Image quality and dose in lumbar spine examinations: results of a 5 year quality control programme following the European quality criteria trial.

The large dose values found for lumbar spine examinations in a centre participating in the European quality criteria trial have been investigated within a 5 year quality control programme. Actions focused mainly on optimizing the focus-to-film distance, tube potential (kV), film optical density and X-ray beam filtration. These actions lead to overall dose reductions of up to 75% in lumbo-sacral joint examinations and prove the need for a regular survey of patient skin doses.

Report of an image quality and dose audit according to directive 97/43/Euratom at Spanish private radiodiagnostics facilities.

An audit of Spanish private medicine radiodiagnostics facilities has been carried out, based partly on Spanish legislation relating to European Directives on health protection against ionizing radiation risks in medical exposure. The study included an appraisal of infrastructure and equipment, and aspects of quality assurance and radiation protection, by means of data collected through surveys. Of the 51 centres audited, a sample of 24 X-ray rooms was chosen, then an external evaluation with regard to image quality and patient dose was performed, by an advisory board of radiologists and medical physicists. The methodology used was similar to that of the group of European Union experts in European dose evaluation and image quality trials. Chest, abdomen, lumbar spine and breast examinations were monitored. Doses were measured with thermoluminescent dosimeters. A third of the X-ray rooms evaluated reached or exceeded dose reference values, and in a third of the cases the image quality left considerable room for improvement. Breast and chest examinations showed themselves to be the hardest to perform, not only as a result of exceeding the reference doses, but also due to failure to meet good image quality standards.

[Non-invasive fungal sinusitis: allergic fungal sinusitis and sinusal mycetomas]. / Sinusitis fúngicas no invasivas: sinusitis fúngica alérgica y micetomas sinusales.

We review non-invasive fungal sinusitis (FS) cases treated at our Unit following the recent SF classification, based on physiopathology, treatment and prognosis. We report 7 FS cases treated during 2 years and followed a minimum of 24 months. They are two allergic FS, one of them related to an allergic bronchopulmonary aspergillosis, and five mycetomas, two of them without a sinusal foreign body, sphenoidal and maxillary respectively, and three caused by a maxillary foreign body. All were treated by endoscopic sinus surgery (ESS). The two allergic cases were also treated with systemic corticoids in the postoperative period. We review the clinical presentation of the different types of non-invasive FS, the importance of endoscopy and imaging techniques in their management, the usefulness of ESS, the common association of FS to foreign bodies, and their prognosis.

Radiographic findings for the adult respiratory distress syndrome in patients with peritonitis.

Ninety-seven consecutive patients admitted to the ICU with peritonitis were studied. Of these, 66 (68%) died and autopsies were performed on 38 (58%). Twelve of the 38 autopsied patients showed pathologic criteria of adult respiratory distress syndrome (ARDS); 26 did not. Chest x-rays of the 38 autopsied patients were examined and 9 (75%) of the 12 patients with histologic criteria of ARDS, specifically, moderate or severe fibrosis, had decreased pulmonary longitudinal diameter on serial chest x-rays. The remaining 3 (25%) patients did not have this specific finding. Of the 26 patients without pathologic criteria of ARDS, only 2 (8%) had reduction in pulmonary longitudinal diameter. We conclude that a marked reduction in the pulmonary longitudinal diameter is highly suggestive of ARDS and especially useful in differentiating ARDS from bilateral pneumonia.