Slow flow or no flow? Color and power Doppler US pitfalls in the abdomen and pelvis.

Color and power Doppler ultrasonography allow rapid assessment of tissue vascularity. Motion sensitivity to phenomena such as flow along the edge of gallstones, urinary jets, and placentation abnormalities can result in artifactual flow patterns that require corroboration with spectral analysis. Similar artifacts have also been noted at the edge of bone and along the bowel wall secondary to bowel motion. These artifacts fall into four categories: (a) twinkle artifacts, which occur behind reflectors; (b) edge artifacts, which occur along strongly reflective interfaces; (c) flash artifacts, which occur due to tissue or fluid motion; and (d) pseudoflow, which occurs due to nonvascular flow of other fluids such as urine or ascites. Knowledge of the most common sites of color and power Doppler artifacts, familiarity with the typical appearances of these artifacts, and liberal use of spectral analysis will help prevent misinterpretation of these findings and may lead to improved diagnostic accuracy.

Report of the ACR task force on international teleradiology.

Telemedicine is becoming an increasingly important tool in the practice of medicine throughout the world. For radiologists, telemedicine translates to teleradiology. Because an increasing amount of imaging is now archived in a digital format, and with the application of more powerful computers in radiology, digital image transmission between display stations is becoming commonplace. The ability to move large diagnostic image data sets to display stations anywhere in the world using the Internet and other high-speed data links is solving some problems and creating others. Medicine and radiology will be challenged in many ways by the issues created from the application of this burgeoning technology. Our task force was charged with investigating the evolving practice of international teleradiology and with developing a pubic statement to be adopted by the ACR Council (). This white paper is our effort to define those issues we believe to be most pertinent to international teleradiology as we know them today. Will these issues be changing? Certainly. For some facets of the issue, there are currently more questions than answers. We describe several scenarios that we believe are acceptable practices of international teleradiology as well as some that are not. We believe that much will be written about international teleradiology in the future as the issues of credentialing, quality assurance, licensure, American Board of Radiology certification, the maintenance of certification, jurisdictional and medical liability issues, patient privacy, fraud and medical ethics are more precisely defined and shaped by state and federal legislation and medical jurisprudence. This white paper is our assessment of what we believe to be the major challenges that exist as of this writing.