Barneradiologi i Norge per 2013
Student paper, others
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During the past 50 years we have experienced a significant development in radiology, with the introduction of ultrasound during the 70-ties, CT during the 80-ties and MRI during the 90-ties. According to the most recent national survey, we performed around 4.3 mill examinations during 2008, of which 21 % were CTs. The importance of a child specific imaging approach has been addressed in a recent paper, showing a high rate of major disagreements between interpretations of pediatric imaging studies by generalist community radiologists and those of specialty radiologists at a tertiary care pediatric hospital. Notably, there was a significant correlation between the second opinion interpretations and the final diagnoses, thus assuming a crucial role in patient management. The major disagreement rates of 14.3 % and 32.6 % for neurologic and body examinations, respectively, encompassed conditions such as fractures, appendicitis, and epidural hemorrhage, all of which imply substantial alterations in management and prognosis. We aimed at examining the status for pediatric imaging in Norway. Material and Methods: We performed a questionnaire among Norwegian radiologists (all members of the Norwegian College of Radiology (NFR), addressing issues on pediatric radiology using the program SurveyMonkey. The questionnaire was custom made, with input from the Norwegian General Medical Council, Research Institute, and the Norwegian Society of Pediatric Radiology. It included 25 questions on organization of radiology departments, number of substantial posts/pediatric radiologists and examinations as well as questions on child friendliness. In cases of more than one responder from each hospital, we selected the most completely answered form. Results: We received an answer from 49 out of the 69 (71.0 %) invited hospitals/institutions; sent by 83 of the 700 invited radiologists (11.9%, 45% women) 42 of 49 (%) state hospitals answered; 9 university hospitals, 19 large hospitals (≥5 consultant radiologists) and 14 small hospitals. 10 out of 42 (23.8 %) radiology departments, including 8 of the university hospitals, had separate sections for pediatric radiology. Two hospitals in Oslo had on-call-rotas including a pediatric radiologist whilst for the remainder 40 hospitals, children were examined by generalists during evening, nights and weekends. At daytime, 25.6 % of the pediatric examinations were performed by pediatric radiographers and radiologists. Two out of the 10 sections for pediatric radiology focused on research and development. 26 out of 42 (61.9 %) radiology departments provided numbers of pediatric examinations (<14 years) during 2011 (n=155 797), representing a mean of 8.7 % of the total numbers. Clinicians in 7 of the 42 hospitals performed some imaging, particularly ultrasound scans, thus without documentation stored in the PACS systems. 41 of 42 radiology departments (97.6 %) had specific protocols for children, while 37 of 42 (88.1 %) departments answered that their department was not particularly well equipped for pediatric examinations. In four departments, CT was frequently performed due to lack of MRI, while this occasionally was the case in 22 hospitals. Conclusion: The results are alarming; more so amongst pediatric radiologists than institutional managers emphasizing economic and leadership principles, and should fuel our efforts to enhance education and research within this field.
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