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"Articles for you, from us"
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Welcome to NewsWire! This bi-weekly e-newsletter from the American Registry for Diagnostic Medical Sonography® (ARDMS®), offers its Registrants and members of the sonography community current and innovative news and technology related to the field of sonography.
We want to hear from you! NewsWire was designed to serve as an informational forum. As such, we welcome your article suggestions, questions, comments and feedback on ways to make this resource a more valuable tool in your day-to-day professional life. Please write to us at: communications@ardms.org |
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Please join the ARDMS on Thursday, April 2, 2009 at 8pm ET for a special SPI webinar
hosted by the Society of Diagnostic Medical Sonography (SDMS).
ARDMS will be presenting information on the new Sonography Principles & Instrumentation (SPI) examination.
I. Who is ARDMS?
II. How are ARDMS examinations developed?
III. How does ARDMS score examinations?
IV. Information about the SPI pilot?
V. What is SPI?
VI. What the SPI examination will mean for specific individuals:
a. Students
b. Registrants
c. Candidates
d. Applicants
VII. SPI Examination Requirement: Documents required/parameters.
VII. Applying online for the SPI examination.
IX. What resources are available for the SPI examination?
a. How to Apply Guide
b.
Prerequisite & Requirement Eligibility Program
c. Content Outlines
d. Practice Examinations
X. Information about the discontinuation of the UPI, CPI, & VPI examinations?
XI. Sonography Principles & Instrumentation FAQ's.
 Space is limited, Register today!
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Only current active SDMS members will be eligible to earn CME credits for attending this webinar.
If you are unable to access the webinar, please visit the SDMS website to access the recorded version of the webinar in its entirety. The recording will be available on Friday, April 3rd. |
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New Mexico Legislature Passes Bill To License Sonography and Magnetic Resonance
The bill's passage makes New Mexico the first state to regulate sonography and only the second to license MR.
American Society of Radiologic Technologists President Linda Holden, M.S., R.T.(R)(QM), RDMS, FASRT, announced the New Mexico Legislature passed House bill 498 adding those who perform sonography and magnetic resonance imaging to the medical imaging professions requiring a state license.
The bill's passage was the culmination of the joint efforts of Rep. Jeff Steinborn of Dona Ana County, the ASRT, the New Mexico Environment Department and the Society for Diagnostic Medical Sonography. "This is a significant happening," said Ms. Holden. "The collaborative effort of all the parties to develop this legislation is a great example of what can happen when participants are motivated to improve the lives of the patients."
Sponsored by Rep. Steinborn, the bill will ensure that individuals performing sonography and MR have the necessary education and skills to practice in clinic settings. The bill underwent several amendments and substitutions prior to its passage, but the final version of the bill focuses on improving patient care, which was the primary goal of all the parties supporting the bill.
"Of course this final passage is not the end of the process but rather the beginning," Ms. Holden added. "New Mexico Gov. Bill Richardson still needs to sign the bill, and of course if he does, the ASRT will work closely with the New Mexico Environment Department and the SDMS to develop regulations necessary to implement the provisions of the bill."
Article written by staff at asrt.org and adapted for the purposes of this newsletter.
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Lowering BP and LDL Cholesterol in Tandem Slows Atherosclerosis
Normal systolic blood pressure and very low LDL cholesterol levels provide the most benefit in slowing the progression of coronary atherosclerosis, researchers here found.
Patients with coronary artery disease who controlled both risk factors to the lowest levels had the least disease progression, as measured using intravascular ultrasound, Adnan Chhatriwalla, M.D., of the Cleveland Clinic, and colleagues reported in the March 31 Journal of the American College of Cardiology.
"This is the first study to demonstrate that normal blood pressure and very low LDL cholesterol in combination are associated with attenuation of the progression of coronary disease in humans," Dr. Chhatriwalla said.
"Even though patients may have reasonable control of blood pressure and cholesterol, getting them to optimal treatment goals is best in terms of slowing plaque progression," he said.
Because it had been unclear what effect controlling both blood pressure and LDL cholesterol concentrations would have, the researchers pooled data from seven clinical trials involving patients with coronary artery disease -- REVERSAL, CAMELOT, ILLUSTRATE, ASTEROID, ACTIVATE, PERISCOPE, and STRADIVARIUS.
The analysis included 3,437 patients who had atheroma burden assessed using intravascular ultrasound.
They were predominantly male (70.6%) and had a high prevalence of hypertension (79.2%), hyperlipidemia (75.4%), and diabetes (31.3%).
Normal systolic blood pressure was defined as 120 mm Hg or less, and very low LDL cholesterol level was defined as 70 mg/dL or less.
A combination of normal systolic blood pressure and very low LDL cholesterol concentration was associated with significantly less disease progression according to percent and total atheroma volume (P<0.001 for trend for both), more frequent disease regression (P=0.01 for trend), and less frequent disease progression (P<0.001 for trend).
Among patients who had systolic blood pressure that was higher than normal, very low LDL concentration was associated with less disease progression according to both percent atheroma volume (P=0.01) and total volume (P=0.001).
For those with normal blood pressure, very low LDL concentration was associated with significantly less disease progression according to percent atheroma volume (P=0.05).
Among those with higher LDL levels, normal blood pressure was not associated with disease progression according to either percent or total atheroma volume.
The findings suggest that "lower levels of LDL cholesterol had a greater impact on progression of coronary artery disease than systolic blood pressure," the researchers said.
They acknowledged that the impact of aggressively controlling blood pressure and LDL cholesterol levels on clinical events remains to be determined and that the findings should be confirmed in a randomized controlled trial.
In an accompanying editorial, Jonathan Tobis, M.D., and Alice Perlowski, M.D., of the University of California Los Angeles, echoed that thought, noting the limitations of using a surrogate endpoint of plaque burden imaged by intravascular ultrasound.
"Although we may use plaque progression/regression on intravascular ultrasound to deduce that we are producing positive results for our patients, the true determination of the impact of our therapy depends on clinical and mortality endpoints, which can only be obtained from large-scale randomized clinical trials," they said.
View the article online.
Article written by staff at medpagetoday.com and adapted for the purposes of this newsletter.
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Fluoro-guided lumbar punctures fail more for infants, elderly
When an infant less than 1 year of age needs a lumbar puncture, radiologists should consider using an ultrasound-guided procedure instead of fluoroscopy.
In a retrospective study, researchers at Wake Forest University School of Medicine in Winston-Salem, NC, discovered that the failure rate for traumatic lumbar puncture during 2005 and 2006 was 58.8% for infants, compared with a 3.2% failure rate in children ages 12 months and older. Caution must also be taken with geriatric patients, as patients older than 80 have a higher risk of bleeding.
These findings were revealed in a study led by Dr. Annette Johnson, an associate professor of radiologic sciences, to determine the factors associated with increased risk of traumatic fluoroscopy-guided lumbar puncture. The study was published in the March issue of the American Journal of Neuroradiology
(2009, Vol. 30:3, pp. 512-515).
Fluoroscopy-guided lumbar punctures are often performed after a difficult or failed bedside lumbar puncture attempt. The rate of fluoroscopy-guided lumbar puncture is estimated to range from zero to 24%, compared with 10.5% to 20% for conventional procedures.
Wake Forest researchers evaluated the records of 742 patients, ranging in age from infancy to 90 years, and found an average rate of traumatic lumbar puncture of 13.3%. The rate of traumatic lumbar puncture was significantly higher at the L4-L5 level, at 19%, compared with 9% at the L2-L3 level, 10% at the L3-L4 level, and 13% at the L5-S1 level.
Patients between the ages of 11 and 80 years averaged a 12.4% failure, compared with older patients who had a 25.9% failure rate. The researchers suggested that this may have been a factor of poor patient cooperation by elderly patients with altered mental status, or medications that could predispose them to bleeding.
The high rate of failure in infants may have been caused by over-insertion of the lumbar spine needle, leading to injury of the venous epidural plexus. The researchers also speculated that the high rate may be linked to traumatic epidural or subdural collections as a result of prior failed bedside lumbar puncture.
View the article online.
Article written by staff at auntminnie.com and adapted for the purposes of this newsletter.
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Sonohysterography Is An Alternative Diagnostic Tool For Women With Adenomyosis
Sonohysterography (SHG), a simple ultrasound technique commonly used to evaluate the uterine cavity, improves the diagnostic capability of transvaginal ultrasound in detecting adenomyosis.
Sonohysterography (SHG), a simple ultrasound technique commonly used to evaluate the uterine cavity, improves the diagnostic capability of transvaginal ultrasound in detecting adenomyosis (a common benign condition of the uterus that causes dysmenorrhea, abnormal vaginal bleeding and pelvic pain), according to a study performed at the Thomas Jefferson University Hospital in Philadelphia, PA.
The study included 26 women who underwent sonohysterography and MRI of the pelvis and in whom either modality suggested adenomyosis. Of these 26 women, 23 (88%) had SHG findings suggestive of adenomyosis. Three remaining women (12%) had adenomyosis identified on MRI performed after sonohysterography. MRI confirmed adenomyosis in 22/23 patients (96%).
"This study describes the presence of ill-defined areas of fluid intravasation extending from the uterine cavity into the myometrium known as fluid containing tracks or so called 'myometrial cracks' on SHG," said Sachit Verma, MD, lead author of the study. "Myometrial cracks have not been described previously as a sign of adenomyosis. The tracks, seen in 26% of our cases, become conspicuous as saline seeps through the 'myometrial cracks'. They are difficult to characterize on standard transvaginal ultrasound. This peculiar appearance was seen in one of our patients on MRI as well," said Dr. Verma.
"Patients often present with symptoms of abnormal bleeding, pelvic pain and infertility which may be due to a uterine fibroid, a polyp, tumor or adenomyosis. MR imaging is expensive and is not always available as a first line investigation to evaluate abnormal bleeding. In addition it is difficult to distinguish lesions in the uterus (myometrium and endometrium) using transvaginal ultrasound alone. SHG then has a role to play in managing these patients," said Dr. Verma.
"Knowledge of 'myometrial cracks' will decrease the errors in interpretation and improve patient care so that specific treatment can be instituted," he said. "This additional information for the referring physician can possibly decrease the number of endometrial biopsies-reducing costs in patient management-in cases where SHG shows no uterine abnormality and adenomyosis is the sole cause of abnormal bleeding," said Dr. Verma.
This study appears in the April issue of the American Journal of Roentgenology.
View the article online.
Article written by staff at sciencedaily.com and adapted for the purposes of this newsletter.
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