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Small and adult patients' uropoetic system examination from radiological assistant's point of view
TRAPLOVÁ, Lenka
This paper deals with issues related to examinations of the uropoetic system. First, I briefly describe the anatomy and physiology of the urinary system, and then I characterize all the particular imaging methods. Patients with identical diagnoses should undergo identical examinations in an identical and, if possible, optimal sequence. I decided to make a comparison of available national and international guidelines with examination algorithms applied in the Czech Republic. For this purpose, I collected data of 115 patients who underwent radiological examinations in the hospital of České Budějovice, a.s. I abstracted the applied algorithm of the indicated examinations for the diagnoses represented in the sample of patients and, after the comparison, I assessed the deviation from the guidelines. I suggested procedures which seemed to be the most suitable ones when comparing Czech and international guidelines and available studies. I realised that the hospital in České Budějovice meticulously follows the standards defined by professional associations, therefore, upon assessment of all aspects, it can be concluded that examination methods using ionizing radiation can only be replaced by other methods which do not use it in a very small percentage of cases.
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Role of diagnostic imaging in hydronephrosis
VOSMÍKOVÁ, Anna
I have chosen the topic of my thesis ?The task of displaying methods for a hydronephrosis ground diagnostic? thanks to the many possibilities of diagnostic and laboratory screening methods. Hydronephrosis and its matters is often discussed topic within a medical staff - how to examine it and which method is the most effective. This is the main goal of my work as well. The main goal of my work is to compare the most effective and the most informative screening methods of the outcome urinary system. Furthermore, I would like to introduce a proposal of an applicable method of the outcome urinary system visualization. I set up the hypothesis, that an outcome urography which used to be the main radiologic method of diagnostic of hydronephrosis, is nowadays successfully replaced by the complex of the modern displaying methods. I have done a quantitative research in two Prague´s hospitals with an accreditation. I focused on 30 patients with a hydronephrosis (also derived from the secondary source) in each hospital. I compared a number of the screenings to which the patients were indicated and also the screenings the clearly displayed the ground of the hydronephrosis. I have also registered the ground of hydronephrosis, which primary was not the goal of my work. It is used to apply an ultrasonography as the first choice of diagnostic in cases where there is the suspection of hydronephrosis in FNM and ÚVN. Ultrasongraphy is a method without ionising radiation and with the fast kidney structure evaluation. It was not always shown clearly by ultrasound by patients with hydronephrosis, and that is why the other methods like RTG, CT, IVU and MR were used. The scintigraphy was done as well, but only for TNM staging tumours. The first objective of my work is a comparison between diagnostic methods. This target was met in the research results, added by charts. The second objective, to present a plan for an appropriate method to display outcome urinary system, is not possible to fulfill. The same procedure cannot be used for each patient ? considering the different ground of the hydronefrosis, we need to use individual attitude. I also present an extensive chapter on causes of hydronefrosis in my work. According to the results I confirm a hypothesis, that an outcome urography is nowadays mainly replaced by modern diagnostic methods, mostly by the computer tomography. In the end, I would like to mention, that the work of the radiologic assistant has changed nowadays, especially thanks to the development of radiodiagnostic and of the digitalization. Radiologic assistant has become very important part of the medical team. His/her work also includes a communication with a patient, his/her monitoring during the screening, and a professional communication with the medical team. The knowledge of the new work methods, its principles and the work with the new Pc programs (e.g. PACs) is also indispensable.
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Observation of non invasive and invasive screening cerebral vessels from the radiologic assistants view.
NOVOTNÁ, Dana
The subject my thesis was ? Observation of non invasive and invasive screening cerebral vessels from the radiologic assistants view". In the theoretical parts I explore the disorder of blood - vessel in cerebral occurrence (CMP) and its diagnosis. It is about the acute illness caused by closure of some of the cerebral arteries and resulting in vapidity brain (ischemic) or bleeding to the brain (haemorrhage). It ranks among the most frequent causes death in developed countries. The practical part includes research of usage non invasive and invasive depict methods in brain and cerebral vessels diagnostics. I processed quantitatively the statistical data which I gained from the Radio-diagnostic Ward in hospital in Ceske Budejovice. The result of this emerges from superiority of non-invasive screening above invasive one. In the non- invasive depict methods in diagnosis of CMP most often uses computation tomography (68 %), which for a certainty will distinguish ischemic from haemorrhage. Magnetic resonance (7 %) is more sensitive method at ischemic diagnostics. Another method is the ultra-sonography (13 %), in which we can assess the level of stenos/occlusion screened vessel. As the only vice invasive methods is catetrizac angiography (12 %), which is considered as the golden standard in displaying the blood - vessel bed. Its advantage is the possibility to join endovascular intervention. The next aim was to compare the role of radiologic assistant during single screening. It was necessary to find common point in practical activities of the radiologic assistant at both types o screening and to show the differences in specific substance and the work demands.
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The role of radiographer as the paramedical staff in the health of patients in defined competencies
ŠKRABALOVÁ, Jana
The topic of the thesis is "The role of a radiology assistant as a paramedical staff in patients health care within defined competencies." The aim of this work is to summarize global information about radiological assistant competencies, as they may be executed in patient care in practice and how these competencies have increased with new Decree No. 55/2011 Coll. Another objective of this study is to compare educational programs of specialized education. Hypothesis have been formulated as follows: In the amended Decree, radiology assistant competencies have increased. The information that this work provides, primarily relate to legal standards and their comparison. Feedback to legislation has been identified in the survey. Questionnaires provided information about radiology assistants satisfaction with their competencies, qualifications, conferences benefits and educational specialization. In the discussion there are evaluated gained informations and opinions on the topic. Conclusion then summarizes all findings related to the research.
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The role of the radiology assistant at operating room
FLÉGROVÁ, Jana
This work aims at furnishing comprehensive information on radiographer as a member of the operating team and explaining his/her activities in the operating theatre. It also wants to point out some recurrent errors and to brief on most frequent operating techniques and the work inside an operating theatre as seen by a radiographer, and thus help improve the work of a radiographer and make it even more precise while facilitating the work of the operating surgeon.
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Radiographers role in biliary interventions.
MINÁŘOVÁ, Olga
Radiological assistance during non-vascular interventions on the biliary tract. The presented Bachelor's thesis includes information from the practical course in an interventional facility of the Department of Imaging Techniques, Motol University Hospital, while assisting during PTC and PTD procedures. In the Czech Republic, these procedures are most frequently performed in patients with inoperable malignant stenosis of the biliary tract where the method of first choice, the endoscopic approach (ERCP), is not possible. I would like to emphasise the importance of knowledge and use of the state-of-the-art materials and technologies that facilitate our work and ensure a non-complicated course of examination for the patient. By comparing the radiation burden in assisted and non-assisted procedures, I would like to demonstrate that the overall final effective dose during assisted procedures is lower than during the procedures performed by the surgeon alone. Data obtained from two groups of thirty patients with an identical diagnosis, who received treatment with or without assistance, was statistically compared and plotted in a graph. In the selected sample of sixty patients in whom this procedure was indicated, I used the parameters obtained to perform a final calculation of the effective dose. The results confirmed the hypothesis that the assisted procedures require less time than the unassisted procedures, and that the effective doses are lower and not dependent on the BMI value. We should also take into account the factors that might influence the overall course of the examination, such as for example the patient?s overall health and his/her diagnosis. The length of the procedure depends on the experience, length of practice and skills of the radiologist. The radiology assistant, as a practicing specialist, plays an important role in the entire interventional team. PTC/PTD is a method which has a low burden for the patients, a low occurrence of complications, and is life-saving in some cases. The possibility of reducing the burden on the patient and the personnel can be achieved by having a sufficient number of qualified staff at the interventional radiology facilities. The symbiosis of the entire examination team is a guarantee that the procedures will be performed in the best possible way and in the shortest possible time, with a low radiation burden for the patient.
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Renal colic - Intravenous excretory urography versus Native examination of uropoetic´s system on spiral CT
CHALUPOVÁ, Dana
Renal colic - intravenous excretion urography versus native examination of the uropoietic system using a spiral CT scan This thesis presents a comparison of two imaging techniques that are most frequently indicated for diagnosis of renal colic. These are intravenous excretion urography and native examination of the abdomen and pelvis using a spiral CT scan. By comparing the following aspects, I would like to contribute to the complete elimination of the indication of intravenous excretion urography and replace it with spiral CT scanning. The objective of this thesis is to demonstrate that native examination of the abdomen and pelvis using a spiral CT scan is more beneficial and more suitable both for the diagnosis and for the patient. Within the thesis, I also compare the aspects of radiation burden, time and financial requirements and last but not least the overall burden on the patient over the course of the examination. The comparison was performed by calculating a typical effective dose in a sample of fifty patients examined by intravenous excretion urography and fifty patients examined by spiral CT scan. The results are shown in graph format. These results did not confirm the hypothesis that the radiation burden is lower in spiral CT scanning. The doses determined in my thesis are up to three times higher in the CT scan. In financial terms, both imaging techniques have been evaluated as almost comparable and the price of the examination should not influence selection of the method. Spiral CT scanning is much more beneficial when comparing the time needed for performance of the two techniques. The results pertaining to the radiation burden for patients during spiral CT scanning suggest how important the radiology assistant?s ability is in influencing the size of the effective dose by the proper selection and inspection of the exposure parameters when selecting the examination protocol. This statement is further strengthened when comparing the results of this work with those of foreign studies, where the radiation burden on patients examined by spiral CT scanning was one to four times lower than my results of effective doses. The effective doses obtained were close to the effective doses determined during intravenous excretion urography. The objective of this Bachelor's thesis is to outline the possibilities for reducing the radiation burden on patients examined by spiral CT scan.
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Prenatal diagnosis by imaging methods
VLČEK, Martin
The bachelor degree thesis focuses on imaging methods in prenatal diagnostics. The theoretical part informs the readers about the current situation in this field, including invasive and noninvasive examination methods. The theoretical part is concluded with a chapter on prenatal detection of heart disease by means of screening examination of pregnant women. The objective of the thesis was to highlight the activities of a radiological assistant, to describe his/her activities during the use of various modalities and possibilities in diagnostics of congenital heart diseases, both prenatally and perinatally. One hypothesis was formulated, concerning the activity of a radiological assistant in diagnostics of congenital heart diseases during the prenatal period. The quantitative research was designed based on the number of examined fetuses and newborns in the teaching hospital (Fakultní nemocnice) in Motol and in the Center of Medical Genetics (Centrum lékařské genetiky s.r.o.) in České Budějovice in the course of 1 year. In 59 fetuses examined with magnetic resonance the following 3 congenital heart diseases were detected most frequently: 7 cases of agenesis of corpus callosum, 6 cases of ventriculomegalia and 7 cases of congenital cystic adenomatoid lung malformation. None of the examined mothers was diagnosed with placenta defects or pathological changes on the fetus heart. The formulated hypothesis has been confirmed. At present, congenital heart diseases are not routinely prenatally examined by means of magnetic resonance due to the too robust technology and insufficient quality of the imaging. The prominent role is still being played by ultrasonic examinations performed by gynecologists and obstetricians. The thesis and the research results may be used by cardiologists, gynecologists, obstetricians, as well as radiologists.
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The specific approach to diagnostic imaging methods in patients with diabetes mellitus
KLIMEŠOVÁ, Jitka
Diabetes mellitus occurs as a result of absolute or relative lack of insulin. It is a chronic disease which can lead to damage of other systems and organs. Number of patients with diabetes mellitus undergoing medical examinations or interventional therapy by the diagnostic imaging methods has been increasing. It brings higher demand on technical parameters of the methods and more exact work of medical staff. Examinations connected with administering contrast media can cause many complications to these patients and the routine examination can be changed into the dangerous one. The position of a radiological assistant has become more responsible. The aim of this Bachelor´s work was to outline diagnostic options while examining patients with diabetes mellitus and consider using diagnostic imaging methods as the administration of diagnostic contrast media can be risky for the patients. Twenty six per cent (236 patients) out of 918 patients with diabetes mellitus type 1 or type 2 who visited the Diabetological Centre and the Department of Radiology of the Hospital in České Budějovice were examined by some of the diagnostic imaging methods. Adult diabetic patients underwent these radiological examinations: 188 skiagraphies of lungs, 119 skiagraphies of skeletons and 18 examinations under skiascopic control. Forty-four patients were examined by the sonography, 10 by the mammography, 110 by the computed tomography, 9 by the magnetic resonance and 10 patients by the angiography. Most diabetic patients were examined by common skiagraphy of arms and legs, sculls, vertebral columns due to injuries, fractures and degenerative changes. Skiagraphies of heart and lungs were indicated before and after operations or they preceded applying an insulin pump. The other numerous group was made up by patients with tumours. They were mostly examined by computed tomography. Fifty-seven patients developed complications caused by diabetes. The examinations of carotid arteries, cerebral arteries, arteries and varicose veins in the legs were carried out by sonography, computed tomography and magnetic resonance. In six cases diagnostic angiography was followed by percutaneous transluminal angioplasty. The use of contrast media in 64 patients was also considered. In all cases non-ionic contrast media of low or medium osmolarity in the volume of 80 {--} 125 ml were used. The findings compared with those presented in literature proved the hypothesis that radiological assistant work requires a specific approach towards the diabetic patients.
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Application of atomic law into a practice of radiology assistant
VOJTKOVÁ, Magdalena
The work of radiologist assistants results from the Act No.13/2002 Coll., Atomic Act, and from executive regulations and must accord with their wording. Practical application of the Act is important especially for radiation protection of patients and medical staff during work with ionizing radiation. The aim of the thesis was to judge from this point of view the radiologist´s activity at my work place in Institution of Imaging Methods in a Teaching Hospital of Saint Anna, Brno. Keeping of legislative rules would confirm their practical applicability and would establish the competency extent of radiologist assistant during performance of his/ her medical job. In methodological process I chose from the text of Atomic Act and from appropriate decrees the parts dealing with radiologist assistant´s activities in a sphere of radiodiagnostics and compared them with their practical keeping. I think, according to results, that radiologist´s work corresponds wording in§7 Radiologist assistant from decree No.424/2004 Coll. Radiologist assistant keeps rules of practical carrying out all treatments stated in §60 Statement on medical irradiation, in§62 Optimalization of radiation protection and in §63 Process of medical irradiation from decree No. 307/202 Coll. Thanks to this thesis I have deepened my knowledge dealing with Atomic Act. My conclusions can serve to radiologist assistants as a basic survey of important rules resulting from Atomic Act that they must keep in accord with these rules.
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