European Teleradiology now and in the future: results of an online survey.

OBJECTIVES: To obtain an overview of teleradiology usage within Europe, to evaluate the current opinion and future vision about this technique. METHODS: A web-based survey targeted at active radiologists throughout Europe. RESULTS: A total of 368 radiology professionals participated in the survey. Among them 65 % currently use teleradiology. The main usages are in-house image distribution (71 %) and on-call readings from home (44 %). The major advantages are improved collaboration with other radiologists (46 %) and efficient distribution of workload (38 %). Outsourcing is performed by 35 % of the participants, among them 68 % use commercial services. The major advantages of outsourcing are availability of second opinions (82 %) and additional capacity for on-call services (71 %). The major disadvantages are insufficient integration of patient history and priors (69 %), and limited communication with clinicians (68 %). The majority expressed a positive opinion regarding the future of teleradiology (80 %) predicting a growing importance (46 %). Opportunities ought to be found in emergency reading services, flexible support of small practices and in collaborative platforms. CONCLUSIONS: A wide usage of teleradiology throughout Europe is perceived; however usage of commercial services is relatively limited. Regarding cross-border services, there is a great demand for a focused Pan-European legislation, an adapted price regulation and a quality assurance framework. MAIN MESSAGES: • A wide variety of teleradiology applications exist in Europe • Implementation mainly occurs in countries with a high concentration of networked PACS • Usage of commercial teleradiology services in Europe is relatively limited • Language is an unsolved issue and limiting factor for further deployment of services • There is a demand for a Pan-European legislation, price regulation and quality assurance framework.

Teleradiology: evolution and concepts.

Teleradiology has become a reality for several years now, but its existence still has not been freed from all controversies. From the beginning the military has been the driving force for teleradiology. Today teleradiology has many purposes worldwide ranging from services for expert or second opinions to international commercial diagnostic reading services. Ten years ago image quality, transmission speed and image compression were important issues of debate. Today the focus is on clinical governance, medico-legal issues and quality assessment. The increasing use of teleradiology reflects the changing world of clinical practice, service delivery and technology.

[Internet communication in radiology]. / Internetkommunikation in der Radiologie.

UNLABELLED: E-mail is an Internet service that can be used for sending messages and binary files between individuals as well as for participating in discussion groups. For sending and receiving these types of messages, the users must use either a dedicated e-mail client or one of the several mailing facilities of the World Wide Web. The news-groups enable like-minded people to discuss subjects on a group-wide basis, but access is generally not limited, and the participants cannot be selected. CONCLUSION: The objective of this paper is to give radiologists an introduction to using e-mail, mailing lists and news-groups, the three most important communication services of the Internet. The function of these services is explained, and the advantages of implementing them in a radiology practice are discussed. Potential problems and concerns including security matters are highlighted, and ways in which they can be resolved are suggested.

[The search for medical information on the World Wide Web]. / Recherche de l'information médicale sur le world wide web.

The internet has experienced tremendous growth over the past few years and has currently many resources in the field of medicine. However, many physicians remain unaware of how to gain access to this powerful tool. This article briefly describes the World Wide Web and its potential applications for physicians. The basics of web search engines and medical directories, as well as the use of advanced search with boolean operators are explained.

Percutaneous hydrodynamic thrombectomy of acute thrombosis in transjugular intrahepatic portosystemic shunt (TIPS): a feasibility study in five patients.

PURPOSE: To evaluate the feasibility of percutaneous hydrodynamic thrombectomy in restoring patency of acutely thrombosed stent-shunts after transjugular intrahepatic portosystemic shunt (TIPS). METHODS: Percutaneous hydrodynamic thrombectomy was performed in five consecutive patients with angiographically documented complete thrombosis of the stent-shunt which developed within 2 weeks after the TIPS procedure. Thrombectomy was performed with a hydrolytic suction thrombectomy catheter, introduced via a transjugular approach. RESULTS: In all patients, immediate restoration of patency of the stent-shunt was achieved after deploying additional stent(s) to cover residual adherent mural thrombus. In two patients early reocclusion occurred. CONCLUSION: Percutaneous hydrolytic suction thrombectomy in acutely thrombosed intrahepatic portosystemic shunts is technically feasible.

Sonographic diagnosis of ischemic colitis.

An abdominal ultrasound examination performed on two patients with abdominal pain showed segmental wall thickening of the colon that proved to be due to ischemic colitis. In one case, the typical "target lesion" was recognized. These findings could be confirmed with computed tomography, whereas a single contrast enema was unable to demonstrate the ischemic disease. In the second case, a typical five-layered structure of the bowel wall could be demonstrated. It is concluded that US can be useful in the early diagnosis of colonic ischemia.

Confined gastric perforation: ultrasound and computed tomographic diagnosis.

A case of confined gastric perforation due to a penetrating antral ulcer diagnosed on ultrasound and computed tomography is presented. Air bubbles were visualized adjacent to the anterior gastric and bulbar wall, associated with small amounts of fluid in the subhepatic region and in the omental bursa. Careful examination of the subhepatic region and upper abdominal cavity in a patient with acute epigastric pain may lead to a correct diagnosis of such confined perforations.

An unusual low-abdominal tumor: cystadenoma of the seminal vesicle.

Cystadenoma of the seminal vesicle is an extremely rare benign tumor, which to our findings has only been mentioned earlier in seven previous reports. It is a benign and mostly multilocular tumor, thought to originate from embryologic remnants. Preoperative diagnosis is rarely made. Complete extirpation is the correct treatment. We present this first Belgian case with a discussion of imaging techniques, symptomatology, pathology, diagnosis, and treatment.

[Popliteal cyst with venous compression]. / Popliteale cyste met veneuze compressie.

Baker's cysts can produce pressure on draining lymphatics and veins in the knee, producing oedema of the lower leg. These cysts are often mistakenly treated as deep vein thrombosis.