RESUMEN
BACKGROUND: For resident doctors the acquisition of technical and professional competence is decisive for the successful practice of their activities. Competency and professional development of resident doctors benefit from regular self-reflection and assessment by peers. While often promoted and recommended by national educational authorities, the implementation of a robust evaluation process in the clinical routine is often counteracted by several factors. OBJECTIVE: The aim of the study was to test a self-developed digital evaluation system for the assessment of radiology residents at our institute for practicality and impact with regard to the radiological training. MATERIAL AND METHODS: The intranet-based evaluation system was implemented in January 2014, which allowed all Radiology consultants to submit a structured assessment of the Radiology residents according to standardized criteria. It included 7 areas of competency and 31 questions, as well as a self-assessment module, both of which were filled out electronically on a 3-month basis using a 10-point scale and the opportunity to make free text comments. The results of the mandatory self-evaluation by the residents were displayed beside the evaluation by the supervisor. Access to results was restricted and quarterly discussions with the residents were conducted confidentially and individually. RESULTS AND DISCUSSION: The system was considered to be practical to use and stable in its functionality. The centrally conducted anonymous national survey of residents revealed a noticeable improvement of satisfaction with the institute assessment for the criterion "regular feedback"compared to the national average. Since its implementation the system has been further developed and extended and is now available for other institutions.
Asunto(s)
Competencia Clínica , Instrucción por Computador/métodos , Evaluación Educacional/métodos , Internado y Residencia/organización & administración , Evaluación de Programas y Proyectos de Salud/métodos , Radiología/organización & administración , Curriculum , Alemania , Encuestas y Cuestionarios , Interfaz Usuario-ComputadorRESUMEN
Fatty liver disease is an important cause of chronic liver disease in Western countries. The purpose of this article is to describe and illustrate the diagnostic criteria and various morphological patterns of fatty liver disease on multidetector computed tomography (MDCT) with an emphasis on potential limitations and diagnostic pitfalls.
Asunto(s)
Hígado Graso/diagnóstico por imagen , Tomografía Computarizada Multidetector , Adulto , Errores Diagnósticos , Femenino , Humanos , Hígado/diagnóstico por imagen , Masculino , Persona de Mediana EdadRESUMEN
The purpose of this pictorial review is to understand the embryological basis of the development of congenital hepatic vascular shunts and to review the multimodality imaging appearances of congenital and acquired hepatic vascular shunts. Hepatic vascular shunts are commonly seen in imaging. Familiarity with their characteristic appearances is important in order to accurately characterise these shunts and diagnose the underlying disorders.
Asunto(s)
Angiografía , Venas Hepáticas/diagnóstico por imagen , Hígado/diagnóstico por imagen , Vena Porta/diagnóstico por imagen , Enfermedades Vasculares/diagnóstico por imagen , Venas Hepáticas/anomalías , Venas Hepáticas/fisiopatología , Humanos , Hígado/irrigación sanguínea , Hígado/embriología , Vena Porta/anomalías , Vena Porta/fisiopatología , Enfermedades Vasculares/embriología , Enfermedades Vasculares/fisiopatologíaRESUMEN
BACKGROUND: We compared the imaging findings in patients with alveolar liver echinococcosis using ultrasound (US), computerized tomography (CT) and magnetic resonance imaging (MRI) in a prospective study. PATIENTS AND METHODS: 30 patients with alveolar echinococcosis (AE) were examined with the above imaging techniques. RESULTS: 30 lesions were detected with all three methods and most lesions (n = 55) were detected with CT. Calcifications were seen in 15 lesions with US, in 21 with CT and in 16 with MRI. MRI best detected necrotic areas and multivesicuLar structures. CONCLUSION: US is the screening method of choice and should primarily be complemented by CT due to its ability to detect the greatest number of lesions and clear demarcation of the characteristic calcifications. MRI may facilitate the diagnosis in uncertain cases with noncalcified or partially calcified lesions by showing the characteristic multivesicular structure, necrotic areas and proximity to vascular structures.
Asunto(s)
Equinococosis Hepática/diagnóstico por imagen , Equinococosis Hepática/patología , Ultrasonografía/normas , Adulto , Anciano , Calcinosis , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Necrosis , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To determine whether embolization of endoleaks after endovascular repair of aortic aneurysms is associated with a decrease in the diameter of the aneurysm. METHODS: Fifteen patients (13 men; median age 76 years) demonstrated primary endoleaks persisting > or =3 months after endovascular abdominal aortic aneurysm repair with a variety of commercial endografts. In 8 patients, coil embolization failed to completely obliterate the leak, whereas embolotherapy proved successful in the remaining 7 patients. Surveillance of endoleaks and the effect of their embolization on aneurysm size were followed with serial computed tomographic (CT) scans. Follow-up after embolization extended for at least 12 months. RESULTS: Patients with persistent leak exhibited a slight increase in mean aneurysm area from 21.41+/-4.25 to 22.47+/-6.70 cm2. Medians differed from 20.03 (range 16.59-28.73) to 23.03 (range 14.14-33.69) cm2 (p = 0.0078, 95% confidence interval [CI] = 0.0075 to 0.0081). Successfully treated patients, however, showed a mean decrease from 20.58+/-3.63 (median 19.87) to 16.36+/-6.46 cm2 (median 18.10) at 1 year (p = 0.0156, 95% CI = 0.0151 to 0.0160). The medians differed significantly between groups (p < 0.05). CONCLUSIONS: Persistent endoleaks after endovascular aortic aneurysm treatment led to an increase in the diameter of the aneurysm, whereas complete occlusion was associated with a significant decrease in aneurysm diameter.
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Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular , Embolización Terapéutica , Complicaciones Posoperatorias/terapia , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aortografía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Falla de Prótesis , Tomografía Computarizada por Rayos XAsunto(s)
Aspergilosis Broncopulmonar Alérgica/complicaciones , Micetoma/etiología , Adolescente , Aspergilosis Broncopulmonar Alérgica/diagnóstico por imagen , Aspergilosis Broncopulmonar Alérgica/patología , Femenino , Humanos , Pulmón/microbiología , Pulmón/patología , Micetoma/diagnóstico por imagen , Micetoma/patología , Alveolos Pulmonares/microbiología , Alveolos Pulmonares/patología , Tomografía Computarizada por Rayos XAsunto(s)
Diagnóstico por Imagen , Gastrinoma/diagnóstico , Neoplasia Endocrina Múltiple Tipo 1/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adulto , Femenino , Gastrinoma/patología , Humanos , Neoplasia Endocrina Múltiple Tipo 1/patología , Neoplasias Primarias Múltiples/patología , Páncreas/patología , Neoplasias Pancreáticas/patologíaRESUMEN
Disparity in prognosis and management between primary and secondary pancreatic tumours makes recognition of metastases to the pancreas on CT and MRI an important goal. Three different patterns of secondary pancreatic tumours may be seen: localized, multifocal, or diffuse enlargement. CT findings include hypodense lesions, which show rim enhancement following intravenous contrast medium. On MR examination, the lesions are usually hypointense on T1 weighted and hyperintense on T2 weighted images.
Asunto(s)
Neoplasias Pancreáticas/secundario , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Calcinosis/diagnóstico , Fascitis/diagnóstico , Fémur , Articulación de la Rodilla , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Adulto , Calcinosis/patología , Calcinosis/cirugía , Diagnóstico Diferencial , Fascia/patología , Fascitis/patología , Fascitis/cirugía , Fasciotomía , Fémur/patología , Fémur/cirugía , Humanos , Articulación de la Rodilla/patología , Articulación de la Rodilla/cirugía , MasculinoAsunto(s)
Quistes Óseos/diagnóstico por imagen , Equinococosis/diagnóstico por imagen , Cuello Femoral/diagnóstico por imagen , Osteólisis/diagnóstico por imagen , Adolescente , Quistes Óseos/patología , Diagnóstico Diferencial , Equinococosis/patología , Cuello Femoral/patología , Humanos , Masculino , Osteólisis/patología , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To compare 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) positron emission tomography (PET) with computed tomography (CT) in primary nodal staging of malignant lymphoma. MATERIALS AND METHODS: Sixty consecutive patients with untreated, histopathologically proved malignant lymphoma (aged 7-72 years; 33 with non-Hodgkin lymphoma, 27 with Hodgkin disease) underwent FDG PET and contrast material-enhanced CT for nodal staging. Lymph node regions identified at both CT and PET were regarded as actual locations of disease. Discordant results were verified with biopsy or clinical follow-up whenever possible. RESULTS: One hundred sixty of 740 evaluated lymph node regions were identified as diseased at both CT and PET. Of the 25 additional regions seen with PET, seven were true-positive; two, false-positive; and 16, unresolved. CT showed six additional disease manifestations; three were false-positive, and three were unresolved. Staging was changed in the four patients with the seven confirmed additional PET findings: from stage I to II in one patient and from stage II to III in three patients. Staging was changed from stage II to I in one of the three patients with false-positive CT findings. CONCLUSION: FDG PET may be more accurate for detecting nodal lymphoma than incremental CT.
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Desoxiglucosa/análogos & derivados , Radioisótopos de Yodo , Metástasis Linfática/diagnóstico por imagen , Linfoma/diagnóstico por imagen , Radiofármacos , Tomografía Computarizada de Emisión , Adolescente , Adulto , Anciano , Biopsia , Niño , Medios de Contraste , Reacciones Falso Positivas , Femenino , Fluorodesoxiglucosa F18 , Estudios de Seguimiento , Enfermedad de Hodgkin/diagnóstico por imagen , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Linfoma no Hodgkin/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Intensificación de Imagen Radiográfica , Tomografía Computarizada por Rayos X , Recuento Corporal TotalAsunto(s)
Enfermedades Renales Quísticas/diagnóstico por imagen , Neoplasias Renales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Tumor de Wilms/diagnóstico por imagen , Preescolar , Diagnóstico Diferencial , Humanos , Riñón/diagnóstico por imagen , Riñón/patología , Enfermedades Renales Quísticas/patología , Neoplasias Renales/patología , Masculino , Tumor de Wilms/patologíaAsunto(s)
Adenoma/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adenoma/patología , Adenoma/cirugía , Adulto , Endoscopía , Femenino , Humanos , Pulmón/patología , Pulmón/cirugía , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , ToracoscopíaAsunto(s)
Lipoma/diagnóstico , Imagen por Resonancia Magnética , Neoplasias de los Tejidos Blandos/diagnóstico , Tomografía Computarizada por Rayos X , Adulto , Nalgas/patología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Lipoma/patología , Neoplasias de los Tejidos Blandos/patologíaAsunto(s)
Infecciones por VIH/complicaciones , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias Nasales/diagnóstico por imagen , Sarcoma de Kaposi/diagnóstico por imagen , Humanos , Neoplasias de la Boca/etiología , Neoplasias de la Boca/patología , Neoplasias Nasales/etiología , Neoplasias Nasales/patología , Radiografía , Sarcoma de Kaposi/etiología , Sarcoma de Kaposi/patologíaAsunto(s)
Diagnóstico por Imagen , Hemoglobinuria Paroxística/diagnóstico , Adulto , Angiografía , Humanos , Imagen por Resonancia Magnética , Masculino , Oclusión Vascular Mesentérica/diagnóstico , Bazo/patología , Rotura del Bazo/diagnóstico , Trombosis/diagnóstico , Tomografía Computarizada por Rayos XAsunto(s)
Nalgas , Fibromatosis Agresiva/diagnóstico , Imagen por Resonancia Magnética , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico , Adolescente , Nalgas/patología , Nalgas/cirugía , Fibromatosis Agresiva/patología , Fibromatosis Agresiva/cirugía , Humanos , Masculino , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Reoperación , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/cirugíaRESUMEN
The papillary cystic and solid tumor of the pancrease (PCSTP) is a primary pancreatic neoplasm of unknown etiology occurring most commonly in young women and regularly containing hemorrhagic areas. Clinical symptoms are non-specific. Although these tumors reach an average diameter of 10 cm, they are often discovered by accident. Because patients with surgically resected PCSTP have very good prognoses, it is important to distinguish these tumors from other growths in the pancreas, for example mucinous cystadenoma. Whereas, due to the variable proportion of fluid components, these tumors offer non-characteristic structure at ultrasonography, computed tomography (CT) possesses high specificity for PCSTP, particularly when calcifications are present. Angiography distinguishes these tumors from hypervascular neoplasms, such as the endocrinologically inactive islet cell tumor. Magnetic resonance tomography (MRT) is especially suited for imaging the hemorrhagic areas in solid tumor formations, as well as hemorrhagic debris in the fluid portions and layer phenomena are frequently observed.