Identificação de itens essenciais na elaboração de um laudo de tomografia computadorizada de feixe cônico com aplicação na endodontia: um estudo delphi / Identification of essential items in cone beam computed tomography report with applications in endodontics: a delphi study

A imagem tomográfica é importante na determinação do diagnóstico e do plano de tratamento em diversos casos clínicos na endodontia. Em decorrência do crescente aumento na solicitação de exames de tomografia computadorizada de feixe cônico (TCFC), a necessidade de um sistema de interpretação e descrição dos achados imaginológicos tornou-se imprescindível. O objetivo desse estudo foi identificar as informações consideradas essenciais pelo cirurgião- dentista solicitante em um laudo tomográfico para a prática clínica na endodontia. Foi realizado um estudo de consenso e-Delphi com um painel de 12 especialistas em Endodontia que participaram de duas rodadas de perguntas on-line, respondidas de maneira sequencial e individual. Os profissionais foram questionados acerca de quais informações eles consideravam importantes em um laudo tomográfico para auxílio no diagnóstico e no planejamento do tratamento em diferentes situações clínicas. As informações obtidas foram categorizadas por dois radiologistas experientes, e os itens assinalados por 80% ou mais dos endodontistas após a segunda rodada de pesquisa foram considerados essenciais em um laudo tomográfico. A identificação de alterações, bem como a descrição de sua localização, e a seleção de imagens em diferentes planos ortogonais que as ilustrem, foram itens considerados essenciais pelos especialistas em um laudo tomográfico. O laudo imaginológico é o principal instrumento de comunicação entre o radiologista e o dentista solicitante, e deve conter todas as informações necessárias ao clínico, descritas de forma clara e concisa, de maneira a oferecer o melhor atendimento ao paciente.

The tomographic image is crucial for determining diagnosis and treatment plans in various clinical cases in endodontics. Due to the increasing demand for cone-beam computed tomography (CBCT) scans, the need for a system to interpret and describe imaging findings has become essential. The objective of this study was to identify the information considered essential by the requesting dentist in a tomographic report for clinical practice in endodontics. A consensus e-Delphi study was conducted with a panel of 12 endodontic specialists who participated in two rounds of online sequential and individual questioning. The professionals were asked about the key information they deemed important in a tomographic report to assist in diagnosis and treatment planning across different clinical scenarios. The gathered information was categorized by two experienced radiologists, and items endorsed by 80% or more of the endodontists after the second round were deemed essential in a tomographic report. Identification of abnormalities, along with their precise location description, and the selection of images illustrating them in different orthogonal planes were considered essential items by the specialists in a tomographic report. The imaging report serves as the primary communication tool between the radiologist and the requesting dentist, and should contain all necessary information for the clinician, presented clearly and concisely, to ensure optimal patient care.

Neuropathy Score Reporting and Data System (NS-RADS): A Practical Review of MRI-Based Peripheral Neuropathy Assessment.

The Neuropathy Score Reporting and Data System (NS-RADS) is a newly developed MR imaging-based classification that standardizes reporting and multidisciplinary communication for MR imaging diagnosis and follow-up of peripheral neuropathies. NS-RADS classification has shown to be accurate and reliable across different centers, readers' experience levels, and degrees of peripheral neuropathies, which include nerve injury, entrapment, neoplasm, diffuse neuropathy, post-interventional status, and temporal changes in muscle denervation. This article brings a practical review of NS-RADS classification, representative MR cases, and a step-by-step tutorial on how to approach this staging system. Readers can gain knowledge and apply it in their practice, aiming to standardize the communications between specialties and improve patient management.

Structured MRI reporting increases completeness of radiological reports and requesting physicians' satisfaction in the diagnostic workup for pelvic endometriosis.

PURPOSE: MRI plays an important role in the diagnosis and surgical planning of pelvic endometriosis (PE), and imaging reports should contain all relevant information (completeness). As structured reports are being increasingly utilized, we aimed to evaluate whether structured MRI reporting increases the quality of reports regarding completeness and, consequently, their perceived value by gynecologists, in comparison to free-text reports. We also aimed to compare the diagnostic performance of both formats. METHODS: We retrospectively included 28 consecutive women with histologically proven PE who underwent MRI within one month before surgery. Two abdominal radiologists (Rd1/Rd2, 3y/12y experience), blinded to clinical and surgical data, individually elaborated free-text reports and, four months later, structured reports. Completeness (defined as description of six key anatomical sites deemed essential for surgical planning in a consensus of four-blinded external experts) and diagnostic performance (sensitivity and specificity) by site (histology as reference) were compared between reports using the McNemar test. The satisfaction of gynecologists was compared using the marginal homogeneity test. RESULTS: Structured reporting increased completeness for both Rd1 (rectosigmoid, retrocervical/uterosacral ligament, vagina, and ureter) and Rd2 (vagina, ureter, and bladder) (p < 0.05), without compromising sensitivity or specificity at any of the evaluated sites. Gynecologists' satisfaction was superior with structured reports in most comparisons. CONCLUSION: Structured MRI reports perform better in fully documenting essential features of PE and are similar in terms of diagnostic performance, therefore having higher potential for surgical planning. Gynecologists found them easier to assess and were more satisfied with the information provided by structured reports.

Telediagnóstico para eletroencelografia em Santa Catarina / Telediagnóstico for electroencephalogram in Santa Catarina

No Brasil, estima-se que em torno de 5 a 7% da população apresentará uma crise epiléptica ao longo da vida. O Eletroencefalograma é um método fundamental para diagnóstico de epilepsia. Este artigo apresenta o desenvolvimento de um protótipo integrado ao Sistema Catarinense de Telemedicina e Telessaúde, com o objetivo de dar suporte a exames de Eletroencefalograma com envio, emissão de laudos e visualização a distância. São utilizados CID-10 e Descritores em Ciências da Saúde como linguagem de indexação de laudos a fim de gerar estatísticas em pesquisas futuras. O sistema está implantado em quatro unidades de saúde no município de Florianópolis. Os laudos são emitidos por um médico especialista da própria rede municipal e os exames são enviados à rede de Telemedicina. Com o uso desta metodologia é possível facilitar o dia-a-dia dos médicos, técnicos e pacientes com acessos mais rápidos e eficientes, melhorando a qualidade de vida dos pacientes.

In Brazil is estimated that around 5-7% of the population will have an epileptic seizure lifelong. The electroencephalogram is a fundamental method for the diagnosis of epilepsy. This paper presents the development of an integrated prototype called Santa Catarina Telemedicine System, in order to support electroencephalogram exams with sending, issuing reports and online viewing. We used ICD-10 and Health Sciences Descriptors as reports indexing language, in order to generate statistics in future research. The system is deployed in four health units in the Florianopolis city. A medical specialist that works in own municipal network issues the reports and the exams are sent to the Telemedicine network. Using this new methodology we can facilitate the day-to-day lives of doctors, technicians and patients with faster and more efficient, Improving Quality of Life for Patients.