Impact of Work Environment on Job Satisfaction among Interventional Radiologists in Japan: A Cross-sectional Study.

Purpose: This study aims to measure job satisfaction among interventional radiology physicians in Japan and analyze the factors affecting job satisfaction. Material and Methods: A web-based survey was conducted among the members of the Japanese Society of Interventional Radiology between October and December 2021. Participants were questioned regarding their job satisfaction, workplace, work status, and demographic information. Principal component analysis was applied to 15 reasons related to job satisfaction, and the factors affecting job satisfaction were analyzed. Results: Valid responses were obtained from 901 (31.9%) of the 2,824 interventional radiology physicians invited to participate. Job satisfaction was reported as "very satisfied" in 79 (8.8%), "moderately satisfied" in 426 (47.3%), "neither satisfied nor dissatisfied" in 230 (25.5%), "moderately dissatisfied" in 133 (14.8%), and "very dissatisfied" in 33 (3.7%) respondents. Thus, there were 505 (56.0%) satisfied physicians. Three principal components were extracted from the reasons for job satisfaction. Job satisfaction tended to be higher among those who reported performing a higher number of interventional radiology procedures and was positively associated with a higher rate of work time dedicated to interventional radiology and the first principal component (the environment of clinical practice, research, and interventional radiology education). The third principal component (salary and work environment) and the absence of an "IkuBoss" [a boss who takes initiative in creating a work environment supportive of the work-life balance of colleagues] were associated with lower job satisfaction. Conclusions: More than half the participants reported high job satisfaction. Job satisfaction of interventional radiology physicians in Japan was positively associated with a favorable clinical, research, and educational environment and negatively associated with the absence of an "IkuBoss," noninterventional radiology work, overtime work, and salary.

A case of small bowel aneurysm hemorrhage with submucosal tumor-like findings.

A 51-year-old woman visited our hospital with the chief complaint of tarry stools. Contrast-enhanced abdominal computed tomography revealed leakage of contrast medium into the lumen of the small intestine. Subsequently, a double-balloon endoscopy was performed, which revealed a submucosal mass-like lesion in the jejunum. Although hemostasis was attempted with clips, complete hemostasis was difficult to achieve, and angiographic embolization was performed. Nevertheless, the anemia progressed, and a small bowel resection was performed. Histopathological examination led to a diagnosis of a ruptured submucosal aneurysm of the small intestine. Endoscopic hemostasis is often difficult to achieve for submucosal aneurysms in the intestine. The submucosal tumor-like finding observed on endoscopy in submucosal aneurysms is termed an "SMT-like sign" and is considered an important finding to diagnose aneurysms.

Endovascular catheter arterial embolization effectively treats secondary hypertension and increased plasma B-type natriuretic peptide level accompanied by idiopathic renal arteriovenous fistula.

A 65-year-old woman with a history of hypertension and atrial fibrillation was referred to our hospital following detection of microscopic hematuria. Physical examination showed continuous vascular murmur with the maximum point on the right side of the umbilicus. Contrast-enhanced computed tomography showed a right renal aneurysmal-type arteriovenous fistula. She underwent endovascular catheter arterial embolization. Following this, her blood pressure was virtually normalized, and her levels of plasma BNP were significantly reduced. We recommend that patients with microscopic hematuria should be auscultated around the navel, because renal AV shunt is treatable; this may facilitate cure of secondary hypertension and cardiac load.

Efficacy of Automated Supplying Artery Tracking Software Using Multidetector-Row Computed Tomography Images for Emergent Transcatheter Arterial Embolization.

PURPOSE: To assess the reliability of a prototype automated supplying artery tracking software (ASATS) using multidetector-row CT (MDCT) images in emergent TAE. MATERIALS AND METHODS: Consecutive 53 patients underwent 57 sessions of emergent TAE during 7 months. Twenty-one cases were excluded due to a lack of CT data (n = 12) or negative angiographic findings (n = 9). Remaining 34 sessions of TAE and MDCT images in 32 patients (mean age 62.9 years; age range 37-92 years) were enrolled. ASATS was retrospectively conducted for the identification of supplying arteries which were confirmed with angiography (automated method). Manual modification was added as needed (semi-automated method). Two observers independently reviewed the MDCT images to detect supplying arteries (manual method). Detectability of supplying artery and time to analysis were compared among the automated, semi-automated, and manual methods by both observers. RESULTS: A total of 64 bleeding sites were demonstrated on angiography. The detectability was 28 (43.8%) for automated method, 53 (82.8%) for semi-automated method, 55 (85.9%) for observer 1, and 58 (90.6%) for observer 2. Detectability of semi-automated method was significantly better than of automated method (P = 0.000) and comparable with manual method by both observers (P = 0.193 and 0.081). Average time to analysis was 185.4 s for automated method, 297.2 s for semi-automated method, 186.2 s for observer 1, and 243.7 s for observer 2. CONCLUSION: ASATS has a sufficient ability to identify supplying arteries of bleeding by adding manual modification as needed and can be used for emergent TAE. LEVEL OF EVIDENCE: Level 4, Case Control Study.

Atraumatic tension hemothorax associated with ruptured aneurysm of intercostal artery-azygous fistula: a case report.

Atraumatic tension hemothorax is extremely rare. We report a case of 62-year-old woman presented with obstructive and hypovolemic shock status by tension hemothorax due to ruptured aneurysm of congenital intercostal artery-azygous fistula. Contrast-enhanced computed tomography and aortography revealed an aberrant 12th intercostal artery flowing into the aneurysm with a fistula draining into the azygous vein and the rupture of aneurysm. Our experience indicates that the rupture of congenital arteriovenous fistulas (AVFs) of systemic circulation in the thoracic cavity might cause not only hypovolemic shock but also atraumatic tension hemothorax. Surgery following preoperative endovascular embolization offers a feasible treatment strategy for ruptured aneurysms associated with AVFs.

The incidence of double hypoglossal canal in Japanese: evaluation with multislice computed tomography.

BACKGROUND AND PURPOSE: Double hypoglossal canal, namely a hypoglossal canal bridging, is a normal variation of the hypoglossal canal. Racial differences in the prevalence of double hypoglossal canal have been reported. We evaluated the prevalence of double hypoglossal canal in a Japanese population with multidetector computed tomography (MDCT). MATERIALS AND METHODS: We reviewed five hundred and ninety consecutive patients (mean age, 61 years: range, 15-94 years: 254 men, 336 women) who underwent computed tomographic angiography (CTA) of the brain for a variety of CNS abnormalities. Two radiologists achieved consensus on the canal being single or double, and measured the sizes of single canals on CT images. Kappa statistics was used to test the reliability between the 2 investigators. A logistic regression was used to evaluate the prevalence of double hypoglossal canal and the following factors: sex, age, and laterality. Student's t-test was used to evaluate the asymmetry of single hypoglossal canal diameters. Statistical significance was accepted at P < 0.05. RESULTS: Double hypoglossal canal was identified in 16.9% of the patients, and was bilateral in 2.2%. Double hypoglossal canal was significantly more frequent on the left side than right (P = 0.004, odds ratio = 1.79) and in males than females (P = 0.011, odds ratio = 1.67). A larger left or right-sided canal was found in 31.6% and 12.2% of the patients, respectively, following the same side preference as that of double hypoglossal canal. Almost perfect agreement was achieved between the two readers (k = 0.975). CONCLUSIONS: In this Japanese population, the prevalence of a double hypoglossal canal was 16.9%, of which 2.2% were bilateral. Double hypoglossal canal was more frequent in males than females, and on the left side than right.

High Signal Intensity in Dentate Nucleus on Unenhanced T1-weighted MR Images: Association with Linear versus Macrocyclic Gadolinium Chelate Administration.

PURPOSE: To assess whether an association exists between hyperintensity in the dentate nucleus (DN) on unenhanced T1-weighted magnetic resonance (MR) images and previous administration of gadolinium-based contrast agents (GBCAs) that contain different types of gadolinium chelates. MATERIALS AND METHODS: The institutional review board approved this study. Written informed consent was waived because this was a retrospective study. Evaluated were 127 cases among 360 consecutive patients who underwent contrast agent-enhanced brain MR imaging. Two radiologists conducted visual evaluation and quantitative analysis on unenhanced T1-weighted MR images by using regions of interest. DN-to-cerebellum (DN/cerebellum) signal intensity ratios were calculated and the relationship between DN/cerebellum and several factors was evaluated, including the number of previous linear chelate and/or macrocyclic GBCA administrations by using a generalized additive model. The Akaike information criterion was used in model selection. Interobserver correlation was evaluated with paired t tests and the Lin concordance correlation coefficient. RESULTS: The images of nine patients (7.1%) showed hyperintensity in the DN. Twenty-three patients (18.1%) received linear GBCAs (median, two patients; maximum, 11 patients), 36 patients (28.3%) received macrocyclic GBCAs (median, two patients; maximum, 15 patients), 14 patients (11.0%) received both types of GBCA (linear [median, two patients; maximum, five patients] and macrocyclic [median, three patients; maximum, eight patients]), and 54 patients (42.5%) had no history of administration of gadolinium chelate. Interobserver correlation was almost perfect (0.992 [95% confidence interval: 0.990, 0.994]). The DN/cerebellum ratio was associated with linear GBCA (P < .001), but not with macrocyclic GBCA exposure (P = .875). According to the Akaike information criterion, only linear GBCA was selected for the final model, and the DN/cerebellum ratio had strong association only with linear GBCA. CONCLUSION: Hyperintensity in the DN on unenhanced T1-weighted MR images is associated with previous administration of linear GBCA, while the previous administration of macrocyclic GBCAs showed no such association.