THE EFFECT OF PACS ON THE VISUALIZATION OF THE LATERAL CERVICAL-SPINEAND THE MANAGEMENT OF PATIENTS PRESENTING WITH TRAUMA

In patients presenting with trauma, early diagnosis of neck injuries i s likely to affect long-term outcome. This paper reports a study that compared lateral images of the cervical spine produced by a Picture Ar chiving and Communication System (PACS) with the same images produced using computed radiography (CR). The study was undertaken at the Hamme rsmith Hospital, London. Data were collected on 100 patients who prese nted with trauma. Both soft copy (PACS) and hard copy (CR) images of t he cervical spine were produced for each patient from the same radiogr aphic exposure. The images were viewed by five clinical members of the Accident and Emergency Department. Data were collected on the level o f the cervical spine that could be viewed, the clinical management fol lowing the viewing of the image and the use of PACS 'tools'. Overall n o statistically significant differences between modalities were found in the level of visualization. Within viewer differences were found fo r three viewers: one indicating better visualization with PACS and two indicating better visualization with CR. The results relating to pati ent management indicate greater clinician confidence following the vie wing of PACS images for two viewers. The use of PACS 'tools' improved visualization of the cervical spine for one viewer.