Abstract:
RATIONALE AND OBJECTIVES:The authors assessed whether a non-sleep-deprived, second-year diagnostic radiology resident assigned to an after-hours "night stalker" emergency radiology (ER) rotation in an urban university hospital has a measurable impact on the number and clinical significance of "missed" radiologic findings. METHODS:After-hours Emergency Department (ED) radiographs interpreted by radiology residents between January and December 1991 were reviewed daily by ER faculty. Faculty-modified final interpretations were recorded on a worksheet and given to the attending ED physician (EDP). The EDP reviewed and, if indicated, modified clinical dispositions, and categorized missed diagnoses as requiring recall into the following categories: 1 = immediately, 2 = in 24 to 48 hours, 3 = no recall necessary, or 4 = recognized during patient visit by clinicians. Morbidity attributable to "misses" was graded A to C (A, definite; B, possible; C, none). All cases requiring patient recall were evaluated monthly with follow-up information and classified as false-positive, false-negative, or indeterminant. The relative performance of control (traditional "call") and night stalker groups were compared. RESULTS:Of 26,421 on-call examinations in 1991, there were 489 (1.1%) misses, of which 202 (1.4%) were from the June-to-December study group. The control group residents averaged 2.75 hours of sleep per call night. On night stalker days, on-call residents and the night stalker averaged 5.75 and 7.25 hours of sleep daily, respectively. The fractions (and number) of recall assignments of discordant cases for the control and night stalker groups, respectively, were: 1) immediate 48% (23) and 26% (32); 2) within 48 hours 31% (15) and 26% (31); 3) no recall 79% (38) and 36% (43); and, 4) abnormality not missed by EDPs 10% (5) and 12% (15). Morbidity for the control and night stalker groups, respectively, were: 1) 4% and 0%; 2) 31% and 30%; and 3) 65% and 70%. The amount of rework between July and December 1991 spent by the EDPs to re-evaluate cases because of discordant opinions was more than 68 hours, with no significant difference noted between the study groups. Errors were false-negative, 84.9% (415); false-positive, 7% (34); and indeterminant, 8.2% (40). Radiology faculty errors contributed 5.8% (13) of patient recalls (false-positive, 11; false-negative, 2). Finally, 58/78 questionnaire respondents believed that service quality had improved. No one believed that the standard of service had been lowered. CONCLUSIONS:A dedicated night-shift ER coverage of a busy urban ED improves quality, appropriateness, and timeliness of patient care.
journal_name
Invest Radioljournal_title
Investigative radiologyauthors
Mann FA,Danz PLdoi
10.1097/00004424-199301000-00032subject
Has Abstractpub_date
1993-01-01 00:00:00pages
92-6issue
1eissn
0020-9996issn
1536-0210journal_volume
28pub_type
杂志文章abstract:OBJECTIVES:The aim of this study was to compare a compressed-sensing free-breathing VIBE (fbVIBE) with a conventional breath-hold VIBE (bhVIBE) for dynamic contrast-enhanced imaging of the upper abdomen. MATERIALS AND METHODS:In total, 70 datasets (bhVIBE, n = 30; fbVIBE n = 40; hard-gated [hg] reconstruction, n = 30;...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000607
更新日期:2019-11-01 00:00:00
abstract::"Satisfaction of search" (SOS) refers to the effect in which a second lesion remains undetected after detection of another lesion on the same radiograph. The objective of this study was to clarify our understanding of SOS by relating it to total time of inspection and time intervals before, between, and after discover...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199107000-00003
更新日期:1991-07-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The authors compare the magnetic resonance (MR) phase contrast flow velocity measurements in varying concentric stenoses with invasive measurements obtained with a Doppler guidewire. METHODS:Flow velocity measurements were obtained using a calibrated 0.018 inch 12 MHz Doppler guidewire and a 1...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199808000-00001
更新日期:1998-08-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:High signal intensity in the basal ganglia on T1-weighted MR imaging has been reported in chronic manganese (Mn) poisoning. However, the exact meaning of the high signal intensity remains unclear: does it result from Mn itself, secondary pathologic changes of the brain tissue, or both? The goal...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199906000-00001
更新日期:1999-06-01 00:00:00
abstract::Gelatin encapsulated nitrogen microbubbles were effective ultrasonic contrast agents in in vitro phantom and in vivo rabbit V2 carcinoma studies. Intra-arterial injection of 80-micrometer gelatin encapsulated nitrogen microbubbles appeared to improve tumor visualization by rim enhancement, which persisted for several ...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198005000-00013
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the extent to which various commercially available gadolinium-containing contrast-enhancing (CE) agents can interfere with the measurement of calcium levels by currently used laboratory methods, suggesting (spurious) hypocalcemia or hypercalcemia with a potential ris...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/01.rli.0000170447.45577.5e
更新日期:2005-08-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:To compare the diagnostic efficacy of a standard dose of MRI contrast agent in the evaluation of primary brain tumors and metastases using a high-field 3 tesla MR unit versus a 1.5 tesla MR unit. METHODS:Sixteen patients with brain tumors were examined at both field strengths using identical a...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-200203000-00003
更新日期:2002-03-01 00:00:00
abstract::Diagnostic radiology is expanding, playing an increasingly central role in patient care, which heightens the importance of radiology teaching in undergraduate medical education. This study examined the impact of increased structure and systematic evaluation on student performance in a radiology elective. The evaluatio...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198505000-00003
更新日期:1985-05-01 00:00:00
abstract::A radiographic method for use in the closed-chest dog is described which allows the quantitation of segmental mechanical performance. Previous work has shown that the area of the pressure-length loop (an approximation of a stress-strain integral) is a useful measure of the mechanical work performed by a segment of myo...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-197611000-00010
更新日期:1976-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Very small dextran-coated magnetite particles were developed. These particles can be used either as immunospecific contrast agents for MRI by coupling to antibodies or as an interstitial contrast agent. METHODS:The particles were synthesized from iron chloride/dextran solutions. Size was evalu...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-200009000-00006
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to explore the impact of dynamic contrast-enhanced (DCE) computer tomography (CT) as a biomarker in metastatic renal cell carcinoma (mRCC). MATERIALS AND METHODS:Twelve patients with favorable or intermediate Memorial Sloan Kettering Cancer Center risk group and clear cell mRCC par...
journal_title:Investigative radiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/RLI.0000000000000058
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess the value of in vivo T2 measurements to noninvasively quantify myocardial fibrosis in diabetic mice at 11.75 T. Diabetic cardiomyopathy is characterized by extracellular matrix alteration and microcirculation impairment. These conditions might provide electrical heterogeneit...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0b013e318243e062
更新日期:2012-05-01 00:00:00
abstract::Using real-time ultrasound, the motions of the tongue, hyoid bone, and larynx were monitored and timed during swallowing in ten normal subjects. A well-defined propulsive wave of the tongue was observed during swallowing a 5-cc water bolus. The body of the hyoid bone was identified on the ultrasound scan as a high ech...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198403000-00003
更新日期:1984-03-01 00:00:00
abstract::Observation of the relaxivity of MRI contrast media over a wide range of magnetic fields is not only necessary for predicting their efficiency at any field but also compulsory for understanding and improving their mechanisms of action. The best experimental approach to this problem is the field cycling method, which a...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198809001-00047
更新日期:1988-09-01 00:00:00
abstract::Observer performance in radiologic interpretation has traditionally been based upon Receiver Operating Characteristic (ROC) analysis. A statistical method that evaluates the reproducibility or consistency of radiologic interpretation is presented. Since this method is not based upon pathologic verification, it cannot ...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198411000-00024
更新日期:1984-11-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Two independent gold standards and diagnoses from three-dimensional computed tomography (CT) images were used to examine the possibility that craniosynostosis is a binary abnormality that potentially may be diagnosed without error. METHODS:Surgical reports, histology of excised sutures, and th...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199410000-00005
更新日期:1994-10-01 00:00:00
abstract::Thromboembolic complications occurring during angiography may result from a number of different causes. Catheters and guidewires can interact with blood to form thrombi; this tendency is related to wall defects and the chemical composition and structural characteristics of the catheters and guidewires. Nonthrombic sou...
journal_title:Investigative radiology
pub_type: 杂志文章,评审
doi:10.1097/00004424-198811002-00009
更新日期:1988-11-01 00:00:00
abstract::A method is presented by whichcomputed tomography scans carried out at a number of energies may be utilized to obtain cross-sectional images of density and atomic number in addition to the conventional array of linear attenuation coefficients. This type of analysis has been carried out for various substances of biolog...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-197703000-00016
更新日期:1977-03-01 00:00:00
abstract:OBJECTIVES:Magnetic resonance imaging guidance has been sporadically reported for renal tumor cryoablation (CA); therefore, clinical experience with this modality is still limited.The aim of this study is to retrospectively analyze our 10-year experience with renal tumor CA performed on a 1.5 T magnetic resonance imagi...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000719
更新日期:2020-09-04 00:00:00
abstract:OBJECTIVES:To test the feasibility of combining inner-volume imaging (IVI) techniques with conventional multishot periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) techniques for targeted-PROPELLER magnetic resonance imaging. MATERIALS AND METHODS:Perpendicular section-selective ...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0b013e3181a8b015
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:The aims of this study were to present a deep learning approach for the automated classification of multiple sclerosis and its mimics and compare model performance with that of 2 expert neuroradiologists. MATERIALS AND METHODS:A total of 268 T2-weighted and T1-weighted brain magnetic resonance imagin scans ...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000735
更新日期:2020-10-26 00:00:00
abstract:RATIONALE AND OBJECTIVES:It is widely believed that down-sizing catheters, and possibly needles, will decrease damage to the entry vessel in the performance of angiography. The purposes of this in vitro experiment are to determine if smaller needles produce less arterial wall damage than larger needles and to assess th...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199210000-00001
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to develop a method to determine hepatic and renal clearance of the 2 diastereoisomers (Gd-A, Gd-B) of Gd-EOB-DTPA separately. MATERIALS AND METHODS:Between July 2017 and February 2018, 41 patients with hepatic disease were prospectively included. For each patient, 1 mL of iopromid...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000622
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Gadolinium leakage in ocular structures (GLOS) was recently observed in fluid-attenuated inversion recovery (FLAIR) images obtained the day after an initial gadolinium injection in stroke patients. The specificity of GLOS to stroke and its mechanisms remain unclear. OBJECTIVE:We investigated the factors ass...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000757
更新日期:2021-01-19 00:00:00
abstract::The interdisciplinary approach to medical education has often been deficient in medical school curricula. Because of the nonintegrated approach to medical education, problem solving capabilities are not fostered. The clinical presentation of a patient, the imaging modalities used to investigate the patient, and the ul...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198604000-00015
更新日期:1986-04-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The authors investigated whether gadolinium-ethoxybenzyl-DTPA (Gd-EOB-DTPA) can be eliminated in the absence of the two usual excretory pathways (urinary or biliary) and whether a remaining excretory pathway is able to compensate for impaired liver or kidney function. METHODS:The study was per...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199402000-00017
更新日期:1994-02-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:The capability of an indirect computed tomographic lymphography (CT-LG) using a nonionic monometric contrast medium iopamidol for visualizing breast lymphatic pathways was preliminarily tested. MATERIALS AND METHODS:In 10 female dogs, a total of 0.5 and 1 mL of undiluted iopamidol was injected...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-200302000-00002
更新日期:2003-02-01 00:00:00
abstract::The rate at which isotopes descend from the cisterna magna to the lumbar subarachnoid space is highly variable. In monkeys, with and without previous lumbar puncture, transit time was measured. In animals with a previous lumbar puncture, transit times were 10 to 120 minutes; in monkeys without a previous lumbar punctu...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198805000-00005
更新日期:1988-05-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance (MR) (with and without diffusion-weighted imaging [DWI]) to F-FDG PET/computed tomography (CT), with regard to the assessment of nodal and extranodal involvement, in patients with Hodgkin lym...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000218
更新日期:2016-03-01 00:00:00
abstract::Biplane angiocardiography has emerged as a standard method for calculating left ventricular volume measurements. Validation of such measurements has separately been made for several projections of silicone casts of the left ventricle. This study was undertaken to establish and compare the regression lines for left ven...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198011000-00002
更新日期:1980-11-01 00:00:00