Re: consulting
From: Philippe Jeanty, MD, PhD (jeanty@TheFetus.net)
Thu Aug 11 10:01:43 2005
When Alfred Abuhamad and I took the initial course with that wizard of Mike
Kammermeier we concluded that 3D stand for "Despair Disbelief and
Depression" on the part of the sonologist... well we outgrew that stage and
now it is clear how useful it is. The case of the week
http://www.thefetus.net/case.php?id=1508 has a neat 4D of a cardiac anomaly
as well as video clip. To me the finding is much easier to recognize on the
4D then on the video.
-----Original Message-----
From: ultrasound-history@medispecialty.com
[mailto:ultrasound-history@medispecialty.com] On Behalf Of James Smeltzer
Sent: Wednesday, August 10, 2005 6:55 PM
To: Multiple recipients of list ULTRASOUND-HISTORY
Subject: Re: consulting
Philippe:
Amen! I used to think color was a gimmick, but now I am not satisfied with
a heart without it. Likewise power for other vascular structures. When I
went from an Aloka to a Voluson, I found out how much I had become dependent
on free angular color M-Mode to make arrhythmia diagnosis more simple. I
will go back to it for some hearts. I find 3-d spinal images very helpful
in evaluating for NTDs, 3-ds looking down from a bladder cut at the
posterior urethral valves. I can forsee a very general usefulness for
vascular 3-d for ovarian cystic masses. Using glass-body for endometrial
polyps is very helpful.
It still slows me down when seeking heart studies and cute face shots -
though the result can be worth the effort. I KNOW that I have identified
"Down S" facies I would have not seen otherwise with the 3-D, when it was
clinically suspected on other grounds.
I have found it useful for demonstrating to the patient - though not finding
- clefts, low set ears, 13-18 fisting, sandal gap, micrognathia,
rocker-bottom feet, skeletal dysplasias, anencephaly. I am very much a
newcomer, and am sure that it will acquire better use with more use.
I should have used it today for better evaluation of a fetal goiter, come to
think of it...!!!
The only way to learn to swim is to get in the water.... Another reason
that trying to schedule max production hurts the quality and quality of life
of your sonographers. Play-time is also think-time, and share-and-consult
time, and improve-your-skills time, and knobology time.
Jim
>>> evsono@pipeline.com 8/10/2005 5:16:59 PM >>>
Philippe Jeanty, MD, PhD wrote:
> We have been doing 3-4D for 4 years. It does not add much time to
> normal exams (it does not add much diagnostic info either) but they
> are cute and fun in normal patient. 1 minute of 4D shows a lot about
> the baby. From time to time 3/4D shows something that could not be
> seen without. In difficult cases 3/4D add info and time. The ability
> to review something that was either missed or not well interpreted
> originally is very important (see Case of the week on http://www.TheFetus.net
> of tomorrow).
>
> I assume just about everyone checks the number of umbilical cord
> vessels with color Doppler along the bladder. Who would have thought
> of this as a common application when color Doppler was introduced ?
>
> New tools are always clumsy at first, just persist, this is not a fad.
> Remember how Ken Taylor famously said that "realtime was an
> unnecessary gimmick"... Don't make the same mistake with 3D.
>
> ------------------------------------------------------------------------
>
> ------------------------------------------------------------------------
> *From:* ultrasound-history@medispecialty.com
> ------------------------------------------------------------------------
> [mailto:ultrasound-history@medispecialty.com] *On Behalf Of *Allen Worrall
> *Sent:* Wednesday, August 10, 2005 2:53 PM
> *To:* Multiple recipients of list ULTRASOUND-HISTORY
> *Subject:* Re: consulting
>
> No, I am sure you are not wrong. I am sure it takes more time when you
> both do and interpret the scan, as you and I do. I am not sure how
> experience influences the time - I have heard that after 6 months or
> so one does become faster.
>
> Of course the Doctor from Boston who gave the lecture at the GE
> evening event may have said that it takes the sonographers less time
> to acquire volumes than to take separate images. Maybe she was not
> including the time it takes the radiologist to work with the volumes.
>
> I tried to get my colleagues here at the clinic interested in a 3D/4D
> machine. It went over like a lead balloon, so I will have to wait longer.
>
> Allen
>
>> ----- Original Message -----
>
> *From:* ACF <mailto:evsono@pipeline.com>
>
> *To:* Multiple recipients of list ULTRASOUND-HISTORY
> <mailto:ultrasound-history@dns.obgyn.net>
>
> *Sent:* Wednesday, August 10, 2005 7:38 AM
>
> *Subject:* Re: consulting
>
> Allen
>
> I also attended that event ... and as you, I do my own scans, many
> involve 3D. Here's my experience to date - NO net time-savings.
> Actually, for some studies, it takes more time - the time normally
> spent with the patient AND the time manipulating volumes for
> additional views. Also, while I'm at it - the ultrasound
> manufacturers need to get together on a uniform standard for
> volume storage to facilitate second opinions, etc. Hopefully,
> these details will get ironed out ASAP - especially if the mavens
> insist on it.
>
> Just my opinion - I could be wrong.
>
> Art
>
> Allen Worrall wrote:
>
> Terry, I think I saw you at that lecture in Orlando, a GE supper
> event, in which a young woman radiologist from Boston,(I think)
> related that her ultrasound department was bogged down with too
> many cases, and one of the things that helped them was 3D
> ultrasound. The volumes can be obtained quickly, and looked at
> later by the radiologist.
>
> Has this speaker published her lecture anywhere? I thought it was
> very good and very thought-provoking.
>
> Allen
>
>> ----- Original Message -----
>
> *From:* Terry DuBose <mailto:terrydubose@sbcglobal.net>
>
> *To:* Multiple recipients of list ULTRASOUND-HISTORY
> <mailto:ultrasound-history@dns.obgyn.net>
>
> *Sent:* Tuesday, August 09, 2005 6:27 PM
>
> *Subject:* Re: consulting
>
> Dr. De Lancer, you ask a question that many have asked. In
> general sonography (Abdomen and OB/GYN) usually no more than
> two an hour in peak rush times. It depends on how detailed
> the studies are, but at bottom line, two an hour average is
> too much if it is all day every day. This is based on my
> experience of 29 years and not on any scientific study.
>
> For you second question I would say anytime the sonographer is
> rushed enough to not be able to focus on the diagnosis, that
> is too many. There needs to be a bit of flexibility to allow
> for the unexpected twins or other detailed study.
>
> Also do not forget that over work, continuously over a period
> of months or years can injure the sonographer. Repeated
> Stress Injuries are well documented now. See:
>
> http://www.sdms.org/msi/default.asp
>
> Hope this helps. Terry
>
> */jose de lancer <josedelancer@yahoo.com>
> <mailto:josedelancer@yahoo.com>/* wrote:
>
> Hi, i am Dr. Jose De Lancer from Dominican Republic.
>
> I am obstetrician, gynecologist and sonologist.
>
> We have troubles in our hospital sonografy department for the
> "overdemand" in ultrasound studies.
>
> What is your opinion in the following isues:
>
> 1-How many studies are reasonable for each sonographer in one day?
>
> 2-How afect the excesive number of patients in the individual
> and department quality?
>
> Thanks for your cooperation!!
>
> */"DuBose, Terry" <DuboseTerryJ@uams.edu>
> <mailto:DuboseTerryJ@uams.edu>/* escribió:
>
> Congratulations to everyone on another landmark event. Good
> work. Terry
>
> Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>
> Associate Professor & Director
> Diagnostic Medical Sonography Program
> University of Arkansas for Medical Sciences, CHRP
> 4301 West Markham St. Mail Slot #563
> Little Rock, Arkansas, 72205 USA
> 501-686-6510
> DuBoseTerryJ@UAMS.edu <mailto:DuBoseTerryJ@UAMS.edu>
> http://www.io.com/~dubose/ <http://www.io.com/%7Edubose/>
> http://www.uams.edu/chrp/dms/default.asp
> http://www.obgyn.net/us/panel/panel.htm
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
------------------------------------------------------------------------
>
------------------------------------------------------------------------
> *From:* Dale R. Cyr [mailto:cyr@ardms.org]
------------------------------------------------------------------------
> *Sent:* Tuesday, August 09, 2005 7:18 AM
> *To:* ALL STAFF; BOARD MEMBERS; All EDTF Committees
> *Cc:* Thomas Magallanes; steve_tapp@promissor.com
> <mailto:steve_tapp@promissor.com>
> *Subject:* Success in Hong Kong ARDMS Exam Delivery
>
> Hello Everyone:
>
> ARDMS began delivering examinations at the University of Hong
> Kong on August 8th. Two candidates sat for ARDMS examinations
> (Neuro and CPI), which were routinely and securely delivered
> with all data safely transmitted back to Promissor as
> per normal procedure. The ARDMS Hong Kong examinations and
> processes are exactly the same as here in the United States
> and Canada. Several other Candidates are scheduled to sit for
> ARDMS examinations in Hong Kong over the next couple of weeks.
>
> Congratulations everyone as ARDMS continues to increase the
> number of credentialed individuals to promote quality and
> patient safety through credentialing and continuing competency
> of ultrasound professionals.
>
> Also, a big thank you to Promissor who has been a great
> partner in assisting ARDMS in meeting our strategic
> initiatives, particularly in the global expansion program.
>
> Regards,
>
> Dale
>
> Dale R. Cyr, MBA, CAE
>
> Chief Executive Officer/Executive Director
>
> ARDMS and the Breast Ultrasound Foundation
>
> 51 Monroe St., Plaza East One
>
> Rockville, Maryland 20850-2400
>
> 301-738-8406, x223
>
> cyr@ardms.org,
> <mailto:ardms.orgcyr@breastultrasound.org>cyr@breastultrasound.org
> <mailto:cyr@breastultrasound.org>
>
> www.ardms.org <http://www.ardms.org/>
> www.breastultrasound.org <http://www.breastultrasound.org/>
>
> //You should always make sure. Verify the Registry status of
> employees - current and potential. ARDMS offers an _online
> directory of its Registrants.
> <http://www.ardms.org/statusverification/index.htm>_//
>
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Gimmick? no not at all ... in fact, 3D has revealed more than a few
embedded IUD's.
Art
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