Purpose: To evaluate the use of an audio/visual (A/V) system in pediatric patients as an alternative to sedation in magnetic resonance imaging (MRI) in terms of wait times, image quality, and patient experience.
Materials and Methods:Pediatric MRI examinations from April 8 to August 11, 2008 were compared to those 1 year prior to the installation of the A/V system. Data collected included age, requisition receive date, scan date, and whether sedation was used. A posttest questionnaire was used to evaluate patient experience. Image quality was assessed by two radiologists.Results: Over the 4 months in 2008 there was an increase of 7.2% (115; P Ͻ 0.05) of pediatric patients scanned and a decrease of 15.4%, (67; P ϭ 0.32) requiring sedation. The average sedation wait time decreased by 33% (5.8 months) (P Ͻ 0.05). Overall, the most positively affected group was the 4 -10 years. The questionnaire resulted in 84% of participants expressing a positive reaction to the A/V system. Radiological evaluation revealed no changes in image quality between A/V users and sedates.
Conclusion:The A/V system was a successful method to reduce patient motion and obtain a quality diagnostic MRI without the use of sedation in pediatric patients. It provided a safer option, a positive experience, and decreased wait times.
The use of cine loop sweeps has the potential to increase the detection of fetal cardiac defects without increasing the rate of false-positive findings or increasing the interpretation and decision-making times.
The use of sonographic imaging for routine fetal screening in the second trimester has been adopted by the Canadian health care system and a number of European countries as a standard of care. 1 According to a survey of 2758 referrals to the fetal cardiology unit at Guy's Hospital,
Introduction: Acoustic Radiation Force Impulse (ARFI) Quantification measures shear wave velocities (SWVs) within the liver. It is a reliable method for predicting the severity of liver fibrosis and has the potential to assess fibrosis in any part of the liver, but previous research has found ARFI quantification in the right lobe more accurate than in the left lobe. A lack of standardised applied transducer force when performing ARFI quantification in the left lobe of the liver may account for some of this inaccuracy. The research hypothesis of this present study predicted that an increase in applied transducer force would result in an increase in SWVs measured.
Methods: ARFI quantification within the left lobe of the liver was performed within a group of healthy volunteers (n = 28). During each examination, each participant was subjected to ARFI quantification at six different levels of transducer force applied to the epigastric abdominal wall.
Results: A repeated measures ANOVA test showed that ARFI quantification was significantly affected by applied transducer force (p = 0.002). Significant pairwise comparisons using Bonferroni correction for multiple comparisons showed that with an increase in applied transducer force, there was a decrease in SWVs.
Conclusion: Applied transducer force has a significant effect on SWVs within the left lobe of the liver and it may explain some of the less accurate and less reliable results in previous studies where transducer force was not taken into consideration. Future studies in the left lobe of the liver should take this into account and control for applied transducer force.
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