Yamamoto L G, Inaba A S, DiMauro R
Emergency Services, University of Hawaii John A. Burns School of Medicine, Honolulu.
Pediatr Emerg Care. 1994 Oct;10(5):273-7. doi: 10.1097/00006565-199410000-00007.
Although teleradiology systems are available commercially, they are expensive ($30,000), and different makes are incompatible with each other, making them unusable for interhospital image transfers. Standard components were added to a personal computer (PC) to build a functional teleradiology unit capable of interhospital image transmission at a low cost ($600 upgrade). This PC teleradiology system was studied to assess its accuracy in the interpretation of soft-tissue lateral neck x-rays with epiglottitis or retropharyngeal abscesses and elbow x-rays with joint effusions, fractures, or both. A radiologist and a pediatric emergency physician were asked to read the PC teleradiology images. Both physicians read 13 of 13 soft-tissue lateral neck x-rays and 15 of 15 elbow x-rays correctly. This study supports the premise that PC teleradiology can be used to facilitate telephone consultation and patient transfers between tertiary pediatric emergency centers by transmitting pertinent radiographic information over a phone line. Although verbal communication can often suffice in a telephone consultation or transfer, there are many instances when visualizing a radiographic image such as an x-ray or computed tomography scan can provide important information that cannot be optimally described verbally. Rural hospitals can form interhospital image transmission links with tertiary center resources. Tertiary centers may elect to organize interhospital image transmission and referral networks with their rural hospital sources.
尽管远程放射学系统已有商业产品,但它们价格昂贵(3万美元),而且不同品牌互不兼容,无法用于医院间的图像传输。在个人计算机(PC)上添加标准组件,构建了一个功能齐全的远程放射学设备,能够以低成本(600美元的升级费用)进行医院间的图像传输。对该PC远程放射学系统进行了研究,以评估其在解读伴有会厌炎或咽后脓肿的软组织颈部侧位X线片以及伴有关节积液、骨折或两者皆有的肘部X线片时的准确性。邀请了一位放射科医生和一位儿科急诊医生阅读PC远程放射学图像。两位医生正确解读了13张软组织颈部侧位X线片中的13张以及15张肘部X线片中的15张。这项研究支持了这样一个前提,即PC远程放射学可通过电话线传输相关放射影像信息,用于促进三级儿科急诊中心之间的电话会诊和患者转诊。尽管在电话会诊或转诊中口头交流通常就足够了,但在许多情况下,查看诸如X线片或计算机断层扫描等放射影像能够提供无法用言语充分描述的重要信息。农村医院可以与三级中心资源建立医院间图像传输链接。三级中心可以选择与它们的农村医院资源组织医院间图像传输和转诊网络。