Objective

The purpose of this article is to discuss how to convert cross-sectional images into a 3D model and embed them in a Portable Document Format (PDF) file. Four programs are used: OsiriX, MeshLab, Microsoft PowerPoint, and Adobe Acrobat. Step-by-step instructions are provided.

Conclusion

Embedding 3D radiology models into PDF files is a powerful tool that may be used for clinical, educational, and research purposes.

Background Appropriate indications for radiologic evaluation of central venous ports are not fully understood. We aimed to quantitatively assess the utility of clinical history and imaging in the evaluation of malfunctioning central venous ports. Methods Clinical history, plain radiographs, and line injections intended to evaluate central venous port malfunction in 153 consecutive cases over a nearly 4-year period were retrospectively reviewed by 2 radiologists. Radiographs and line injections were separately categorized as normal or abnormal, and a consensus was reached on the final imaging diagnosis. The likelihood of a port-related abnormality necessitating immediate intervention was determined for all represented combinations of clinical history, radiographic findings, and line injection results. Results A radiologic diagnosis was made in 96.1% of cases; 19.7% of these diagnoses were classified as critical, requiring prompt intervention. Very low risk histories had a 0.0% incidence of critical port abnormalities in our cohort, regardless of imaging findings. Low risk histories had a 10.5% incidence of a critical abnormality and were best evaluated either by line injection, either directly or following an abnormal chest radiograph. Intermediate and high risk histories were associated with a 30.5% and 61.1% incidence of critical port abnormalities, respectively, and were best evaluated by line injection without preceding chest radiograph. Conclusions There are several scenarios in which imaging does not meaningfully affect management of malfunctioning central venous ports. Recognizing these inefficiencies may allow for more appropriate and cost-effective use of radiographs and line injections to evaluate the cause of port malfunction. © 2014, ASSOCIATION FOR VASCULAR ACCESS. Published by Elsevier Inc. All rights reserved.

Objective

To investigate prevalence and predictors of cardiovascular risk in pediatric liver transplant recipients using noninvasive markers of subclinical atherosclerosis: carotid intima-media thickness (cIMT) and aorta intima-media thickness (aIMT).

Study design

Cross-sectional study of 88 pediatric liver transplant recipients. The cIMT and aIMT were measured by ultrasound imaging using standardized protocol.

Results

Participants were 15.4 ± 4.8 years of age, and 11.2 ± 5.6 years post-transplantation. The cIMT and aIMT were both higher in males than females. In analyses adjusted for sex, age, and height, the cIMT was higher in subjects transplanted for chronic/cirrhotic liver disease and lower in subjects on cyclosporine (n = 9) than tacrolimus (n = 71). The cIMT was not associated with rejection history or current corticosteroid use. The cIMT increased with increasing diastolic blood pressure and triglycerides. The aIMT (n = 83) also increased with age, and its rate of increase post-transplant varied by age at transplantation. In adjusted analyses, aIMT was higher in subjects with glucose intolerance. In analysis of patients ≤20 years of age for whom blood pressure percentiles could be calculated (n = 66), aIMT increased with increasing diastolic blood pressure percentile (0.010 mm per 5-percentile; 95% CI, 0.000-0.021; P = 0.05). Neither the cIMT nor the aIMT was associated with obesity, systolic hypertension, or other dyslipidemia at study visit.

Conclusion

Measures of long-term cardiovascular risk were associated with conditions that are more common in pediatric liver transplant recipients than nontransplanted peers, namely, diastolic hypertension and glucose intolerance. Larger, longitudinal studies are warranted to investigate whether cIMT could be useful for stratifying these patients' cardiovascular risk-and potential need for proactive intervention-during long-term follow-up.

Discovery of scrotal swelling in a neonate can be a source of anxiety for parents, clinicians, and sonologists alike. This pictorial essay provides a focused review of commonly encountered scrotal masses and mimics specific to the neonatal setting. Although malignancy is a concern, it is very uncommon, as most neonatal scrotal masses are benign. Key discriminating features and management options are highlighted to improve the radiologist's ability to diagnose neonatal scrotal conditions and guide treatment decisions. Neonatal scrotal processes ranging from common to uncommon will be discussed.

Rationale and objectives

There are little data as to whether appropriate, cost effective, and safe ordering of imaging examinations are adequately taught in US medical school curricula. We sought to determine the proportion of noninterpretive content (such as appropriate ordering) versus interpretive content (such as reading a chest x-ray) in the top-selling medical student radiology textbooks.

Materials and methods

We performed an online search to identify a ranked list of the six top-selling general radiology textbooks for medical students. Each textbook was reviewed including content in the text, tables, images, figures, appendices, practice questions, question explanations, and glossaries. Individual pages of text and individual images were semiquantitatively scored on a six-level scale as to the percentage of material that was interpretive versus noninterpretive. The predominant imaging modality addressed in each was also recorded. Descriptive statistical analysis was performed.

Results

All six books had more interpretive content. On average, 1.4 pages of text focused on interpretation for every one page focused on noninterpretive content. Seventeen images/figures were dedicated to interpretive skills for every one focused on noninterpretive skills. In all books, the largest proportion of text and image content was dedicated to plain films (51.2%), with computed tomography (CT) a distant second (16%). The content on radiographs (3.1:1) and CT (1.6:1) was more interpretive than not.

Conclusions

The current six top-selling medical student radiology textbooks contain a preponderance of material teaching image interpretation compared to material teaching noninterpretive skills, such as appropriate imaging examination selection, rational utilization, and patient safety.

Rationale and objectives

Modern radiology clerkships require a rigorous, in-depth curriculum usually involving a variety of educational activities. With increasingly constrained faculty time and departmental resources, finding activities that are easy to implement and of high educational value can be a challenge.

Materials and methods

We introduced a novel educational activity to our radiology clerkship in which students created independent learning modules (ILMs) that were reviewed by their classmates. Feedback surveys were used to assess the activity and guide a revision to the program. Feedback surveys after the revision were used to assess the overall perceived value of the program.

Results

Twenty-seven students in two successive sessions of our elective radiology clerkship completed the ILM activity and provided feedback. Sixty-four students in five subsequent sessions completed a modified version of the activity and provided feedback. Students in this final group rated the activity's educational value at 8.3/10, with most describing both the creation and reviewing of the ILMs as similarly or more educationally valuable than lectures (41 of 64 [64%], 48 of 64 [75%], respectively). Students indicated the target ILM length of 15 minutes was "about right" (61 of 64 [95%]), and that the overall proportion of the course dedicated to the ILM activity was appropriate (49 of 64 [77%]).

Conclusions

A novel student-created ILM activity was highly reviewed by radiology elective students, both with regard to the educational value of creating and taking the ILMs. Clerkship directors wishing to supplement their curricula with an easy-to-implement high-value activity may consider adding a student-created ILM assignment.

Purpose

Educating medical students is a core mission of academic radiology departments. In some programs, residents participate in student teaching. The aim of this study was to retrospectively compare medical student evaluations of radiology resident lectures with lecture evaluations of radiology faculty members.

Methods

Numeric evaluations for lectures given by faculty members, fellows, and residents were collected over a 1-year period as part of routine course evaluations for a fourth-year medical student radiology elective. Faculty member, fellow, and resident lecture scores were compared, overall using analysis of variance and pairwise using Student's t test. A predefined low P-value threshold was used for the t tests to account for the multiple comparisons. To account for the inherent clustering of the data due to repeat lecturers, the data were reanalyzed on a "per lecturer" basis.

Results

Three hundred seven individual lecture scores were collected. There was no statistical difference between the lecture scores received by attending faculty members (mean, 9.10 on a scale of 10) and residents (mean, 8.99) (P = .08). Fellows, however, scored statistically significantly lower (mean, 8.45) than attending faculty members and residents (P <.001 for both comparisons). The per lecturer analysis yielded similar results.

Conclusions

Lectures delivered by residents received similar evaluations as lectures delivered by faculty members. Given that teaching can be an educational experience for residents, involving radiology residents in medical student teaching may benefit students and residents alike.

Background

Games with educational intent offer a possible advantage of being more interactive and increasing learner satisfaction.

Objective

We conducted a two-armed experiment to evaluate student satisfaction and content mastery for an introductory pediatric radiology topic, taught by either an interactive digital game or with a traditional didactic lecture.

Materials and methods

Medical students participating in a fourth-year radiology elective were invited to participate. Student cohorts were alternatively given a faculty-supervised 1h session playing a simple interactive digital Tic-tac-toe quiz module on pediatric gastrointestinal radiology or a 1h didactic introductory lecture on the same topic. Survey questions assessed the learners' perceived ability to recall the material as well as their satisfaction with the educational experience. Results of an end-of-rotation exam were reviewed to evaluate a quantitative measure of learning between groups. Survey responses were analyzed with a chi-squared test. Exam results for both groups were analyzed with a paired Student's t-test.

Results

Students in the lecture group had higher test scores compared to students in the game group (4.0/5 versus 3.6/5, P = 0.045). Students in the lecture group reported greater understanding and recall of the material than students in the game group (P < 0.001 and P = 0.004, respectively). Students in the lecture group perceived the lecture to be more enjoyable and a better use of their time compared to those in the game group (P = 0.04 and P < 0.001, respectively). There was no statistically significant difference between the lecture and game group in ability to maintain interest (P = 0.187). In comparison to pre-survey results, there was a statistically significant decrease in interest for further digital interactive materials reported by students in the game group (P = 0.146).

Conclusion

Our experience supported the use of a traditional lecture over a digital game module. While these results might be affected by the specific lecture and digital content in any given comparison, a digital module is not always the superior option.

Reading room electives are among the most challenging curricula to develop for medical student educators. Students tend to have few responsibilities and poorly defined learning objectives. The authors review the components of a successful reading room elective. The important components include a thorough orientation, written goals and expectations, attendance and feedback systems, objective mid-elective and end-of-elective evaluations, and an end-of-elective debriefing session. Many educational activities, tools, and assessments are available and should be considered to supplement the curriculum. Radiology electives must break free of the "radi-holiday" stereotype and adopt increased responsibilities and expectations, similar to rigorous clinical subinternships.

Rationale and objectives

This study aimed to determine the degree of involvement of radiologists in ultrasound education in medical schools in the United States.

Materials and methods

An online survey was sent to 129 directors of medical student education in radiology, identified by the Alliance of Medical Student Educators in Radiology. Each survey recipient represented a unique medical school.

Results

There was a 31% survey completion rate. Radiology education was incorporated into the majority of respondents' medical school curricula (95%). Ultrasound images were used in preclinical education in the majority of schools (76%). Students were trained to perform hands-on ultrasound examinations in half of schools (49%), and a minority of schools offered a dedicated point-of-care ultrasound elective (14%). Radiology and emergency medicine were the most involved departments in teaching ultrasound to medical students (88% and 75% of medical schools, respectively).

Conclusions

Ultrasound imaging was incorporated into the curricula of most of the responding medical schools, although actual hands-on training was less widespread.