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The classic radiologic teaching file consists of hundreds, if not thousands, of films of various ages, housed in paper jackets with brief descriptions written on the jackets. The development of a good teaching file has been both time consuming and voluminous. Also, any radiograph to be copied was unavailable during the reproduction interval, inconveniencing other medical professionals needing to view the images at that time. These factors hinder motivation to copy films of interest. If a busy radiologist already has an adequate example of a radiological manifestation, it is unlikely that he or she will exert the effort to make a copy of another similar image even if a better example comes along. Digitized radiographs stored on CD-ROM offer marked improvement over the copied film teaching files. Our institution has several laser digitizers which are used to rapidly scan radiographs and produce high quality digital images which can then be converted into standard microcomputer (IBM, Mac, etc.) image format. These images can be stored on floppy disks, hard drives, rewritable optical disks, recordable CD-ROM disks, or removable cartridge media. Most hospital computer information systems include radiology reports in their database. We demonstrate that the reports for the images included in the users teaching file can be copied and stored on the same storage media as the images. The radiographic or sonographic image and the corresponding dictated report can then be 'linked' together. The description of the finding or findings of interest on the digitized image is thus electronically tethered to the image. This obviates the need to write much additional detail concerning the radiograph, saving time. In addition, the text on this disk can be indexed such that all files with user specified features can be instantly retrieve and combined in a single report, if desired. With the use of newer image compression techniques, hundreds of cases may be stored on a single CD-ROM depending on the quality of image required for the finding in question. This reduces the weight of a teaching file from that of a baby elephant to that of a single CD-ROM disc. Thus, with this method of teaching file preparation and storage the following advantages are realized: (1) Technically easier and less time consuming image reproduction. (2) Considerably less unwieldy and substantially more portable teaching files. (3) Novel ability to index files and then retrieve specific cases of choice based on descriptive text.
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