Film retakes in digital and conventional radiography

To determine the film-retake rates and causes in digital radiography comparison to conventional X-rays method. Comparative study. Radiology Department, Aga Khan University Hospital, Karachi, from January 2004 to December 2006. X-rays of different body parts, conducted during the year 2004, with conventional radiography [n=170300], and in 2006 with digital radiography [n=174550], were included in this study. Measurements were done for number of X-rays re-take due to different quality control reasons for both the conventional and digital radiography. Quality control reasons included underexposure, overexposure, positioning errors, patient movements, portable X-rays, grid cut-off, and others [i.e. equipment related] due to which X-ray quality was questionable. Results were expressed in percentages. A total of 9423 X-rays [5.5%] were repeated in conventional radiography [n=170300] due to underexposure [38%], overexposure [28.5%], positioning errors [25%], portable procedures [4%], patient movement [2%], grid cut-off [0.5%], and others [2%]. Underexposure was the most frequently responsible factor for the X-ray repetition as compared to other factors [p<0.001]. In digital radiography [n=174550], 1464 X-rays [1%] needed to be repeated, which was significantly less in comparison to X-ray repetition in conventional method of radiography [5.5%] [p<0.001]. In digital radiography, the most frequent factor for X-ray re-take was positioning error [435, 30%]. Digital radiography is associated with significantly lesser number of re-take X-rays as compared to conventional radiography, hence minimizes the exposure of the patients to unnecessary radiations due to re-take X-rays. Positioning error remains a problem even in digital radiography, emphasizing training need for technologists

High-resolution ultrasound imaging guidance increases efficacy and safety of supraclavicular brachial plexus block

High frequency ultrasound [12 MHZ] imaging equipped with a digital linear scanhead offers excellent resolution of superficial structures during brachial plexus block. Ultrasound can be used to identify the brachial plexus before block, guide the block needle to reach the target nerves, and visualize the pattern of local anesthetic spread. In the present study we compared the state-of-the-art ultrasound technology for supraclavicular brachial plexus block with the classical technique that depended on the anatomical landmarks as regard efficacy, quality and safety. We found that ultrasonic guidance decreased the time to perform the block, shortened the onset of block, prolonged the duration of postoperative analgesia, increased the proportion of successful blocks, increased patient's satisfaction and reduced the incidence of complications than the classical method of supraclavicular blocks. High resolution ultrasound guided supraclavicular block is easier, more effective, of better quality, and safer than the classical block that depends on the anatomical landmarks

Investigación sobre niveles de dosis en exámenes con fluoroscopia gastrointestinal como parte de un programa de control de calidad / An investigation of the levels of radiation exposure in diagnostic examinations involving gastrointestinal tract fluoroscopy

El Servicio de Radiodiagnóstico del Hospital Universitario de la Universidad Federal de Río de Janeiro, juntamente con el Instituto de Radioprotección y Densitometría de la Comisión Nacional de Energía Nuclear, se encuentra desarrolllando programas en el área de garantía de calidad en radiodiagnóstico. Estas actividades contemplan como objetivo importante la optimización de las dosis. Uno de los programas en marcha comprende exámenes de fluoroscopia gastrointestinal. A fin de investigar los niveles de exposición a la radiación fueron realizadas medidas de dosis de entrada en la piel recibidas por pacientes y médicos en exámenes de esofagografía, seriografía y colon, utilizando dosímetros colocados en varias posiciones del cuerpo. En este trabajo se describe la metodología seguida y se muestran los resultados obtenidos hasta el presente. Se hace un análisis del espectro de dosis observadas en pacientes y profesionales, de acuerdo con diversos parámetros tales como ubicación de dosímetros, tiempo de exposición, técnicas empleadas, número de radiografías, etc. También se describen los pasos a seguir con el objeto de concretar la implantación de un programa de control de calidad en los exámenes mencionados