Panos Prassopoulos

Over a 10-week period, 38 third-year medical students participated in an online course integrated into a basic breast ultrasound workshop. The primary objective of this article is to comprehensively assess the impact of the online self-directed training phase. In the experimental group, students engaged with a curated selection of publicly available audiovisual resources sourced from Instagram®, while the control group followed traditional instruction through conventional masterclasses using PowerPoint presentations. The experimental hypothesis posited that foundational breast ultrasound skills could be effectively acquired through the exploration of public Instagram content combined with self-assessment via Kahoot®. In this context, Kahoot® served not only as the platform for disseminating Instagram-related topics and links but also as a tool for ongoing formative assessments within the experimental group. A quasi-experimental design was employed, incorporating pre- and post-assessments and a control group for comparison. The findings demonstrated significant gains in both knowledge and confidence among students exposed to the gamified, Instagram-based intervention. Specifically, in the domain of Histology and Anatomy, the experimental group improved their post-test scores from 6.68 to 8.68, whereas the control group’s scores increased from 4.47 to 5.14. Regarding ultrasound physics knowledge, the experimental group's scores rose from 6.26 to 7.74, in contrast to an increase from 4.17 to 4.90 in the control group. In terms of understanding normal breast anatomy, the experimental group achieved a post-test score of 6.83, while the control group improved from 4.79 to 6.79. Moreover, the experimental group demonstrated a marked improvement in their ability to identify benign and suspicious breast findings. Self-assessment data indicated enhanced confidence in ultrasound skills among experimental group participants, who also reported high levels of enthusiasm for the program, reflected in an average satisfaction rating of 4.63 out of 5. This elevated satisfaction may contribute to increased program visibility and future enrollment. Despite these encouraging results, the limited sample size (19 participants per group) restricts the generalizability of the findings. Future research should involve larger sample sizes and longitudinal designs to better evaluate knowledge retention and the long-term impact of social media platforms on medical education. Durante 10 semanas, 38 estudiantes de medicina de tercer año participaron en un curso en línea como parte de un taller básico de ultrasonido mamario. Este artículo evalúa los efectos de la fase de autoformación en línea. Un grupo experimental utilizó recursos audiovisuales curados de Instagram®, mientras que un grupo de control continuó con clases magistrales tradicionales. La hipótesis se centró en el aprendizaje del ultrasonido mamario básico a través de material público de Instagram y autoevaluaciones mediante Kahoot®, que facilitó tanto la entrega de contenido como evaluaciones continuas para el grupo experimental.El diseño del estudio fue cuasi-experimental, utilizando evaluaciones pre y post y grupos de control. Se encontraron mejoras significativas en el conocimiento y la confianza de los estudiantes que usaron intervenciones gamificadas basadas en Instagram. En cuanto al conocimiento de histología y anatomía, el grupo experimental aumentó sus puntajes de post-prueba de 6.68 a 8.68, mientras que el grupo de control mejoró de 4.47 a 5.14. En conocimiento de física del ultrasonido, el grupo experimental pasó de 6.26 a 7.74, en contraste con el aumento del grupo de control de 4.17 a 4.90. En la comprensión de la anatomía mamaria normal, el grupo experimental alcanzó 6.83 en la post-prueba, mientras que el grupo de control subió a 6.79 desde 4.79. Además, el grupo experimental mostró confianza mejorada en sus habilidades de ultrasonido, con una alta puntuación media de satisfacción de 4.63/5. A pesar de estos hallazgos positivos, el pequeño tamaño de muestra (19 participantes por grupo) limita extrapolar, sugiriendo que futuros estudios deberían incorporar grupos más grandes y diseños longitudinales para investigar la retención del conocimiento y el impacto de las plataformas de redes sociales en la educación médica.

Aim To investigate whether linear measurements or ratios on the Graf's "standard plane" ultrasound images of the neonatal/infantile hip, can support the clinically important differentiation between type I and type II hips. Material and methods A total of 60 Graf type II hips and 124 randomly selected Graf type I hips, matched to the gestational age at delivery, birth weight, delivery mode, and age at the time of the examination, were identified through our hip screening service, during a period of two years. The images were diagnostically suitable, following anatomical identification and usability check, according to Graf. Anatomical landmarks including the lower limb of the os ilium, the bony rim, the silhouette of the os ilium, the labrum and the femoral head's borders, were used to determine the measurements and ratios which quantified their inter-relationships. Results The indices which differed significantly between type I and type II hips included: (a) the width of the "bony roof" (cut-off value 5.91 mm, sensitivity: 75%, specificity: 70%), (b) the ratio of the width of the "bony roof" to the femoral head's width (cut-off value 0.40, sensitivity 83%, specificity 71%), and (c) the ratio of the cartilaginous acetabular roof's width (including the labrum), to the width of the femoral head (cut-off value 0.450, sensitivity 82%, specificity 67%). Conclusions Newly introduced measurements and calculated ratios on "standard plane" ultrasound images can be used as additional indices in the differentiation between Graf's types of "centered hips", thus increasing the diagnostic certainty of the examiner in borderline cases and limiting unnecessary re-examinations or treatment.

The evolution of ultrasound (US) techniques has greatly improved the evaluation of many parameters in dialysis vascular access, which is typically achieved through an arteriovenous fistula (AVF) or graft (AVG). These techniques include grayscale B-mode, color Doppler, power Doppler, spectral Doppler, non-Doppler US flow imaging techniques, contrast-enhanced US, and elastography. In conjunction with a patient’s medical history and physical examination, US provides crucial information about the native vascular bed prior to the surgical creation of an arteriovenous anastomosis. It also tracks the maturation progress of the newly created AVF or AVG and aids in diagnosing potential complications of the vascular access. These complications include thrombosis, steal syndrome, aneurysms, pseudoaneurysms, hematomas, infection, ischemic neuropathy, exacerbation of preexisting congestive heart failure, and stenosis.

Primary adenocarcinomas of the appendix are uncommon. Mucoceles that result from mucinous adenocarcinomas of the appendix may be incidentally detected on imaging. A case of a mucocele of the appendix, due to cystadenocarcinoma, is presented as an incidental imaging finding in a female, 86-year-old patient. The patient was admitted due to rectal hemorrhage and underwent colonoscopy, x-ray, US and CT. Adenocarcinoma of the ascending colon, adenomatous polyp of the sigmoid colon and a cystic lesion in the right iliac fossa were diagnosed. The cystic lesion was characterized as mucocele. The patient underwent right hemicolectomy, excision of the mucocele and sigmoidectomy. She recovered well and in two-year follow-up is free from cancer. Preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management, but it is difficult on imaging studies. Small lymph nodes or soft tissue stranding in the surrounding fat on computed tomography examination may suggest the possibility of malignancy.

Background: The purpose of the current study was to optimize a gadolinium-barium sulfate solution suitable for performing conventional and MR enteroclysis examinations in the same session. Methods: Eighteen vials of 20% barium sulfate and various gadolinium concentrations (lower 0 ml/lt, higher 45 ml/lt) were prepared and placed in the magnet. The imaging protocol was consisted of the following sequences: true FISP, HASTE with fat saturation and 3d FLASH with fat saturation in various flip angles. Ten patients underwent conventional enteroclysis with 1.2 lt of 20% barium sulfate enema and 18 ml of gadolinium. MR enteroclysis was performed afterwards using true FISP, fat suppressed 3d FLASH and fat suppressed HASTE sequences. Results: The lowest gadolinium concentration in the barium sulfate solution generating low intraluminal signal on HASTE and high intraluminal signal on true FISP and 3d FLASH sequences was 15 ml/lt. The presence of gadolinium did not influence the lumen opacification in conventional enteroclysis examination. In all patients the proposed contrast medium acted as positive in 3d FLASH (T1w), true FISP (T2/T1 w) and as a negative in HASTE (T2w). Bowel wall conspicuity, lumen opacification and distention were ranked as very good to excellent on MR enteroclysis images while artifacts level did not downgraded the overall image quality. High quality virtual MR endoluminal views of the small bowel, based on 3d FLASH images, were obtained in all cases. Conclusion: A 20% barium sulfate enema with 15 ml/lt gadolinium is appropriate for conventional and MR enteroclysis examinations.

Preoperative diagnosis and staging of primary gastrointestinal (GI) neoplasms are challenges for both clinicians and radiologists. Barium studies are very sensitive in disclosing primary malignancies, even at an early stage. Radiologic signs depend on the evolutional stage of the disease and its appearance on gross pathology. A neoplasm may be manifested on barium studies by a wide spectrum of findings, including mucosal abnormalities, mass presence, ulcerative lesions, submucosal infiltration, and lumen stenosis. Advanced disease can be accurately diagnosed, whereas early cancer should be differentiated from other neoplastic or inflammatory disorders by meticulous analysis of radiologic findings. The extent of GI involvement and multiplicity of the lesions can be assessed on barium studies. In the staging of GI neoplasms, barium studies are of little value. Skeletal survey by conventional radiographs and chest plain films can reveal distant metastases in a short time and with low cost, although they are not that sensitive to the detection of early or subtle lesions. The exact role of conventional radiology in the imaging workup of GI malignancies depends on local expertise and availability of other diagnostic techniques and modalities. Semin. Surg. Oncol. 20:91–108, 2001.