radiology resident perception of emergency radiology (ER). (2) Identify potential barriers to pursuing fellowship training or a career in ER among radiology residents.

Materials and methods

A 9-question digital survey was designed using Qualtrics Experience Management software (Qualtrics Inc., Provo, UT) and distributed to all US radiology residents via a multi-pronged distribution approach.

Results

Four hundred fifty-one residents responded out of an estimated national total of 4432 residents (10.2%). Gender proportion was nationally representative (female?=?24.5%; p?=?0.57), with a slight R1 predominance (p?=?0.034). Of the residents, 88.8% were aware that an ER subspecialty exists, 82.0% were aware that ER fellowships exist, but only 51.7% were aware that the American Society of Emergency Radiology (ASER) exists. Nearly a quarter reported no ER division or ER resident rotation. Residents in a program without an ER division or rotation were nearly twice as likely to be unaware of the existence of ER subspecialty, ER fellowships, and ASER compared to others (p?=?0.017). The presence of an ER division and rotation significantly increases the knowledge of ASER (65.5% vs. 40.7%, p?<?0.001) and increases residents’ ratings of their ER training (p?<?0.001). The following factors were ranked as the most important for fellowship choice: (1) personal interest, (2) intellectually stimulating, and (3) work hours. When asked if ER had an appealing work schedule, the mean response was 56 out of 100 (0?=?disagree, 100?=?agree).

Conclusion

US radiology residents with the greatest exposure to ER during residency are more familiar with ER training, ER career opportunities, and ASER and had a more favorable perception of the field. Subspecialty leaders should focus on ER’s inherent intellectual appeal and reframe its nontraditional schedule as positive (flexible).

     

乳腺癌的影像学诊断进展

早期诊断和早期治疗是降低乳腺癌死亡率的关键.介绍了目前诊断乳腺癌的各种影像检查方法,分析了不同方法的优势及局限性,评价了其临床应用价值及现状.     

Networks in the radiology department and the hospital

Data networks are a basic technology with regard to an appropriate design of the information technology (IT) infrastructure for the hospital. Due to the distributed workflow within the hospital, an integrated Hospital Information System (HIS) is based mostly on a set of network applications facing specific items. Medical communication standards, i. e., HL 7, DICOM, and in the near future the migration towards XML, support the interoperability between the IT subsystems and pave the way to patient information systems with access to unified and complete electronic medical records (EMR). Furthermore, with standardized communication techniques, such as CORBAmed, an object-oriented design of Healthcare applications will be possible in the near future. The intent of this paper is to give an overview of which basic technologies are suitable for building comprehensive, flexible, and reliable hospital networks and which also meet the special demands of the radiology department. Received: 14 April 2000/Accepted: 17 May 2000     

Diagnostic imaging and interventional radiology in abdominal abscess formations

Abdominal abscesses as a complication of laparotomic surgery have a high mortality rate. The authors reviewed the diagnostic and therapeutic procedures of 36 patients who developed intra-abdominal abscesses after surgical treatment for abdominal neoplasias. The first-step diagnostic procedures (plain film of the abdomen and chest, CT and US) showed a sensibility of 78%. In 25/36 patients (69.5%) two interventional radiology procedures were performed: fine needle aspiration and catheter drainage of the abscess. In 16% of patients fine needle aspiration led to a complete evacuation of the abscess cavity and guaranteed the recovery. In 84% of cases a drainage catheter was positioned into the cavity and left indwelling. This case review is aimed at stressing how plain film of the abdomen is still a diagnostic procedure with high sensibility and specificity for this pathology, even though it is currently considered as a second-choice diagnostic step--US and CT being assessed as the methodologies of choice. The latter techniques can both provide a more accurate imaging when interventional radiology procedures are to be performed.     

Diagnostic reference levels in pediatric radiology in Austria

Background  

Because of the higher sensitivity to radiation in children, optimization plays an essential role in pediatric radiology. Diagnostic reference levels are a helpful tool to optimize patient dose for standard radiographic procedures.     

特发性间质性肺炎的影像学诊断进展

特发性间质性肺炎(idiopathic interstitial pneu-monia,ⅡP)为原因不明的一组肺间质性疾病的总称,其分类及诊断标准一直比较混乱,人们对此缺乏统一的认识。近10年来,由于环境污染的日益加重,室内小环境的明显恶化,病毒感染的概率日渐增     

Diagnostic radiology in the tropics: technical considerations

An estimated two thirds of the world's population is currently without access to diagnostic radiology services, and most of them live in resource-limited tropical regions with harsh environments. Most patients are diagnosed and treated in poorly equipped government-funded hospitals and clinics that have insufficiently trained staff and are barely operational. Any available imaging equipment is likely to be functioning suboptimally and be poorly maintained. The root of the problem is usually a lack of know-how and a quality culture, combined with insufficient basic equipment and infrastructure. Radiological imaging is an essential aspect of primary care and used in the critical diagnosis and management of trauma, tuberculosis, pneumonia, acquired immunodeficiency syndrome, cancer, and other respiratory and abdominal diseases. Considerations such as quality management and infrastructure, personnel, equipment, and radiation protection and safety are important to ensure the proper functioning and rational use of a diagnostic radiology facility in the tropics.     

特发性间质性肺炎的影像学诊断进展

特发性间质性肺炎（idiopathic interstitial pneumonia,IIP）为原因不明的一组肺间质性疾病的总称,其分类及诊断标准一直比较混乱,人们对此缺乏统一的认识。近10年来,由于环境污染的日益加重,室内小环境的明显恶化,病毒感染的概率日渐增加,加之对该病认识水平的不断提高,检测手段的日趋先进,以及其他一些未知因素。使临床上IIP病例显著增多,已引起国内外研究者的高度重视。本文就各亚型IIPs的临床、组织学特点进行阐述并重点讨论IIP在HRCT上的表现。     

Transluminal angioplasty in ambulatory care

The authors report their experience of 143 transluminal angioplasties performed over a three-year period on outpatients. Retrospective analysis of this case study did not demonstrate any late complications, and the only immediate complication (thrombosis at the arterial puncture) was treated surgically, a few days later, with thromboarterectomy. Of the 121 patients who underwent dilatation, 116 reached their home 6-8 hours after treatment; 4 were hospitalised for the following night, and 1 underwent TEA of the iliac artery. The authors conclude that most transluminal angioplasties can be performed on outpatients.