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[透明度机制:泌尿外科诊断中放射影像的符号学]

[Transparency regime: semiotics of radiographical images in urological diagnostics].

作者信息

Martin M, Fangerau H

机构信息

Institut für Geschichte, Theorie und Ethik der Medizin, Universität Ulm, Frauensteige 6, 89077 Ulm, Deutschland.

出版信息

Urologe A. 2012 Oct;51(10):1450-8. doi: 10.1007/s00120-012-2973-8.

Abstract

Shortly after Röntgen discovered x-rays urology became one of the main test fields for the application of this new technology. Initial scepticism among physicians, who were inclined to cling to traditional manual methods of diagnosing, was replaced by enthusiasm for radiographic technologies and the new method soon became the standard in, for example the diagnosis of concrements. Patients favoring radiographic procedures over the use of probes and a convincing documentation of stones in radiograms were factors that impacted the relatively rapid integration of radiology into urology. The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem. Several patients died during this research. A new diagnostic dimension was revealed when radiography and cystography were combined to form the method of retrograde pyelography. However, the problem of how urologists could learn how to read the new images remained. In order to allow trainee physicians to practice interpreting radiograms atlases were produced which offered explanatory texts and drawings for radiographic images of the kidneys, the bladder etc. Thus, urologists developed a self-contained semiotics which facilitated the appropriation of a unique urological radiographical gaze.

摘要

在伦琴发现X射线后不久,泌尿外科就成为了这项新技术应用的主要试验领域之一。医生们最初倾向于坚持传统的手动诊断方法,对此持怀疑态度,但很快就被对放射技术的热情所取代,这种新方法很快就成为了例如结石诊断的标准。相较于使用探针,患者更倾向于放射检查程序,以及X光片中结石令人信服的记录,这些因素影响了放射学相对较快地融入泌尿外科。软组织和体腔的射线成像更困难,尤其是造影剂的研发构成了一个严重问题。在这项研究中有几名患者死亡。当放射照相术和膀胱造影术结合形成逆行肾盂造影术时,揭示了一个新的诊断维度。然而,泌尿外科医生如何学会解读这些新图像的问题依然存在。为了让实习医生练习解读X光片,人们制作了图谱,为肾脏、膀胱等的射线图像提供解释性文本和图示。因此,泌尿外科医生开发了一套自成体系的符号学,这有助于形成独特的泌尿外科放射影像学视角。

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