Using teach-back in patient education to improve patient satisfaction and the clarity of magnetic resonance imaging.

OBJECTIVE: To explore the effects of using the teach-back method prior to contrast-enhanced magnetic resonance imaging (MRI) on patients' knowledge and satisfaction as well as the clarity of the resulting scans. METHODS: A total of 254 patients who underwent contrast-enhanced MRI examination from July 4, 2022 to September 19, 2022 were enrolled and assigned to the intervention and control groups. Patients in the intervention group received education using the teach-back method, while those in the control group were given routine health education. A questionnaire that included patients' knowledge of contrast-enhanced MRI examination was answered before and after patient education. Data on patient satisfaction with nursing services were also collected. The clarity of the MRI images of all patients was assessed. RESULTS: The scores of knowledge related to MRI after receiving education were significantly higher than those before receiving education (P < 0.001), and there were no significant differences between the intervention and control groups (11.27 ± 9.74 vs. 12.07 ± 8.71, P = 0.498). The score of satisfaction with nursing service in the teach-back group was significantly higher than that in the control group (39.82 ± 0.86 vs. 38.59 ± 3.73, P < 0.001), as was the image clarity score (96.4 ± 0.5 vs. 95.0 ± 0.4, P = 0.039). CONCLUSION: Teach-back improves patient satisfaction and contrast-enhanced MRI clarity. PRACTICE IMPLICATIONS: Including teach-back in patient education improves patient satisfaction and contrast-enhanced MRI clarity.

The maximum length of T2-dark intraplacental bands may help predict intraoperative haemorrhage in pregnant women with placenta accreta spectrum (PAS).

PURPOSE: To investigate the relationship between the maximum length of T2-dark intraplacental bands (MLTIB) and intraoperative haemorrhage in pregnant women with placenta accreta spectrum (PAS). METHODS: Between February 2018 and February 2021, 86 pregnant women with PAS who delivered in Taizhou Hospital of Zhejiang Province and underwent preoperative magnetic resonance imaging (MRI) examination were retrospectively recruited. The presence of T2-dark intraplacental bands, placental/uterine bulge, loss of retroplacental T2-hypointense line, myometrial thinning, bladder wall interruption, focal exophytic mass, and abnormal vascularization of placental bed were recorded, and the MLTIB was measured. The relative risk ratios of the MRI findings and intraoperative bleeding were measured. Receiver operating characteristic (ROC) analysis was used to evaluate the ability of the MLTIB to help predict intraoperative haemorrhage in pregnant women with PAS. RESULTS: Of the 86 pregnant women, 32 had intraoperative blood loss ≥ 1000 ml; of these, 18 had intraoperative blood loss ≥ 2000 ml. Abnormal vascularization of placental bed was associated with the highest relative risk ratio for the detection of intraoperative haemorrhage (RR = 10.66), followed by the presence of T2-dark intraplacental bands (RR = 8.02). The optimal cut-off of the MLTIB for predicting intraoperative haemorrhage (≥ 1000 ml) in pregnant women with PAS was 28.95 mm, and the AUC was 0.91 (sensitivity: 84%; specificity: 91%). The optimal cut-off of the MLTIB for predicting massive intraoperative haemorrhage (≥ 2000 ml) was 35.65 mm, and the AUC was 0.94 (sensitivity: 89%; specificity: 85%). CONCLUSION: MLTIB was related to intraoperative haemorrhage in pregnant women with PAS. An MLTIB greater than 28.95 mm is an effective predictor of intraoperative haemorrhage. An MLTIB of 35.65 mm or greater strongly suggests the possibility of massive intraoperative haemorrhage.

Diagnostic Performance of Vascular Permeability and Texture Parameters for Evaluating the Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Squamous Cell Carcinoma.

BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is an aggressive type of cancer, associated with poor prognosis. The development of an accurate and non-invasive method to evaluate the pathologic response of patients with ESCC to chemoradiotherapy remains a critical issue. Therefore, the aim of this study was to assess the importance of vascular permeability and texture parameters in predicting the response to neoadjuvant chemoradiotherapy (NACRT) in patients with ESCC. METHODS: This prospective analysis included patients with T1-T2 stage of ESCC, without either lymphatic or metastasis, and distant metastasis. All patients underwent surgery having received two rounds of NACRT. All patients underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) twice, i.e., before the first NACRT and after the second NACRT. Patients were assessed for treatment response at 30 days after the second NACRT. Patients were divided into the complete response (CR) and partial response (PR) groups based on their responses to NACRT. Vascular permeability and texture parameters were extracted from the DCE-MRI scans. After assessing the diagnostic performance of individual parameters, a combined model with vascular permeability and texture parameters was generated to predict the response to NACRT. RESULTS: In this study, the CR and PR groups included 16 patients each. The volume transfer constant (Ktrans), extracellular extravascular volume fraction (ve), and entropy values, as well as changes to each of these parameters, extracted from the second DCE-MRI scans, showed significant differences between the CR and PR groups. The area under the curve (AUC) of Ktrans, ve, and entropy values showed good diagnostic ability (0.813, 0.789, and 0.707, respectively). A logistic regression model combining Ktrans, ve, and entropy had significant diagnostic ability (AUC=0.977). CONCLUSIONS: The use of a combined model with vascular permeability and texture parameters can improve post-NACRT prognostication in patients with ESCC.

MRI-Based Radiomics: Nomograms predicting the short-term response after transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma patients with diameter less than 5 cm.

PURPOSE: To construct MRI radiomics nomograms that can predict short-term response after TACE in HCC patients with diameter less than 5 cm. METHODS: MRI images and clinical data of 153 cases with tumor diameter less than 5 cm before TACE from 3 hospitals were collected retrospectively and divided into 1 internal training set and 1 external validation set. The T2-weighted imaging (T2WI) and dynamic contrast-enhanced MRI arterial phase (DCE-MR AP) images were studied. Multivariable logistic regression was used to construct Radiomics models, Clinics models, and Nomograms based on T2WI and DCE-MR AP, respectively. The receiver characteristic curve (ROC) was used to evaluate the predictive performance of each model. RESULTS: In this study, 113 eligible cases in Hospital 1 were collected as the training set, and 40 eligible cases in other hospitals were used as the verification set. 11 T2WI features and 11 DCE-MRI AP features with the most predictive value were finally screened. 3 models based on T2WI and 3 models based on DCE-MRI AP were established, respectively. The area under curve (AUC) value of Nomogram based on T2WI of training set and validation set was 0.83 and 0.81, respectively. The AUC value of the models based on T2WI and models based on AP was almost equal, and Nomograms were the most effective models among all three types of models. CONCLUSION: MRI-based Nomogram has greater predictive efficacy to predict the response after TACE than Radiomics and Clinics models alone, and the efficacy of T2WI-based models and DCE-MRI AP-based models was almost equal.