Trinidad-and-Tabago-Congerss-Abstract-Book

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20 th ISRRT World Congress 2018 Hosted by Website: www.isrrt2018.org.tt Email: queries@isrrt2018.org.tt Results: There were variations of effective dose among facilities conducting CT examinations of similar anatomic areas ranging from 8.03 mSv to 23.2 mSv. In excess of 50% of the cases reviewed reported normal radiological findings. This raises the issue of diagnostic efficacy, was there a need for a CT scan to be done? Conclusion: There is a need to manage and document effective dose delivered to patients during CT procedures as accumulated radiation exposure increase the risks for cancers and other genetic anomalies. STORIES FROM THE FRONTLINE: Identifying Challenges and Solutions for Improper CT Colonography Patient Preparation Using a Case Study Approach Tracy Wakeford 1 , Jaqueline Razik, Feng Chen 1 CT Technologist, Mount Sinai Hospital, Canada CT1-3 Purpose: A CT colonography (CTC) is a viable alternative for those patients who cannot complete a traditional colonoscopy. CTC requires intensive and very specific patient preparation that differs significantly from colonoscopy. Large numbers of patients attend for CTC improperly prepped. This results in frequently cancelled appointments, and extends the number of days of “clear fluid” diet for patients. The aim of this abstract is to describe the most common reasons for, and potential solutions to, inadequate CTC patient prep using a case study approach. Methods: The CTC practice for a busy urban, multi-cultural hospital was reviewed over 4 weeks. Patients who were inadequately prepped were identified, and their clinical history, images and the course of communication between healthcare professionals was reviewed. Four case studies were identified that were most illustrative of the spectrum of potential causes of inadequate patient prep. Results: Case 1: Out-patient attending for a routine CTC. Technologist screened and consented the patient, who stated prep was followed as directed. Upon completing primary imaging, it became apparent that the patient had not understood or followed the prep. The patient was re-instructed about the prep, and remained on a clear liquid diet for an additional day. Case 2: CTC booked following a failed colonoscopy. The technologist is told by the medical team that the patient is prepped, and should have the CTC that afternoon as they were still fasting. The medical team is not aware of need for specialized prep for CTC and became angry with the technologist for not completing the study with the patient as is. Case 3: Patient with long standing history of constipation arrives for CTC. This information is not noted on the requisition. Patient asks the technologist if the laxative preparation was correct, as they have yet to have a bowel movement in the last day. A scout image is completed and determines that the patient’s bowels are not clean. The patient must endure an additional day of clear liquid diet. Case 4: An online request was created for an inpatient to have CTC. After several days of phone calls between the multiple members of the patient’s medical team, nursing floor, radiologists, and technologists, the patient had yet to receive appropriate preparation. During this time, the patient was kept on a restricted clear fluid diet. Conclusions: Improper patient prep for CTC causes problems for patient care, and inefficiencies within the healthcare system. The most frequent causes of improper prep were: 1) patients not understanding the instructions; 2) patients receiving prep for the wrong examination; 3) the medical need for non-standard prep; 4) miscommunication between healthcare professionals. It is possible to solve many of these challenges through improvements in communication and information availability. The Use of MIYABI Angio-CT for Diagnosis and Treatment of Lower Gastrointestinal Bleeding Commonly Seen in Emergency Wei-Yao Kao 1 , Chieu-An Liu 1 Radiographer, Department of Radiology Veterans General Hospital Taipei, Taiwan CT1-4 Purpose:The diagnosis or treatment of lower gastrointestinal bleeding is one of the common situation by emergency angiography. How to improve the diagnosis positive rate, in order to avoid the situation that after several times of intermittent bleeding still cannot find the bleeding location. 20 th International Society of Radiographers and Radiological Technologist, World Congress April 12 – 15, 2018 • Hyatt Regency Trinidad, Wrightson Road, Port of Spain, Trinidad, W.I. Website: www.isrrt2018.org.tt Email: queries@isrrt2018.org.tt
20 th ISRRT World Congress 2018 Hosted by Website: www.isrrt2018.org.tt Email: queries@isrrt2018.org.tt Methods: Using MIYABI Angio-CT to examine patients with lower gastrointestinal bleeding, and using the contrast injection to improve the diagnosis of bleeding and its location. This procedure can also help using microcatheter to catch the blood vessels and thus improve treatment rate and reduce operation time. Results: Use several cases of lower gastrointestinal bleeding patients to confirm the use of MIYABI Angio-CT helps finding bleeding location and then treating it. It is recommended to use this method for cases that are not able to find bleeding locations after repeated intermittent bleeding. Conclusion: With the advancement in technology, equipment is also more advanced. The use of MIYABI Angio-CT to examine lower gastrointestinal bleeding patients can improve diagnosis rate, but also provide more comprehensive treatment plans. Although the amount of radiation may rise, for such critical situation is still a viable recommendation. ULTRASOUND A Case Study: Diagnosis of Heterotopic Pregnancy in an Emergency Situation US1-1 Yonella Demars Assistant Professor, Department of Radiation Sciences, Virginia Commonwealth University, Richmond, USA Purpose: The purpose of this case study is to inform sonographers on the diagnosis, treatment, ultrasound appearance, and outcomes of heterotopic pregnancies. Methods: Using both the transabdominal and transvaginal approaches to exclude ectopic pregnancy in a woman over 30 years of age, the rare diagnosis of heterotopic pregnancy was established. The role of the sonographer, when excluding ectopic pregnancy, cannot be suboptimal when an intrauterine pregnancy (IUP) is confirmed. Further in depth evaluation of the adnexas is mandatory to exclude a heterotopic/ectopic pregnancy. Results: After the diagnosis of a heterotopic pregnancy, the patient underwent a diagnostic laparoscopy with right salpingectomy. The 8-week intrauterine pregnancy was carried to term. Conclusions: Heterotopic pregnancy is a rare occurrence, accounting for 1/30,000 spontaneous pregnancies. The role of sonographer in excluding an ectopic pregnancy cannot be limited when an IUP is identified. A thorough examination of the adnexas during the transvaginal ultrasound allows for timely intervention on the patient’s behalf. Key words: ectopic pregnancy, heterotopic pregnancy, ultrasound Ultrasound of an Adult Meningocele US1-2 Choong, Denise Ai Wen 1,2,3 , Sheehan, Colette 2 , Stanton, Marie. 1 , Herlihy, Therese. 1 1 Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4; 2 Radiology Department, Connolly Hospital Blanchardstown, Dublin 15; 3 National University Hospital, Singapore Introduction: Meningoceles are herniations of meninges, through an embryological defect in the neural arches of the vertebrae. Classified as spina bifida cystica, meningoceles are a rare type of closed neural tube defect, which is covered by skin. This case study demonstrates the possible ultrasound findings of an adult meningocele. Methods and results: A 39 year old male presented at the emergency department with a palpable, tender mass on his left lateral chest wall. He stated that this was a new swelling and complained of unexplained weight loss over the last 6 months. He has a history of spina bifida. Ultrasonography revealed a complex cystic mass with internal septations and soft tissue components. Colour Doppler interrogation demonstrated minimal vascularity within the soft tissue components and pulsation artefacts within cystic portions of the mass. Additionally a solid fingerlike projection was identified at the inferior aspect of the mass. Due to posterior shadowing from the spine, the deep extension of the mass could not be fully evaluated. Discussion: A previous renal computed tomography scan reported an incidental finding of a meningocele 5 years prior. Most meningoceles are detected and surgically treated in the antenatal or perinatal stages. Adult meningoceles are much rarer and patients often present with pain or neurological symptoms. Ultrasound is useful for assessing cyst contents which may include fibrous bands, aberrant nerve roots or glial nodules. Sonographers should be aware of normal pulsations of cerebrospinal fluid which can differentiate meningoceles from other complex cystic lesions. 20 th International Society of Radiographers and Radiological Technologist, World Congress April 12 – 15, 2018 • Hyatt Regency Trinidad, Wrightson Road, Port of Spain, Trinidad, W.I. Website: www.isrrt2018.org.tt Email: queries@isrrt2018.org.tt
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