The optimized methodology and results of the new characterization in terms of dose and image quality of the X-ray system used in the main pediatric hemodynamics service in Chile are presented. In addition, scattered dose rate values at the operator’s eye level are reported for all acquisition modes available in different thicknesses of absorbent media and angiography. The characterization was performed according to the European DIMOND and SENTINEL protocols adapted to pediatric procedures. The air kerma at the entrance surface (ESAK) was measured and the image quality parameters signal-to-noise ratio (SNR) and a figure of merit (FOM) were calculated. The scattered dose rate was measured in personal dose equivalent units. The ESAK for fluoroscopic modes ranged from 0.2 to 35.6 μGy/image when passing from 4 to 20 cm of polymethyl methacrylate (PMMA). For the cine mode, these values ranged from 2.8 to 160.1 μGy/image. The values of the image quality parameters showed a correct system configuration, although abnormal values were observed in the medium fluoroscopic mode. As for the scattered dose rate at the level of the cardiologist’s eyes, the highest value is PMMA with a thickness of 20 cm, where the cine mode reached 9.41 mSv·h-1. The differences found from previous evaluations can be explained by the deterioration of the system and the change of one of the X-ray tubes.
Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.
Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. Magnetic resonance imaging is the ideal modality for the evaluation of colorectal cancer, since it allows staging by determining invasion beyond the muscularis propria, extension towards adjacent organs, identification of patients who are candidates for chemotherapy or pre-surgical radiotherapy and planning of the surgical procedure. The key point is based on the differentiation between T2 and T3 stages through the use of sequences with high-resolution T2 information. In addition to this, it allows the assessment of the size and morphology of the lymph nodes, and considerably increases the specificity for the detection of lymph node involvement. MRI is a technique with high specificity and high reproducibility.
Cardiovascular imaging analysis is a useful tool for the diagnosis, treatment and monitoring of cardiovascular diseases. Imaging techniques allow non-invasive quantitative assessment of cardiac function, providing morphological, functional and dynamic information. Recent technological advances in ultrasound have made it possible to improve the quality of patient treatment, thanks to the use of modern image processing and analysis techniques. However, the acquisition of these dynamic three-dimensional (3D) images leads to the production of large volumes of data to process, from which cardiac structures must be extracted and analyzed during the cardiac cycle. Extraction, three-dimensional visualization, and qualification tools are currently used within the clinical routine, but unfortunately require significant interaction with the physician. These elements justify the development of new efficient and robust algorithms for structure extraction and cardiac motion estimation from three-dimensional images. As a result, making available to clinicians new means to accurately assess cardiac anatomy and function from three-dimensional images represents a definite advance in the investigation of a complete description of the heart from a single examination. The aim of this article is to show what advances have been made in 3D cardiac imaging by ultrasound and additionally to observe which areas have been studied under this imaging modality.
In Costa Rica, there is no explicit recommendation from the competent authorities for the use of a specific phantom, so experts must explore what suppliers offer, among which the Normi Mam Digital phantom from PTW stands out. This article presents the results of the dosimetry and image quality control applied to the Normi Mam Digital phantom to validate it as equipment that complies with the recommendations of the Human Health Series No. 17. The results obtained were satisfactory, proving that the equipment complies with the tolerances recommended by international health bodies.
Focused Assessment with Sonography for Trauma (FAST) has been widely used and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly used to diagnose intra-abdominal injuries. Today, the FAST examination has evolved into a more comprehensive study of the abdomen, heart, thorax, inferior vena cava, among others, with many variations in technique, protocols and interpretation. Trauma management strategies such as laparotomy, endoscopy, computed tomography angiography, angiographic intervention, serial imaging and clinical observation have also changed over the years. This technique, at times, has managed to replace computed tomography and peritoneal lavage diagnosis, without producing delays in the surgical procedure. As such, the relationship between the patient’s clinical information and the results of the exam should be guided to guide therapeutic approaches in difficult to access settings such as intensive care units in war zones, rural or remote locations where other imaging methods are not available. This review will discuss the evolution of the FAST exam to its current status and evaluate its evolving role in the acute management of the trauma patient.
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