Search

When first learning abdominal CT studies, residents are often given little concrete, practical direction. There is, however, a large literature from the visual and cognitive sciences that can provide guidance towards search strategies that maximize efficiency and comprehensiveness. This literature has not penetrated radiology teaching to any great extent. In this article, we will examine the current pedagogy (and why that falls short), why untutored search fails, where misses occur in abdomen/pelvis CT, why these misses occur where they do, how expert radiologists search 3d image stacks, and how novices might expedite the acquisition of expertise.

Superficial venous thrombosis (SVT) of the upper and lower extremities has long been considered a relatively benign condition. But in recent years, the literature has suggested a benefit to anticoagulation in patients with certain thrombus characteristics (size, location, and distance to deep venous system) resulting in updates to clinical guidelines for the treatment of lower extremity SVT. Despite these now well-established guidelines, there remains a paucity of guidance from national and international societies regarding the imaging of superficial veins when evaluating for venous thrombosis. We recommend potential strategies to close this gap.

OBJECTIVES To determine how measurements of the internal carotid artery (ICA) cross-sectional area will differ systematically when obtained by grayscale, color Doppler, and power Doppler imaging. METHODS A total of 451 patients had greater than 40% diameter stenosis in at least a single ICA. Anteroposterior and transverse luminal diameters were measured in 609 arteries on grayscale, color, and power Doppler transverse images of the carotid bulb and proximal and distal ICAs. Cross-sectional areas were calculated and compared by a repeated-measures analysis of variance model to assess for significant differences. RESULTS Mean ICA cross-sectional areas ± SDs as measured by grayscale, power Doppler, and color Doppler imaging were 122 ± 81, 122 ± 79, and 125 ± 79 mm2 , respectively. The mean ICA area estimated by color Doppler imaging was significantly greater than that estimated by power Doppler imaging (P

Sonographers experience stress-related musculoskeletal injuries at alarming rates. The magnitude of the problem has resulted in substantial economic and human costs. Early efforts, such as the transposition of office ergonomic models to the ultrasound suite, have been only marginally successful because of the vast difference between clerical and sonography work demands. In addition, although the issue has attracted the attention of professional sonographer societies, equipment manufacturers, and governmental agencies, such as the OSHA (Occupational Safety and Health), the causative mechanisms by which sonographers are injured remain inadequately addressed. A definitive ergonomic solution has been elusive.With the help of occupational therapists and biomechanical engineers, we have developed a number of possible ergonomic modifications of ultrasound equipment. We explain the rationale behind these approaches to transducer design and assess the strengths and deficiencies of each.

Objectives To characterize fluctuations in peak systolic velocities (PSVs) in Doppler waveforms of the carotid artery in patients with and without obstructive airway disease and in volunteers subjected to incremental levels of airway resistance in an experimental model. Methods The PSV variation in common carotid waveforms was measured in 100 patients who had had a carotid ultrasound examination and no respiratory or carotid disease. This was compared to that of patients who had this study during an admission for acute exacerbation of chronic obstructive pulmonary disease (COPD). The PSV variation was correlated with pulmonary function testing. In addition, 14 healthy volunteers were asked to breathe through 5 resistors. Simultaneous recordings were made of Doppler waveforms in the common carotid artery, cardiac activity, and respiration. Peak systolic velocity changes from inspiration to expiration were calculated. Results Of the 100 patients without respiratory disease, the magnitude of the PSV variation averaged 6.3 cm/s. Of the 33 patients with COPD, the PSV variation averaged 16.5 cm/s. Nineteen of the 33 patients with COPD had concurrent pulmonary function testing; there was a statistically significant correlation between the PSV variation and forced vital capacity and forced expiratory volume indices. For the volunteers, mean velocity changes were 7.1, 6.6, 8.3, 15.1, and 16.1 cm/s for 0.00-, 2.15-, 3.27-, 3.58-, and 5.77-cm H2 O/L/s levels of breathing resistance, respectively. There was a statistically significant relationship between an increasing airway load and the decline in PSV during inspiration (P = .02). Conclusions The PSV variation is greater in patients with increased airway resistance. Similar changes are evident in volunteers breathing into resistors. These findings likely reflect pulsus paradoxus.