Estado actual del diagnóstico vascular no invasivo en España / Current state of noninvasive vascular diagnosis in Spain

Objetivo: El diagnóstico vascular no invasivo (DVNI) se ha convertido en una actividad cotidiana en los servicios de radiología de nuestro país. El objetivo del artículo es comunicar los resultados de la encuesta remitida a un gran numero de hospitales españoles para obtener información acerca del diagnóstico vascular no invasivo: cómo y quién lo realiza, en qué condiciones, cuáles son los problemas con relación a estas técnicas y cómo es la docencia. Material y métodos: En octubre de 2008 se remitió la encuesta a 93 hospitales con docencia en radiodiagnóstico y a 45 hospitales sin docencia. La encuesta solicitaba información sobre datos del hospital, dotación de personal y tecnólogica, tipo de organización del servicio, realización de las diferentes exploraciones de DVNI, así como la opinión acerca de los problemas existentes con estas técnicas y sobre el estado de la docencia. Resultados: De las 93 encuestas remitidas a hospitales docentes fueron contestadas 43 (46%) y de las 45 a los hospitales no docentes se respondieron 9 (20%). Mediante la utilización de múltiples tablas y figuras se comunican de forma comprensible las respuestas obtenidas en estas encuestas. Conclusiones: Los resultados de la encuesta aportan una visión actual del estado del DVNI en los hospitales docentes de España y pone cifras concretas a la realidad de esta parte de la radiología, esperando que estos datos puedan estimular la protección de estas técnicas por parte de los servicios de radiología y la promoción activa de la formación en DVNI (AU)

Objective: Noninvasive vascular diagnosis has become routine in radiology departments in Spain. This article aims to communicate the results of a survey sent to a large number of Spanish hospitals to obtain information about the following aspects of noninvasive vascular diagnosis: who performs it and how, in what conditions it is performed, what problems there are in relation to these techniques, and what the training is like. Material and methods: In October 2008, we sent a questionnaire to 93 hospitals with training programs in diagnostic imaging and to 45 hospitals without training programs. The questionnaire solicited information about the hospital and its technological and human resources, the organization of the diagnostic imaging department, the performance of different noninvasive vascular examinations, and the respondents’ opinions about problems related to these techniques and about the state of training programs. Results: A total of 43 (46%) of the 93 teaching hospitals and 9 (20%) of the non-teaching hospitals responded to the survey. This article uses multiple tables and figures to communicate the responses obtained in the survey. Conclusions: The results of the survey provide a view of the current state of noninvasive vascular diagnosis in teaching hospitals in Spain in concrete figures. We hope that these data will stimulate diagnostic imaging departments to protect these techniques and to actively promote training in noninvasive vascular diagnosis (AU)

[Current state of noninvasive vascular diagnosis in Spain]. / Estado actual del diagnóstico vascular no invasivo en España.

OBJECTIVE: Noninvasive vascular diagnosis has become routine in radiology departments in Spain. This article aims to communicate the results of a survey sent to a large number of Spanish hospitals to obtain information about the following aspects of noninvasive vascular diagnosis: who performs it and how, in what conditions it is performed, what problems there are in relation to these techniques, and what the training is like. MATERIAL AND METHODS: In October 2008, we sent a questionnaire to 93 hospitals with training programs in diagnostic imaging and to 45 hospitals without training programs. The questionnaire solicited information about the hospital and its technological and human resources, the organization of the diagnostic imaging department, the performance of different noninvasive vascular examinations, and the respondents' opinions about problems related to these techniques and about the state of training programs. RESULTS: A total of 43 (46%) of the 93 teaching hospitals and 9 (20%) of the non-teaching hospitals responded to the survey. This article uses multiple tables and figures to communicate the responses obtained in the survey. CONCLUSIONS: The results of the survey provide a view of the current state of noninvasive vascular diagnosis in teaching hospitals in Spain in concrete figures. We hope that these data will stimulate diagnostic imaging departments to protect these techniques and to actively promote training in noninvasive vascular diagnosis.

[Multislice CT angiography in the study of aneurysm of the abdominal aorta: comparison of three different volumes of contrast agent]. / Angio-tomografía computarizada multidetector en el estudio del aneurisma de aorta abdominal. Comparación de tres volúmenes de contraste diferentes.

OBJECTIVE: To prospectively and quantitatively compare the use of different volumes of contrast in 16-slice CT angiography for the study of aneurysms of the abdominal aorta before and/or after treatment. MATERIAL AND METHODS: From November 2005 to March 2006, we included 63 consecutive patients referred for CT angiography for aneurysm of the abdominal aorta or for post-treatment follow-up. Each patient was randomly assigned to one of three groups: group A was administered 100 mL of contrast agent, group B 80 mL, and group C 60 mL. In all cases, contrast was administered with 40 mL of physiological serum at a rate of 4 ml/s. A 16-detector CT scanner was used. In the last 61 patients, attenuation was measured in different locations using circular ROIs. Hounsfield units were recorded in the first slice (initial contrast), in the last slice (final contrast), at their maximum value, and also at one-second intervals. RESULTS: No statistically significant differences in the Hounsfield units recorded in the first slice, in the last slice, or in the maximum values were found between the different groups. Mean values were above 200 in 58 of 61 patients. Weight and body mass index (BMI) were negatively correlated with aortoiliac attenuation. CONCLUSION: Using a 16-detector CT scanner enables the volume of contrast for studies of aneurysms of the abdominal aorta to be reduced considerably; however, 60 mL might not be sufficient for patients with high weight or BMI.

Angio-tomografía computarizada multidetector en el estudio del aneurisma de aorta abdominal. Comparación de tres volúmenes de contraste diferentes / Multislice CT angiography in the study of aneurysm of the abdominal aorta: comparison of three different volumes of contrast agent

Objetivo. Comparar cuantitativamente, mediante un estudio prospectivo, la utilización de diferentes volúmenes de contraste en el estudio del aneurisma de aorta abdominal y en el control del tratamiento mediante angio-TC realizado con una unidad de tomografía computarizada multidetector (TCM) de 16 coronas. Material y métodos. Desde noviembre de 2005 hasta marzo de 2006 se incluyeron consecutivamente 63 pacientes remitidos para realizarse una angio-TC de aneurisma aórtico abdominal o para control postratamiento. Aleatoriamente se asignó cada paciente a tres grupos, al A se le administró 100 ml de contraste, al B 80 ml y al C 60 ml, en todos los casos más 40 ml de suero fisiológico y a 4 ml/s. Se utilizó un TMC de 16 coronas. En los 61 pacientes finales se efectuaron mediciones de atenuación en diferentes localizaciones mediante el uso de ROI circulares. Se recogieron las unidades Hounsfield en el primer corte (contraste inicial), en el último (contraste final), el valor máximo (contraste máximo) y también a intervalos de 1 segundo. Resultados. No se encontraron diferencias estadísticas significativas en los valores de contraste inicial, final y máximo entre los diferentes grupos. Cincuenta y ocho de los 61 pacientes presentaron valores medios superiores a 200. Se demostró que existe correlación negativa entre peso e índice de masa corporal (IMC) y la atenuación aorto-iliaca. Conclusión. Mediante el uso de tecnología TCM de 16 coronas es posible reducir considerablemente el volumen de contraste en los estudios de aneurisma aórtico abdominal y en su control postratamiento, con la salvedad de que volúmenes de 60 ml podrían no ser suficientes en pacientes con peso o IMC elevado (AU)

Objective. To prospectively and quantitatively compare the use of different volumes of contrast in 16-slice CT angiography for the study of aneurysms of the abdominal aorta before and/or after treatment. Material and methods. From November 2005 to March 2006, we included 63 consecutive patients referred for CT angiography for aneurysm of the abdominal aorta or for post-treatment follow-up. Each patient was randomly assigned to one of three groups: group A was administered 100 mL of contrast agent, group B 80 mL, and group C 60 mL. In all cases, contrast was administered with 40 mL of physiological serum at a rate of 4 ml/s. A 16-detector CT scanner was used. In the last 61 patients, attenuation was measured in different locations using circular ROIs. Hounsfield units were recorded in the first slice (initial contrast), in the last slice (final contrast), at their maximum value, and also at one-second intervals. Results. No statistically significant differences in the Hounsfield units recorded in the first slice, in the last slice, or in the maximum values were found between the different groups. Mean values were above 200 in 58 of 61 patients. Weight and body mass index (BMI) were negatively correlated with aortoiliac attenuation. Conclusion. Using a 16-detector CT scanner enables the volume of contrast for studies of aneurysms of the abdominal aorta to be reduced considerably; however, 60 mL might not be sufficient for patients with high weight or BMI (AU)