For adequate assessment of CT or MRI scans digital data (DICOM), which provide better quality and allows post processing of the images, should be obtained. In community hospitals and even more important in stroke centres large monitors with a high resolution are needed [21]. After every single teleconsultation a written report should be sent to the remote hospital and be preserved just like the standards for in-patient documents. To date more than 6000 Nutlin-3 in vivo patients suffering from stroke have been treated in the 15 hospitals of the TEMPiS-network every year. Meanwhile the TEMPiS has emerged from a scientific stroke

research project to regular patient care, and the health insurances cover the costs by reimbursing the remote hospitals, which in turn finance the costs of the consulting stroke centres. Since 2003, more than 25,000 teleconsultations have been performed and more than 2200 patients received thrombolysis. In Germany

today the percentage of acute stroke patients receiving rtPA is about 10 percent (www.dsg-info.de), whereas in the TEMPiS network it is 13.8%. In addition, the TEMPiS-network not only provides telemedical advice. The ongoing stroke education, provided to the network hospitals due to on-site visits with ward rounds, standardised clinical procedures, actualised every year and updates, performed twice a year in order to update SCH727965 mw knowledge concerning new therapeutic options. The network also provides training courses for

young clinicians in network hospitals regarding acute stroke therapy. Hereby face-to-face contact is facilitated, which lowers the barriers to requests for a teleconsultation and transports stroke knowledge in both directions. Quality assurance is given by follow-up presentations in critical patients. But not only rtPA treatment in acute stroke is improved in rural areas. As there are new options SSR128129E in acute stroke therapy like neuroradiological interventions as thrombectomy and treatment of complications like hemicraniectomy in malignant infarctions, therapies just available in specialised stroke centres, patients in rural areas can profit from telemedic networks as well. Due to the videoconference and assessment of CT and MRI images patients requiring more than standard stroke care can be identified and transferred to stroke centres with the opportunity to provide these therapeutic options. In summary, only a minority of stroke patients all over Europe receive thrombolytic and specialised stroke unit therapy. Due to telemedic approaches like the TEMPiS-network, patients, especially in rural areas can now receive highly specialized stroke treatment. Therefore a high quality of the technical equipment is needed and beside the teleconsultations a continuous training should be performed to achieve high quality. “
“Ultrasound fusion is an emerging technique in the field of abdominal imaging with translation possibilities to neuroradiology.