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Demands on radiology assistants at three-dimension visualization
ČECH, Svatopluk
Fast development of three-dimension visualization in radiology relates to more sophisticated diagnostic machines, with the development of computer technology and digitizing. Increasing demands on radiology assistants in operating programs of reconstruction images increase the importance of their position at modern radiology workplace. Three-dimension images offer exact and undistorted images of patient's anatomy, they give better diagnostic information for physicians - radiologists and more objective imagination for physicians - clinicians. They find the application in a number of examinations in skiagraphy, angiography, computer tomography, magnetic resonance and ultrasonography. We can say that three-dimension visualization substitutes other examination which are invasive and represent certain complications for a patient. The question is whether some three-dimension examination can reduce radiation load of a patient. We can suppose that digital imaging methods will be part of near future and three-dimension visualization and further development of computer technique will acquire still more impact in diagnostic of many diseases.
Risk factors at public health work: differences among professions in non-medical fields
The paper focuses on health risk factors for non-medical healthcare workers, namely general nurses and radiology assistants. Factors which may have negative impacts on healthcare workers{\crq} health affect both physical and mental health. Factors such as toxic substances, biological radiation, infectious diseases and spine and joints overloading caused by the incorrect manipulation with patients can have negative impact on physical health. Both physical and mental health is affected by stress, as well as by workers{\crq} lifestyle and education. Healthcare workers who take care of patients must be in a good physical and mental shape in order to provide quality care. Therefore, the goal of healthcare workers themselves, as well as of their employer, should be obtaining sufficient information on work safety and hygienic measures and being able to use the information in practice - they should actively participate in prevention of health damage related to the performance of their profession. The first hypothesis {--} non-medical healthcare workers are informed about risk factors associated with the performance of their profession - was confirmed. The second hypothesis - there are differences in the presence of risk factors among non-medical healthcare workers - was also confirmed; differences in the occurrence of some risk factors are clearly visible. Different healthcare professions should therefore be approached in a targeted way, with respect to the type of workplace and job description of healthcare workers. The third hypothesis {--} non-medical healthcare workers comply with preventive measures preventing health damage - was not confirmed. One of the reasons why hypotheses 1 and 2 were confirmed may be the fact that increased attention has been paid to this topic recently - standards have been made, and consequently also targeted audits. These measures have usually a positive impact - healthcare workers have gradually realized that safety measures are not useless, and by obeying them, healthcare workers protect not only patient and their surrounding, but especially themselves.
The conventional imaging techniques in radiology with a view to the musculosceletar system (the educational program)
This paper provides information on the role of an X-ray technician in conventional imaging techniques in musculoskeletal system affections. An X-ray technician is expected to provide imaging of the demanded part of human body at least on the level of diagnostic acceptability while all principles of radiation protection, ethic rules, and the rights of a patient are respected. The first part of the paper describes the formation and creation of an X-ray image, it provides a short history and describes the X-ray equipment needed to provide a quality imaging of musculoskeletal system. In the next part the description of imaging techniques is given in dependance on the demand of the indicating physician and also of the folowing medical treatment when, in many cases, the assistence of an X-ray technician is necessary. Better training and information of the the X-ray technician result in higher quality care for patients, in better communication between the personnel and the patients and it may also result in decrease of radiation charge of patients while a high quality of imaging is preserved. In the conlusion of the paper mistakes in imaging are shown that arose from poor communication between the physician and the X-ray technician, ignorance of the therapeutic procedure by the X-ray technician respectively. The false X-ray images are taken from a file of patients who were treated in the radiodiagnostic department of Oblastní nemocnice Kolín, a.s. in the period from 1st January 2007 to 30th June 2007. They were diagnosed with hip joint affection or affection of proximal part of femur.
The role of radiographer during MR angiography
The role of radiographer during MR angiography Objectives: The thesis and the tutorial CD provide information on the magnetic resonance angiography {--} MRA. Due to upgraded hardware and software and the non-invasive character of the examination the method is currently the most common form of the imaging of flowing blood in vessels. It is essential for a radiographer to acquire comprehensive knowledge of the basic principles and techniques of MRA. The objective of my thesis was to find out if the method can be used not only for a high-quality imaging of the arteries but also for subsequent therapeutical procedures. Methodology: The research was conducted with 106 patients (66 men and 40 women) whose lower limb arteries had been tested by MRA between 1 January and 31 December 2007 at the Multiscan RC Pardubice. I determined the number of patients who had undergone a therapeutical procedure after the MRA test (operations on arteries, percutaneous transluminal angioplastics) and assessed to what degree the MRA examination had been sufficient for the surgery. Results: In 91 % out of 46 patients indicated for therapeutical procedures the results obtained by MRA enabled other treatment or a surgical procedure. Only in 9 % patients the results obtained by MRA were not sufficient for other medical treatment and suplementary examinations such as the diagnostic digital subtraction angiography were necessary. Conclusions: MRA is a non-invasive medical diagnostic technique to visualize the blood in vessels which provide satisfactory accuracy without exposing the patient to any ionizing radiation. The results are used for other treatments. Radiographers who master the MRA techniques avoid mistakes that might devalue the test. Key words: digital subtraction angiography, magnetic resonance angiography, magnetic resonance imaging, percutaneous transluminal angioplastics, radiographer {--} radiologic technologist.
Impact of digital imaging on practical work of radiographer
MAREK, David
The submitted bachelor{\crq}s paper deals with the impact of digital imaging on the practical activity of a radiological assistant. In 2006, I participated in a professional seminar held by the AURA-GROUP company, which focused on digitalization of modalities in the health service. This topic seemed to be so interesting for me that I decided to find out what their experience were and what the comparison of the analogue and digital imaging would be like from the point of view of assistants working in practice and to find out more about requirements concerning a radiological assistant{\crq}s work both under the analogue and under the digital operation. In the theoretical section, the principle of X-rays is provided together with a small excursion into the history and the method of analogue and digital imaging and current methods of archiving as well. In this section, the current state of radiology is surveyed and the principles of the individual methods, their advantages and disadvantages together with future prospective are described here as well. In the practical section, I decided to verify the hypothesis that the digital imaging is more valuable in practice that the analogue one. Within the framework of quantitative methodology, the method of fact-finding through questionnaire was used. This questionnaire was presented to employees of radiological departments and the results were subsequently statistically processed and evaluated. The research sample was set up from employees working in the radiological departments in the hospitals in České Budějovice and Český Krumlov. For the purposes of this research, I made no difference as far as the individual age categories or educational background or any other criteria are concerned. This means that this selection was not limited in any way and it has, in my opinion, sufficient support both from the theory and practice and thus it has a sufficient testifying value with respect to the knowledge and experience of the radiological assistants subject to the research. The results of this work confirmed the respective hypothesis and it was demonstrated that digitalization has positive impact on practical activity of a radiological assistant for the purpose of post-processing adjustments, X-ray images archiving using the PACS system, and the fact that there is no need of the so-called wet process is particularly beneficial as well. In the summary, we should also see economic advantages, as they are one of The most important criteria for development of new methods of activities in the field of health care at the present time. The fact that the digital method of imaging saves costs relating to films, chemical substances, archiving capacities (rooms and staff) brings substantial savings, which may be utilized for example for the purchase of technologically advanced equipment.
Possibilities of separate activity of radiologic assistant on the field workplace
This bachelor thesis with in the range of independent work of radiologic assistant in different types of field departments. The teoretical part describes tha systém of field departments and the work of the radiologic assistant in this department. There are physical notes necessary for the introduction of the problem, there is also a description of the analogue system, division and description of the process. The final part of the work deals with teleradiology that in the future can expedite the work of radiologic assistants in their field departments. The aim of this work was to estimate the benefit of data digitizing the work of radiologic assistant in different field departments. It was estimate that there will be improvement in the technical and organizational part of work. Two hypoteses were determined. First hypotesis assumed that digitizing will expedite and improve the quality of work of the radilogic assistant. The second hypotesis assumed that digitizing will improve the care of patients. Both the hypoteses were confirmed. The outcomes were gained by comparison of time and economic savings in the of radiologic assistants in two different types of medical centres. This work proves that data digitizing can reduce the time of diagnostic process, and can improve the quality of care of patients. It also speeds-up and expedites the work of radiologic assistant, and for large medical centres it is also economic gain.
Influence of the contrast medium iodine concentration on quality of the CT examination
RANŠOVÁ, Pavlína
Our work focused on determining absolute and relative density of various contrast agents in relation to iodine contents using in vitro and in vivo methods. It was documented that the relative density of contrast agents increases with the decreasing contents of iodine, i.e. density absolute values vary inversely as iodine content in these substances. Four various agents, bearing commercial names Visipaque 270, Visipaque 320, Ultravist 370 and Iomeron 400, in their original glass packing were used for our in vitro measurements. The measurements were carried out using CT equipment Emotion Duo (Siemens, Forchheim, Germany). Individual packing of the contrast agents were scanned by means of a standard protocol and under standard conditions. The obtained data were entered into tables. A retrospectively selected array of patients with standard scan of their stomachs was used for our in vivo measurements with a defined standard protocol using the same CT equipment and pressure injector CT 9000 Advantage (Liebel-Flarsheim, Mallinckrodt, the U.S.A.). The following data from 258 patients were recorded: age, sex, blood density after administering contrast agent in vitro on the level of diaphragm hiatus and on the bifurcation level, AP dimension of the patients on the hiatus level. Mean densities of the individual kinds of contrast agents were compared and a good correlation with the in vitro measurements was found out. The measured values were then analysed. The interdependence was studied in the measured densities and age, density changes measured on the hiatus level and on the bifurcation level for the individual contrast agents. The interdependence of the blood density on the AP dimension of the patients was also studied due to its practical use and it was documented that there is a good correlation of the decreasing density with the AP dimension as a simple parameter used instead of finding out patients{\crq} weights.
Function of radiographer at embolization procedure
KŘÍŽOVÁ, Pavlína
As a radiographer can be regarded an educated health worker who is prepared to perform demanding work in medical branches. One of them is radiology and its important subspecialty, interventional radiology, where they perform a very responsible work. They communicate with patients, cooperate with medical personnel and operate a complex angiographic apparatus. Therefore it is essential for them to have finished a profes-sional training and to possess the required qualities. A person becomes a radiographer after they have completed a specialised educational programme, which can nowadays be studied at a college and it is completed by achieving a title Bc. (written before the na-me). During the studies they acquire proficiency and competence in the field of radiology which is needed for the experience in the interventional radiology working place. During both theoretical and practical education skills in the field of technical equipment (angiography equipment) and required IT technologies (HIS, PACS) are mastered, as well as the anatomic orientation in examinated area. They learn the latest procedure in the embolization techniques from the medical personnel, orientate themselves in the instrumentarium. Moreover, they are accustomed to the contrasting materials and their undesirable reactions to them. If needed, they are fully able to give the first aid.In addi-tion to that, a non-medical personell who participate in carrying out the embolizations should possess following qualities: communication skills - proficient cooperation with the medical personnel and the patients, empathy - patient awareness, ability to handle stressful situations. Working with an ill person demands a psochologically accurate individual approach and strict following of the medical ethic principles. Embolization is a way of occluding (closing) one or more blood vessels that are doing more harm than good. Various materials may be used, depending on whether vessel occlusion is to be temporary or permanent, or whether large or small vessels are being treated. The material is passed through a catheter with its tip lying in or near the vessel to be closed. This approach can be used to control or prevent abnormal bleeding as well as shut down the vessels that support a growing tumor. Therapeutic embolization may also serve to eliminate an arteriovenous malformation (AVM), an abnormal connection between an artery and a vein. The term "embolization" derives from embolus, which can be any object that circulates in the bloodstream until it lodges in a blood vesel - in this case, a synthetic material or medication specially designed to occlude the blood vessels.
Role of radiological assistant by angiografic procedures
Angiography as an X - ray examination of blood vessels showed an expressive development since its creation. From translumbal puncture of the abdominal aorta up to more tender Seldinger technique it led to considerable decrease of occurrence of peripro-cedural complications. Angiographic interventions and involved materials, instrumenta-tion devices and image processing possibilities are expressively improving. Invasive an-giopraphic examinations are substituted by non-invasive interventions like ultrasonogra-phy, magnetic resonance or computer tomography. After all they remain integral part of examination algorithms, especially by vessels interventions. A common note of invasive procedures in Cath-lab - in addition to diagnostics also by an intravascular ultrasonography or by therapeutical procedures like percutaneous transluminal angioplasty, stent implantation, vessels embolisation, trombolysis and trombectomy and other {--} is using of fluoroscopy with ionizing radiation and intravascular application of a contrast medium. Radiologic assistant has its more and more unsubstitutable role by diagnostic im-aging of vessels. Radiologic assistant has to be familiar with course of single intervention and with sequence of doctor{\crq}s operations, in order to be able to fulfill his requirements in time and at the same time he has to understand possible risk of complication's and he has to know how to respond to them properly and in time. Further he must well manage an-giography device and all its parts and know postprocessing picture adjustment. Quality work of radiologic assistant should have fundamental influence on dose of ionizing radiation for patient and for examining staff and on consumption and risks of application of contrast medium. By my own experiences with assistance by 4 628 non-coronary and 14 620 coro-nary angiographic examinations in last 10 years (1997-2006) I found set of 40 patients who were examined by pulse and continual fluoroscopy during angiography of lower limbs arteries at Cardio angiographic department of Faculty hospital in Motol. Conclusions make out advantage of pulse fluoroscopy, of digital postprocessing of images iclusive of 3D imaging and they confirmed hypothesis of ionizing radiation{\crq}s dose and carload of contrast medium. By conclusions of this work I suggest to take care of new imaging technics by invasive digital angiography and insert these knowledges to system of lifelong learning of radiologic assistants.
The thoracic and lumbar spine injury - role of imaging modalities in diagnostic and therapy
This article provides information about thoracic and lumbar spine injury with reflection to the role of radiologic assistants. Spine injury belongs to the most serious injuries and its incidence is rising. These injuries are diagnosed using imaging methods like plain X-ray, computed tomography and magnetic resonance imaging. Radiologic assistant himself is the person, who is responsible for the correct examination. If these injuries are treated surgically, radiologic assistant meets them at operating theatres too. Here the assistant manipulates with fluoroscopy machines and helps the operator with procedure navigation. Important is that the radiologic assistant should know all the steps of each procedure and should take care of radiation protection. If the procedure is done inadequately, the patient can be misdiagnosed and the radiation dose for him and for the staff may be increased. Since 1st January 2006 to 31st December 2006, 84 patients (48 women, 36 men) were hospitalised at the Neurosurgery departement of University Hospital Hradec Králové under diagnosis of thoracic or lumbar spine fracture. The age, frequency of vertebral fractures in thoracic and lumbar region and percentual use of various therapeutic methods are noted. But the most important aim of the study are imaging methods used in these patients and mistakes done during these examinations.

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