Ultrasound General Staff and Image Quality

Review Meeting

February 16th 2011 5:30-7:00 IIBC

Agenda

Exam QA Tech scorecardNew exam codeBPPDocumentationWhat makes a good imageImage quality review

Exam QA Tech score card

Not tied to raises or evaluations. Scores are not being quantified or

compiled. Not part of yearly evaluations. Learning tool only. Help to identify trends. Can we learn something from the

comments and leave the rest.

New Exam Code

UABPVR ULTRASOUND ABDOMEN WITH POST VOID RESIDUAL CPT 76700

To include abdominal protocol with pre and post void bladder. No longer have the abdomen and renal charge at the same time.

Discussion.

Biophysical Profile Protocol

Cine clips for passing criteria only. No longer includes CX, Biometry or S/D

ratio’s AFI included, but use single vertical

pocket for passing or failing score. ( Greater than 2 cm normal)

Documentation

Remember to document all interaction or advice that we receive from a Radiologist regarding a case.

Notify PRA if the Radiologist was consulted or has protocoled an exam. The exam will need to be placed in their Q to be read.

Ovarian Cysts

Please review the protocol for pelvic US. It says to measure the outer wall to outer wall of ovarian cystic lesions. No one does. I am re-measuring them all, for years now. Thank you.

New generation versus old generation ovarian measurements.

RECENT COMMENTS FROM THE RADIOLOGISTS

• Several examples of incorrect or transposed measurements on the on line forms.• Fetus labeled breech in Viewpoint and was

actually vertex.• Severely growth delayed fetus not brought to the

Radiologists attention.• Need a sagittal image of the right kidney and

liver in the same image.• Poor cervix measurement.• 14 cm spleen not described as enlarged.

NO LIVER / KIDNEY IMAGES

FOV AND LANDMARKS

NEXT THREE SLIDES DESCRIBED AS POOR IMAGES OF CERVIX… SAME PATIENT

EXPECTED AGE 38 WEEKS

• IMPRESSION: • 1. Single live intrauterine fetus of 34 weeks, 1 day

average• ultrasound age. Interval growth is significantly less

than expected.• The estimated fetal weight is 2547 g.• 2. The fetus is in cephalic position. The amniotic fluid

volume is• subjectively low. The four-quadrant amniotic fluid

index is 9.9.

ExamplesViewPoint Workflow

GROUND RULES

You can’t cry

It’s not my fault….It’s Cubberley’ s

Fred probably was a stalker.

Ground Rules

Before you begin:

◦ Check order

◦ Check for and look at prior exams

◦ Reconfirm important information that the assistant has taken. Does everything make sense? Have the important questions been asked or over-looked?

Image Quality Review

Have we selected the proper preset?

Right probe?

Harmonics, Crossbeam, Both ?

Image Quality

Are cystic structures looking cystic?

Is the image balanced from top to bottom?

Does my image fill the screen, but not too much?

Image Quality During the Exam

Is there something odd in my image that is not associated with the structure that I’m looking at ?

Have I created a phantom mass somewhere in the image?

Do my pictures tell the story…because our history won’t.

Image Quality before hitting print