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The development of the Multimedia Electronic Medical Record System (MEMRS) promises new opportunities to significantly reduce the routine use of film as the medium for viewing radiological medical images....Full Text Available

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Sommario La patologia polmonare acuta rappresenta una sfida quotidiana per il Radiologo d'Urgenza, al quale e richiesto di porre una diagnosi sulla base di un radiogramma del torace, eseguito spesso in condizioni tecniche precarie. La Tomografia Computerizzata (TC), pur essendo uno strumento decisivo per ovviare alla scarsa accuratezza del radiogramma del torace, non sempre e eseguibile in questi pazienti che necessitano di assistenza continua. Recentemente e stato proposto l'impiego dell'ecografia toracica per lo studio della patologia acuta. L'esame e eseguito rapidamente al letto del paziente e non necessita di apparecchiature particolari. In 168 pazienti con patologia toracica acuta e stato eseguito uno studio ecografico del torace a completamento dell'esame radiologico. Sono stati val...

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The American Organization of Nurse Executives (AONE) and The Leadership Studio have collaborated to create a one-of-a-kind Executive Coaching Resource Center for nurse leaders and their teams. This resource-designed specifically for AONE members-is a one-stop web-based library developed to assist nurse leaders who want to learn more about utilizing executive coaching services. It focuses on the overall benefits of coaching for nurse leaders-both tangible and intangible-and provides return on investment information for executive coaching based on the most current research.

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Over the past three decades, rising competition from television and other new media prompted the FCC to ease the responsibilities of radio stations to maintain extensive records of issues programming, while retaining the responsibility of stations to provide ready public access to records. This study investigated the availability of Issues-Programs Lists in nearly 100 Missouri radio station Public Files. One in five randomly sampled stations failed to produce access to Lists upon demand as required under federal law. Noncompliance themes include: Inability to access Public Files within 20 minutes of face-to-face requests; station personnel with limited or no knowledge of Files; denial of access to Files and Lists (i.e., verbal refusals, locked studio doors); and incomplete Files. The rate ...

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The reduced polluting emissions make natural gas a quite interesting alternative fuel for automotive applications. Therefore a car diesel engine has been transformed into a dual fuel engine with pilot injection via the common rail injection system used to ignite the methane-air charge. Standard injection pumps show a certain instability at low flow rates and high engine speed. On the opposite the new common rail system allows to ignite the fuel in all conditions with an amount of gas oil less than 8% of the entire energy required by the engine was enough to ignite the fuel. Furthermore, a power increase has been obtained, with an overall efficiency equal to or even higher than a conventional engine. The article deals with a series of test carried out on 1929 cm{sup 3} direct injection turbo-charged engine and presents the preliminary results. [Italian] La riduzione delle emissioni inquinanti rende il metano un combustibile alternativo piuttosto interessante per applicazioni ...

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In Spiral CT, the pitch is the ratio of the distance to tabletop travels per 360 degrees rotation to nominal slice width, expressed in mm. Performing Spiral CT examination with pitch 2 allows to reduce examination time, exposure and contrast dose, and X-ray tube overload. The authors investigated the yield of pitch 2 in lung parenchyma studies, particular relative to diagnostic image quality. [Italian] Nella Tomografia Computerizzata (TC) spirale il rapporto tra la distanza percorsa dal lettino portapaziente in una rotazione e lo spessore nominale dello strato, entrambi espressi in millimetri, si definische pitch. Se i due valori del rapporto coincidono si avra' pitch uguale a 1, mentre raddoppiando la distanza percorsa dal lettino portapaziente, per il medesimo spessore nominale, conseguentemente raddoppia il pitch (pitch 2). Eseguire gli esami TC spirale utilizzando pitch 2, consente di ridurre la durata dell'esame, la dose di esposizione, il consumo mdc e ...

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SommarioScopo In questo studio riportiamo i dati relativi all'ablazione percutanea con Radiofrequenza (RF) di HCC e trombosi neoplastica dei vasi portali. Pazienti e metodi Dieci pazienti (pz) cirrotici, 7 maschi e 3 femmine, eta media 68 anni, con 10 noduli di HCC e trombosi neoplastica dei vasi portali sono stati sottoposti ad ablazione percutanea con RF del trombo neoplastico e dell'HCC. La RF veniva ritenuta efficace quando alla TC con mdc si osservava la necrosi completa dell'HCC e al Color Doppler si osservava la ricanalizzazione completa dei vasi portali. Risultati La necrosi completa dell'HCC e la ricanalizzazione completa dei vasi portali si osservava in 7 (70%) dei 10 pazienti. Nei rimanenti 3 (30%) la necrosi dell'HCC e la ricanalizzazione dei vasi portali non risultavano comple...

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Aim of this study was to evaluate the sensitivity of virtual colonoscopy (CT colonography) in the identification of colorectal cancer and to define the limitations and the advantages of this imaging modality, as well as indications to the examination. It was examined prospectively 62 symptomatic patients aged 36 to 82 years (28 women and 34 men). All patients underwent both conventional and virtual colonoscopy on the same day; the conventional examination allowed exploration of the entire colon. Conventional colonoscopy identified 89 lesions 3-50 mm in diameter, namely 84 benign and 5 malignant lesions. No lesions were identified in 12 patients. CT colonography identified 52 of the 89 lesions, with 57.1% diagnostic accuracy. They were 11 false positives (82.5% positive predictive value and 52.2% specificity) and 37 false negatives (24.5% negative predictive value and 58.4% sensitivity). Sensitivity was significantly higher (85.7%) for polyps {>=} 1 cm. Virtual colonoscopy is an ...

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The main purpose of this work is to report the personal experience with addition of contrast-enhanced multiphase helical CT to unenhanced CT (Lipiodol CT) in the evaluation of patients with hepatocellular carcinoma treated with chemoembolization and to analyze the present role of oily agent CT. It has been retrospectively reviewed the examinations of 42 consecutive patients submitted to global chemoembolization over a 2-year period. CT was performed 18-30 days after the treatment. The Lipiodol CT study was carried out with volume acquisitions. It has been considered as nodules all well-defined areas with dense oily agent uptake; uptake itself was classified as: 0=absent, I=lower than 10% of the tumor volume; II=lower than 50%, III=50%, IV=homogeneous. Contrast-enhanced helical CT was performed with the 2-phase technique in 28 patients and with the 3-phase technique in 14; it has been considered as nodules all well-defined and relatively homogeneous areas with hyper attenuation in the ...

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The purpose of this work is to investigate the possible role of Helical CT defecography in pelvic floor disorders by comparing the results of the investigations with those of conventional defecography. The series analyzed consisted of 90 patients, namely 62 women and 28 men, ranging in age 24-82 years. They were all submitted to conventional defecography, and 18 questionable cases were also studied with Helical CT defecography. The conventional examination was performed during the 4 standard phases of resting, squeezing, Valsalva and straining; it is used a remote-control unit. The parameters for Helical CT defecography were: 5 mm beam collimation, pitch 2, 120 KV, 250 m As and 18-20 degrees gantry inclination to acquire coronal images of the pelvic floor. The rectal ampulla was distended with a bolus of 300 mL nonionic iodinated contrast agent (dilution: 3g/cc). The patient wore a napkin and was seated on the table, except for those who could not hold the position and were thus ...

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Mycobacterium xenopi is one of the most common agents responsible for nontubercolar mycobacterial pulmonary disease on AIDS patients. These lesions have been studied with conventional radiography while CT has been used in patients with aspecific mycobacterioses or non-AIDS pulmonary conditions from Mycobacterium xenopi. 12 AIDS patients were examined. They had pulmonary lesions from Mycobacterium xenopi, patients age ranged 30 to 46 years. All patients had CD4 blood levels lower than 250 cells/mL and Mycobacterium xenopi in the sputum. All patients underwent a standard chest radiograph and a CT examination. CT images were evaluated by three radiologists independently and the definitive diagnosis was made in the presence of a fourth radiologist. Chest CT showed parenchymal consolidation in 66% of cases, associated with bilateral basal bands in 16% of cases. Consolidation was unilateral in 41% of cases and most frequently involved the right lower lobe. Bilateral reticular interstitial ...

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Purpose: To assess the role of CT in the evaluation of traumatic and spontaneous oesophageal perforation. Materials and methods: From March 2001 to May 2003, we studied 12 patients (7 males and 5 females; age range: 25-66 years, mean age: 43.5 years) with suspected oesophageal perforation due to motor-vehicle accidents (4 cases), stab wound (one case), post-intubation (2 cases), foreign body ingestion (2 cases) and spontaneous (3 cases). Five patients underwent standard chest and cervical radiography; two patients with suspected foreign body ingestion also underwent a gastrografin swallow study; all of the 12 patients underwent CT of the neck, chest and abdomen before and after intravenous, and in four cases oral, administration of contrast material. Results: In 5 patients with cervical, thoracic and abdominal trauma, the CT examination showed the presence of pleuroparenchymal injury (pneumothorax, pleural effusion and subcutaneous emphysema) as well as findings suggestive of ...

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Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. It was investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. It was compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous contrast agent administration and the pitch 2 technique. After a previous baseline ...

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Gastric stromal tumors are an ill-defined group of lesions arising from muscle wall cells and characterized by extremely variable biological patterns. Thanks to modern immunohistochemical and ultrastructural techniques, four main classes of these lesions have been identified, namely: (1) tumors with differentiation toward smooth muscle cells; (2) tumors with differentiation toward neural elements; (3) tumors with differentiation toward neural elements; (3) tumors with dual differentiation toward either cell type. It was investigated the yield of CT in diagnosing and characterizing gastric stromal tumors. It was retrospectively reviewed the CT findings of 38 patients (15 men and 23 women; mean age 51 years) with pathologically proven gastric stromal tumors, namely 31 of myoid origin, 4 of neural origin, 2 with both muscle and neural differentiation, 1 lacking differentiation with either cell type. The myoid tumors involved gastric fundus in 9/13 and 5/7 benign lesions and lesions with ...

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Purpose of this work is to evaluate the effectiveness and role of CT in blunt diaphragmatic injuries by reviewing our 8-year experience. It is reviewed the preoperative CT findings of 35 patients with surgically confirmed diaphragmatic rupture. Surgical repair was performed in the acute setting (within 12 hours of trauma) in 22 cases, and late (8 months-5 years) in 13 cases. Twenty-eight patients (80%) were examined with conventional CT and 7 (20%) with Helical CT. Of the 13 patients examined long after trauma, the left hemi diaphragm was ruptured in 12 cases (with visceral herniation in 4), and the right hemi diaphragm in 1, with no herniation. The diaphragmatic rent was found in the dome (15 cases, 43%), muscolotendinous junction (11 cases, 31%), muscular portion (8 cases, 23%), and at the muscular attachments on the ribs (1 case, 3%). As for the site of diaphragmatic injury, CT never depicted the diaphragmatic rent in the dome and at the muscolotendinous junction (74%), not even ...

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Computed Tomography (CT) and, more recently, ultrasound (US), have proved excellent tools for quantifying adipose tissue distribution. Body fat distribution is an important factor in the treatment of obesity and its complications. In this work it is investigated the correlation between CT and US measurements in pediatric obesity. Forty obese children and adolescents aged 4.1-14.8 years were submitted to CT and US. Intra-abdominal, subcutaneous and total body fat were calculated (in cm{sup 2}), with the CT image analysis software. The rectus muscle-spine and rectus muscle-aorta distances, as indicative of visceral fat thickness, were measured on US images with(out) compression. The distance between skin fat and fat-rectus muscle interfaces was measured as subcutaneous fat thickness. US-CT findings have been compared with other morphometric variables-i.e., patient's (ideal) body weight and skin fold measures. A statistically significant correlation was found between the CT ...

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The purpose of this paper is to report the personal experience with helical CT evaluation of hepatocellular carcinoma treated with various percutaneous interventional procedures. From December 1996 to September 1998 it were examined with helical CT 41 patients (73 nodules in all) with hepatocellular carcinoma treated with percutaneous ablation therapies: conventional ethanol injection in 18 subjects (31 nodules), one-shot ethanol injection 3 (8 nodules), radiofrequency thermal ablation in 16 (25 nodules), and combined chemo embolization and ethanol injection in 4 (9 nodules). CT performed was 4-27 days after the last session, acquiring biphasic volumetric images in 14 patients and triphasic volumetric images in 27. A second treatment with subsequent CT study was performed for 28 lesions; 15 underwent 3 serial studies and 6 underwent 4 studies. Compared with pretreatment findings, the diameter was unchanged in 62% of the nodules and increased in 38%. Morphology was unchanged in 63% of ...

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The main purpose of this work is to evaluate the role of CT in identifying other morphological signs of met static lymph node involvement from non small cell bronchogenic carcinoma. This is done to improve N staging, a critical step in this disease. In fact, since diameter is the only criterion used to distinguish normal form abnormal lymph nodes, mediastinal CT only has 80% diagnostic accuracy. 137 patients with known or suspected lung cancer were examined with Helical CT during early and late arterial phases (2 min. delay, 3 mm thickness, 5 mm inter slice gap) to depict node characteristics. Mediastinal lymph nodes, located according to the American Thoracic Society mapping, were considered normal when they were not visible or, if visible, less than 1 cm in diameter and of homogeneous density; lymph nodes over 1 cm in diameter and homogenous density were considered reactive. A lymph node was considered metastatic when, independent of size, the following signs were found: central hypo ...