gms | German Medical Science

Particularly in rural areas, neurosurgical units serve a large geographic area and unnecessary transfers of patients should be avoided e.g. by means of teleradiology. To evaluate the usefulness, reliability and limits of image transfers utilizing mobile phones in neurosurgical emergencies a prospective study was carried out.

Neurosurgical teleconsulting was performed in cooperation with 8 referring regional hospitals from 04/2004 to 12/2004. Mobile phones with a build-in 300000 pixel digital camera were provided and up to 5 pictures of CT scans, MRI or plain x-rays were sent via GPRS to the neurosurgeon on call. Correspondance between the registrar and the consultant was backed up by mobile image transfer likewise. A standardized protocol was used to query clinical data and a questionnaire was filled out to document time of image transfer, quality of data, technical errors and clinical decision making.

105 photo messages were sent in 72 cases of intracerebral hemorrhages or SAH (46%), head injuries (19%) cerebral ischemia (6%) or other neurosurgical disorders like acute hydrocephalus or intracranial tumors. Almost all picture transfers were performed without errors and in only two cases was image messaging useless due to poor data quality. Communication time varied from 2 to 8 minutes and the best contrast was achieved with hemorrhages in CT scans. In 46% of cases unnecessary patient transfers could be avoided in vew of the clinical information.

Mobile phone-supported image transfer is useful in neurosurgical teleconsulting and can be applied in clinical practice with a small expenditure of time and cost. Limitations of image quality and restricted picture selection will be revised by advanced telecommunication technologies.