REPORT OF A NATIONAL NEUROSURGICAL EMERGENCY TELECONSULTING SYSTEM

OBJECTIVE: The goal was to develop a low-cost, national, neurosurgical emergency teleconsulting system that is independent of vendor compute d tomographic (CT) or magnetic resonance imaging (MRI) scanner type. M ETHODS: Charge-coupled device scanners are used to digitize hard copie s of CT and MRI scans. An enhanced optical density range is achieved b y using an algorithm to fuse data from multiple exposures at different integration periods. The system is based on personal computers using Microsoft Windows 3.11. Data are transmitted on a wide-area network at 128 kilobits/s, over Integrated Systems Digital Network lines. The ne twork connects both neurosurgical departments in Ireland to all major hospitals with CT/MRI scanners. RESULTS: The scanner optical density i s 0.05 to 3.0, with 2.24 to 2.5 line pairs/mm. Five-megabyte images ar e transmitted uncompressed in 6 minutes. To date, more than 750 CT and MRI scans have been transmitted. The system is completely automated, and operator acceptance has been very high. Images are automatically s tored and displayed at the receiving workstation, where the images can be viewed and manipulated on-screen. This system has significantly en hanced acute neurosurgical patient care. CONCLUSION: The system is cos t effective and simple to use, has gained widespread physician accepta nce, and delivers an image quality superior to that of many commercial ly available systems.