Tuesday, October 31, 2006

Consumers Dont Check the Source & Date of Health Information Online

Online Health Search 2006 reveals some surprising but predicatble results.
"Most internet users start at a search engine when looking for health information online. Very few check the source and date of the information they find. "

Full Report on Pew Internet

Sunday, October 29, 2006

Radiology Grand Rounds-V

Welcome to the Fifth Edition of the monthly summary of the best in the Radiology Blogsosphere known as “ Radiology Grand Rounds”. Grand Rounds is an old tradition that doctors have. Once a week, they get together and talk about one case in detail. Keeping up with this tradition this Carnival of Medical Imaging has been named “Radiology Grand Rounds”. Every physician would agree that Subspecializtion is the need of the hour in medical field, hence the concept of a specialized Radiology Grand Rounds. Radiology Grand Rounds will be hosted on last Sunday of each month, the schedule and archive will be available at- Radiology Grand Rounds. I would like to thank all the contributors for this edition of Radiology Grand Rounds.

This Edition I will start with a tribute to the person responsible for the discovery of the science of Radiology Or X-Rays and the story associated with the X-ray discovery.

The Beginning Of The Science Of Radiology

Photobucket - Video and Image Hosting

"On the evening of November 8, 1895, Wilhelm Conrad Röntgen found that, if the discharge tube is enclosed in a sealed, thick black carton to exclude all light, and if he worked in a dark room, a paper plate covered on one side with barium platinocyanide placed in the path of the rays became fluorescent even when it was as far as two metres from the discharge tube. During subsequent experiments he found that objects of different thicknesses interposed in the path of the rays showed variable transparency to them when recorded on a photographic plate. When he immobilised for some moments the hand of his wife in the path of the rays over a photographic plate, he observed after development of the plate an image of his wife's hand which showed the shadows thrown by the bones of her hand and that of a ring she was wearing, surrounded by the penumbra of the flesh, which was more permeable to the rays and therefore threw a fainter shadow. This was the first "röntgenogram" ever taken. In further experiments, Röntgen showed that the new rays are produced by the impact of cathode rays on a material object. Because their nature was then unknown, he gave them the name X-rays."
Reference- Nobelprize.org

Patient Information

Dr. Kavokin presents Patient Information on Medical Imaging technique known as Ultrasound followed by a Quiz.

"Let's say you have a belly pain. Did you ever get it?Let's say this time the pain is really unbearable. What will you do? Where would you go? You should rush to a doctor.When you arrive to ER, doctor asks you lots of questions. How bad is pain, where is it located, where does it refer (go)? Any nausea, vomiting, defecation problems and so on. He will also ask about your history. Then he looks up for your past problems in your written history or history stored on computer.He will listen your lungs, palpate your belly, sometime even causing more pain by touching. Eventually he suspects a disease and confirms it with some type of the tests. What tests will he choose? There will be blood work, urinalysis and some other analysis.Eventually you will probably go into the radiology department to get some imaging test. Abdominal US"

Featured Cases

Mikhail Serebrennik of Filmjacket.com has submitted this case. Its Scary for Sure!

Photobucket - Video and Image Hosting

Case Details-One (relatively senior!) surgical resident at our hospital, who no longer works here, has punctured the left chest wall with a trochar in an attempt to place a left thoracic pigtail drainage catheter. You can be the judge of the resulting situation. The chest tube ended up in the left ventricle!

Bhavin's Blog Features an interesting case of Subependymal heterotopia
The MRI images show a smooth, nodular area, isointense to grey matter, on all pulse sequences, along the margin of the atrium of the right lateral ventricle.


Film Jacket.com now offers New Radiology Video Database - the Video Jacket.

That wraps up this month's highlights of the Radiology blogosphere. Hope the readers enjoyed the Fifth edition of the Radiology Grand Rounds. If you liked any of these blogs, keep visiting them. Please email me at sumerdoc@yahoo.com if you are interested in hosting future Radiology Grand Rounds. Archive for the Radiology Grand Rounds here-Radiology Grand Rounds. Be sure to tune in Next Month Last Sunday 26th November, when Grand Rounds will be hosted at- Spot Diagnosis Send the Submissions to- bhavin@jankharia.com

Saturday, October 28, 2006

Now You Can Control MRI Over The Internet

Software, developed by UCLA radiologists and Siemens Medical Solutions, has been shown to be quite capable in helping to control MRIs remotely and to deliver high quality images to a clinician's home or call room.

Full Text-UCLA News

Hat Tip- Medgadget

Tuesday, October 24, 2006

Will Radiologists Keep Control Over Ultrasound?

Diagnsotic Imaging Online talks about The seminar, Strategic Planning for the Future of Ultrasound in Radiology, took place at the 2006 Society of Radiologists in Ultrasound meeting in San Francisco.

"Going from gloom to bloom at a seminar yesterday, radiology luminaries dissected the latest practice trends, technological developments, and clinical applications in ultrasound use and turf. Their conclusions, to be published in a major radiology journal, should indicate if radiologists will choose to relinquish control of ultrasound for good or reclaim a modality that could thrive in the hands of experts through the next decade.
The shortage of radiologists, an obesity epidemic that curtails ultrasound's utility, a payment system that excessively rewards CT and MRI, and the multislice CT revolution may have facilitated the migration of ultrasound to other specialties. Cronan recently wrote an editorial expanding on these and other related issues (JACR 2006 Sept. 3;[9]:645-646). "

Monday, October 23, 2006

Seems like Canada is also looking towards Teleradiology

"Tonight, thousands of Canadians will check themselves into emergency rooms complaining of everything from minor pains to serious injuries or life-threatening illnesses. In the most critical cases, a doctor will order a middle-of-the-night diagnostic scan such as an MRI, which will likely tax the hospital's already overworked radiologists. Everyone else will be placed on waiting lists of up to three months or more to get the results of X-rays, MRIs or CT scans.But if Normand Laberge has his way, such test results could be obtained in as little as 30 minutes, practically obliterating current wait times and dramatically improving the quality of Canada's health-care system. There's only one problem: for his plan to work, radiological tests from Canada would have to be sent to physicians in other countries, including the United States, Australia, Switzerland and India."
Source & Full Article-
Reading MRIs, X-rays and other scans overseas touted as way to slash wait times.

More on Medical Tourism

"At least 40 American corporations have signed a health plan, which allows sending employees abroad, including to India, Malaysia, Thailand and Singapore, where they could save more than 80 per cent on the cost of medical procedures. More than 150,000 North American and European are currently seeking medical treatment abroad, it said. Giving instances of the savings, Newsweek quoted GlobalChoice Healthcare, a firm arranging foreign procedures, as saying that angioplasty which costs $50,000 in an American hospital can be performed for merely $6000 in Mohali in India. The magazine quotes Abacas International, a leading travel facilitator, estimating that medical tourism to Asia could generate up to $4.4 billion by 2012."
Source and Full article-

Friday, October 20, 2006

Happy Diwali & Submissions requested for upcoming Radiology Grand Rounds

Happy Diwali, The Festival of light to all my readers & visitors.
Also Radiology Grand Rounds V are coming up!!
"This is the first call for submissions to the fifth edition of the monthly
Radiology Grand Rounds which will be hosted here on the last Sunday of this month on Sumer's Radiology Site. Anything that is relevant to Radiology or Medical Imaging will be accepted. You don’t have to be a radiologist to contribute. We would love to hear from Doctors, Nurses, Medical Students, Radiographers, Imaging Technicians, Patients, etc."

Please send in your submissions by email to-

Free Medical Imaging Software

"Medical imaging research is complex, time-consuming and often very expensive, with a wide range of standards, equipment and software available. Worse, medical researchers can find themselves unable to share data easily with colleagues—something that they need to do constantly in order to improve understanding for diagnosis and treatment. Two enterprising medical doctors addressed this problem and came up with a Macintosh-only solution called OsiriX that is changing how many in the field examine and share scanned images, medical image data and visualizations. It’s powerful, fully integrated with many Apple applications and hardware, and it’s open source, so others can contribute to the expansion and refinement of the tool. And, it’s freely available for download and use. "
For more information on OsiriX, see the OsiriX website.

Saturday, October 14, 2006

Dengue can show Hippocampal involvement & other neurological manifestations

  • Hippocampal involvement in dengue fever
Singapore Med J 2005 Nov;46(11):647-50.
Authors report a 25-year-old man with dengue fever complicated by selective hippocampal involvement manifesting as amnesia. This has not been described in the literature previously. Dengue polymerase chain reaction and serology were positive. Magnetic resonance imaging of the brain showed bilateral hippocampal involvement.
  • Preferential gray matter involvement in dengue myelitis.
Neurology 2004 Nov 23;63(10):1980-1
  • Unusual neurologic manifestations occurring during dengue fever infection.
Am J Trop Med Hyg 1993 Jun;48(6):793-802.
The first patient developed a focal subarachnoid hemorrhage that was associated with transient thrombocytopenia. No neurologic vascular malformation was detected; a mild dengue hemorrhagic fever after a previous dengue infection was suspected. The second patient showed peripheral facial palsy one week after apyrexia without any other etiology except the dengue infection. This case was probably a postinfectious syndrome associated with dengue virus. Both patients recovered spontaneously.
  • Hemorrhagic encephalopathy in dengue shock syndrome: a case report.
Braz J Infect Dis 2005 Jun;9(3):257-61. Epub 2005 Oct 3.
Dengue fever is the most important arboviral infection in the world, with an estimated 100 million cases per year and 2.5 billion people at risk. Encephalopathy is a rare complication of dengue virus infection and may occur as a consequence of intracranial hemorrhage, cerebral edema, hyponatremia, cerebral anoxia, fulminant hepatic failure with portosystemic encephalopathy, microcapillary hemorrhage or release of toxic products.

Tuesday, October 10, 2006

RSNA News points to Radiologists Shortage

Radiologists are still in Demand..

"Radiologists are still highly sought after nationwide, with organizations using a blend of incentives to entice candidates, according to statistics released by a national healthcare search and consulting firm. According to Irving, Texas-based Merritt, Hawkins, & Associates®, radiology was the third most frequent physician search the firm conducted between March 31, 2005 and April 1, 2006. Of the 2,840 physician and certified registered nurse anesthetist (CRNA) searches conducted by the firm in all 50 states, 237 were for radiologists—a 9 percent increase over the previous year."
Full News item here-

Who should read a Coronary CT angiogram?

Diagnostic Imaging has a very thought provoking article where a top insuring company has asked ACR about opinion on who is the right person to read a Coronary CT Angiogram. Will Cardiac CT stay with Radiologists?
"One of the largest health insurers in the U.S. has solicited the American College of Radiology for its opinion regarding who should read coronary CT angiography studies. In discussions with the ACR, Highmark had indicated it was considering two options: allow a radiologist to interpret the entire cardiac CT or coronary CTA study, or allow a cardiologist to read the cardiac images and contract with a radiologist to read the noncardiac portion of the study. The ACR responded in a letter in late summer that a properly trained radiologist is the best qualified physician to supervise and interpret the full data set of images involved in cardiac CT and coronary CTA. "
Read the entire article in Diagnostic Imaging here-

Friday, October 06, 2006


"Sirenomelia is a rare congenital anomaly characterized by abnormal development of the caudal region of the body with variable degree of fusion of lower extremities. It derives its name by its resemblance to the Mermaid ( Siren ) of Greek mythology. About 300 cases have been reported in the world so far out of which 9 have been reported in India. Sirenomelia is also known as Sirenomelia sequence, Symmelia, Symposia, Uromelia and Monopodia. The exact etiopathogenesis is uncertain. The proposed theories are Vascular steal or Vitelline artery steal theory by Stevenson which is the most accepted. Others include teratogenic effects of lead, cadmium and vit.A, primitive streak defect, axial mesodermal dysplasia sequence.Maternal diabetes mellitus and genetic predisposition is also implicated. Vitelline artery steal theory states that an aberrant vessel(derived from the vitelline artery) arises from high abdominal aorta in the affected fetus and functions as the vessel returning blood through the umbilical cord to placenta. This vessels steals blood from structures distal to its origin."
Read the full case report here (Full Text Available Free)

Thursday, October 05, 2006

Cardiac CT Tutorial

Cardiac CT
Reference- Medgadget Wiki
"With the advent of subsecond rotation combined with multi-slice CT (up to 64 slices), high resolution and high speed can be obtained at the same time, allowing excellent imaging of the coronary arteries. Images with a high temporal resolution are formed by updating a proportion of the data set used for image reconstruction as it is scanned. In this way individual frames in a cardiac CT investigation are significantly shorter than the shortest tube rotation time. It is uncertain whether this modality will replace the invasive coronary catheterization.
Cardiac MSCT carries very real risks since it exposes the subject to the equivalent of 500 chest X Rays in terms of radiation. The relationship of radiation exposure to increased risk in breast cancer has yet to be definitively explored.
Also a lot of MSCT technicians are trained cardiologist as opposed to radiologists. The positive (93-95%) and negative (97-98%) predictive values of the scan are calculated on the basis of a knowledgable staff which may not always be the case.
Much of the software is based on data findings from caucasian study groups and as such the assumptions made may also not be totally true for all other populations.
Dual Source CT scanners, introduced in 2005, allow higher temporal resolution when acquiring images of the heart, allowing a greater number of patients to be scanned. "
Much More Information About Medical Gadgets-

MRI in patients with Cardiac Pacemakers now looks feasible!!

Low-energy “fix” for machine, other steps vastly reduce risk
Researchers at Johns Hopkins have painstakingly figured out how to safely perform magnetic resonance imaging (MRI) scans on men and women who have any one of 24 modern types of implanted defibrillators and pacemakers.Henry Halperin, M.D., and his team have developed a combination of methods that reduce the risk of life-threatening meltdowns and other complications posed by MRI’s ability to charge and manipulate the electrical properties of cells to produce real-time images from inside the body. "
(Hat Tip- Medgadget.com )

Wednesday, October 04, 2006

Too Obese For Routine Imaging, Use Veterinary Facilities!!

Not An Urban Legend
"They may not admit it, but some physicians around the country are asking veterinary facilities to image their morbidly obese patients. They are inquiring about airlifting out-of-state patients and even transferring them directly to animal hospitals with emergency personnel. "

Read the full article here-
Advance For Imaging & RT Professionals

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