Skip to main content
Erschienen in: Skeletal Radiology 6/2024

02.12.2023 | Scientific Article

Axial T1-weighted imaging of the lumbar spine: a redundancy or an asset?

verfasst von: Ali Ghasemi, Rodrigo Luna, Arvin Kheterpal, Patrick Debs, Laura Fayad

Erschienen in: Skeletal Radiology | Ausgabe 6/2024

Einloggen, um Zugang zu erhalten

Abstract

Objective

To determine the diagnostic value of axial T1-weighted imaging for patients suffering from lower back pain.

Materials and methods

In this retrospective study, 100 consecutive lumbar spine MRIs obtained in patients with chronic low back pain were reviewed in two sessions: First, readers viewed core sequences (sagittal T1-weighted, STIR and T2-weighted, and axial T2-weighted) with axial T1-weighted sequences, and second, readers viewed cores sequences alone. Readers recorded the presence of disc degeneration, nerve root compromise, facet joint arthritis, and stenosis at each lumbar spine level as well as the presence of lipoma of filum terminale (LFT), spondylolisthesis, transitional vertebrae, and fractures. The McNemar, Wilcoxon signed-rank, and student T tests were utilized.

Results

For 100 studies, 5 spine levels were evaluated (L1–L2 through L5–S1). There were cases of disc disease (444/500 bulges, 56/500 herniations), nerve root compromise (1/500 nerve enlargement, 36/500 contact only, 20/500 displacement or compression), facet arthritis (438/500), stenosis (58/500 central canal, 64/500 lateral recess, 137/500 neuroforaminal), 6/100 LFTs, and other abnormalities (58/500 spondylolisthesis, 10/100 transitional vertebrae, 10/500 fracture/spondylolysis). There was no difference in diagnostic performance between the interpretation sessions (with and without axial T1-weighted imaging) at any level (p > 0.05), although four small additional LFTs were identified with axial T1-weighted imaging availability.

Conclusion

There was no clinically significant difference in the interpretation of lumbar spine MRI viewed with and without axial T1-weighted imaging, suggesting that the axial T1-weighted sequence does not add diagnostic value to routine lumbar spine MRI.
Literatur
1.
Zurück zum Zitat Wang L, Ye H, Li Z, Lu C, Ye J, Liao M, et al. Epidemiological trends of low back pain at the global, regional, and national levels. Eur Spine J. 2022;31(4):953–62.CrossRefPubMed Wang L, Ye H, Li Z, Lu C, Ye J, Liao M, et al. Epidemiological trends of low back pain at the global, regional, and national levels. Eur Spine J. 2022;31(4):953–62.CrossRefPubMed
2.
Zurück zum Zitat Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–47.CrossRefPubMed Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–47.CrossRefPubMed
3.
Zurück zum Zitat Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37.CrossRefPubMed Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37.CrossRefPubMed
4.
Zurück zum Zitat Chou R, Qaseem A, Owens DK, Shekelle P. Clinical Guidelines Committee of the American College of Physicians. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154(3):181–9.CrossRefPubMed Chou R, Qaseem A, Owens DK, Shekelle P. Clinical Guidelines Committee of the American College of Physicians. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154(3):181–9.CrossRefPubMed
6.
Zurück zum Zitat Essman M, Lin CY. The role of exercise in treating low back pain. Curr Sports Med Rep. 2022;21(8) Essman M, Lin CY. The role of exercise in treating low back pain. Curr Sports Med Rep. 2022;21(8)
7.
Zurück zum Zitat Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, et al. ACR Appropriateness criteria low back pain. J Am Coll Radiol. 2016;13(9):1069–78.CrossRefPubMed Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, et al. ACR Appropriateness criteria low back pain. J Am Coll Radiol. 2016;13(9):1069–78.CrossRefPubMed
8.
Zurück zum Zitat Czervionke LF, Berquist TH. Imaging of the spine. Techniques of MR imaging. Orthop Clin North Am. 1997;28(4):583–616.CrossRefPubMed Czervionke LF, Berquist TH. Imaging of the spine. Techniques of MR imaging. Orthop Clin North Am. 1997;28(4):583–616.CrossRefPubMed
9.
Zurück zum Zitat Zanchi F, Richard R, Hussami M, Monier A, Knebel J, Omoumi P. MRI of non-specific low back pain and/or lumbar radiculopathy: do we need T1 when using a sagittal T2-weighted Dixon sequence? Eur Radiol. 2020;30(5):2583–93.CrossRefPubMedPubMedCentral Zanchi F, Richard R, Hussami M, Monier A, Knebel J, Omoumi P. MRI of non-specific low back pain and/or lumbar radiculopathy: do we need T1 when using a sagittal T2-weighted Dixon sequence? Eur Radiol. 2020;30(5):2583–93.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Pfirrmann CWA, Dora C, Schmid MR, Zanetti M, Hodler J, Boos N. MR image-based grading of lumbar nerve root compromise due to disk herniation: reliability study with surgical correlation. Radiology. 2004;230(2):583–8.CrossRefPubMed Pfirrmann CWA, Dora C, Schmid MR, Zanetti M, Hodler J, Boos N. MR image-based grading of lumbar nerve root compromise due to disk herniation: reliability study with surgical correlation. Radiology. 2004;230(2):583–8.CrossRefPubMed
11.
Zurück zum Zitat Carrino JA, Lurie JD, Tosteson ANA, Tosteson TD, Carragee EJ, Kaiser J, et al. Lumbar spine: reliability of MR imaging findings. Radiology. 2009;250(1):161–70.CrossRefPubMed Carrino JA, Lurie JD, Tosteson ANA, Tosteson TD, Carragee EJ, Kaiser J, et al. Lumbar spine: reliability of MR imaging findings. Radiology. 2009;250(1):161–70.CrossRefPubMed
12.
Zurück zum Zitat Miskin N, Gaviola GC, Huang RY, Kim CJ, Lee TC, Small KM, et al. Intra- and intersubspecialty variability in lumbar spine MRI interpretation: a multireader study comparing musculoskeletal radiologists and neuroradiologists. Curr Probl Diagn Radiol. 2020;49(3):182–7.CrossRefPubMed Miskin N, Gaviola GC, Huang RY, Kim CJ, Lee TC, Small KM, et al. Intra- and intersubspecialty variability in lumbar spine MRI interpretation: a multireader study comparing musculoskeletal radiologists and neuroradiologists. Curr Probl Diagn Radiol. 2020;49(3):182–7.CrossRefPubMed
13.
Zurück zum Zitat Li Y, Fredrickson V, Resnick DK. How should we grade lumbar disc herniation and nerve root compression? A systematic review. Clin Orthop Relat Res. 2015;473(6):1896–902.CrossRefPubMed Li Y, Fredrickson V, Resnick DK. How should we grade lumbar disc herniation and nerve root compression? A systematic review. Clin Orthop Relat Res. 2015;473(6):1896–902.CrossRefPubMed
14.
Zurück zum Zitat Doktor K, Jensen TS, Christensen HW, Fredberg U, Kindt M, Boyle E, et al. Degenerative findings in lumbar spine MRI: an inter-rater reliability study involving three raters. Chiropr Man Therap. 2020;28(1):8.CrossRefPubMedPubMedCentral Doktor K, Jensen TS, Christensen HW, Fredberg U, Kindt M, Boyle E, et al. Degenerative findings in lumbar spine MRI: an inter-rater reliability study involving three raters. Chiropr Man Therap. 2020;28(1):8.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Kuittinen P, Sipola P, Aalto TJ, Määttä S, Parviainen A, Saari T, et al. Correlation of lateral stenosis in MRI with symptoms, walking capacity and EMG findings in patients with surgically confirmed lateral lumbar spinal canal stenosis. BMC Musculoskelet Disord. 2014;23(15):247.CrossRef Kuittinen P, Sipola P, Aalto TJ, Määttä S, Parviainen A, Saari T, et al. Correlation of lateral stenosis in MRI with symptoms, walking capacity and EMG findings in patients with surgically confirmed lateral lumbar spinal canal stenosis. BMC Musculoskelet Disord. 2014;23(15):247.CrossRef
16.
Zurück zum Zitat Lee S, Lee JW, Yeom JS, Kim K, Kim H, Chung SK, et al. A practical MRI grading system for lumbar foraminal stenosis. AJR Am J Roentgenol. 2010;194(4):1095–8.CrossRefPubMed Lee S, Lee JW, Yeom JS, Kim K, Kim H, Chung SK, et al. A practical MRI grading system for lumbar foraminal stenosis. AJR Am J Roentgenol. 2010;194(4):1095–8.CrossRefPubMed
17.
Zurück zum Zitat Sayah A, Jay AK, Toaff JS, Makariou EV, Berkowitz F. Effectiveness of a rapid lumbar spine MRI protocol using 3D T2-weighted SPACE imaging versus a standard protocol for evaluation of degenerative changes of the lumbar spine. AJR Am J Roentgenol. 2016;207(3):614–20.CrossRefPubMed Sayah A, Jay AK, Toaff JS, Makariou EV, Berkowitz F. Effectiveness of a rapid lumbar spine MRI protocol using 3D T2-weighted SPACE imaging versus a standard protocol for evaluation of degenerative changes of the lumbar spine. AJR Am J Roentgenol. 2016;207(3):614–20.CrossRefPubMed
18.
Zurück zum Zitat Shah LM, Hanrahan CJ. MRI of spinal bone marrow: part 1, techniques and normal age-related appearances. Am J Roentgenol. 2011;197(6):1298–308.CrossRef Shah LM, Hanrahan CJ. MRI of spinal bone marrow: part 1, techniques and normal age-related appearances. Am J Roentgenol. 2011;197(6):1298–308.CrossRef
19.
Zurück zum Zitat Vargas MI, Boto J, Meling TR. Imaging of the spine and spinal cord: an overview of magnetic resonance imaging (MRI) techniques. Rev Neurol (Paris). 2021 May;177(5):451–8.CrossRefPubMed Vargas MI, Boto J, Meling TR. Imaging of the spine and spinal cord: an overview of magnetic resonance imaging (MRI) techniques. Rev Neurol (Paris). 2021 May;177(5):451–8.CrossRefPubMed
21.
Zurück zum Zitat Cools MJ, Al-Holou WN, Stetler WRJ, Wilson TJ, Muraszko KM, Ibrahim M, et al. Filum terminale lipomas: imaging prevalence, natural history, and conus position. J Neurosurg Pediatr. 2014;13(5):559–67.CrossRefPubMed Cools MJ, Al-Holou WN, Stetler WRJ, Wilson TJ, Muraszko KM, Ibrahim M, et al. Filum terminale lipomas: imaging prevalence, natural history, and conus position. J Neurosurg Pediatr. 2014;13(5):559–67.CrossRefPubMed
22.
Zurück zum Zitat Al-Omari M, Eloqayli HM, Qudseih HM, Al-shinag M. Isolated lipoma of filum terminale in adults: MRI findings and clinical correlation. J Med Imaging Radiat Oncol. 2011;55(3):286–90.CrossRefPubMed Al-Omari M, Eloqayli HM, Qudseih HM, Al-shinag M. Isolated lipoma of filum terminale in adults: MRI findings and clinical correlation. J Med Imaging Radiat Oncol. 2011;55(3):286–90.CrossRefPubMed
23.
Zurück zum Zitat Winklhofer S, Held U, Burgstaller JM, Finkenstaedt T, Bolog N, Ulrich N, et al. Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters. Eur Spine J. 2017;26(2):353–61.CrossRefPubMed Winklhofer S, Held U, Burgstaller JM, Finkenstaedt T, Bolog N, Ulrich N, et al. Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters. Eur Spine J. 2017;26(2):353–61.CrossRefPubMed
24.
Zurück zum Zitat Fu MC, Buerba RA, Long WD3, Blizzard DJ, Lischuk AW, Haims AH, et al. Interrater and intrarater agreements of magnetic resonance imaging findings in the lumbar spine: significant variability across degenerative conditions. Spine J. 2014;14(10):2442–8.CrossRefPubMed Fu MC, Buerba RA, Long WD3, Blizzard DJ, Lischuk AW, Haims AH, et al. Interrater and intrarater agreements of magnetic resonance imaging findings in the lumbar spine: significant variability across degenerative conditions. Spine J. 2014;14(10):2442–8.CrossRefPubMed
25.
Zurück zum Zitat Sherwood D, Haring RS, Schirmer D, Modic M. The interrater reliability of Modic changes among a potential basivertebral nerve ablation population: why AC1 may be preferred to kappa. J Orthop Res. 2023;41(5):1123–30.CrossRefPubMed Sherwood D, Haring RS, Schirmer D, Modic M. The interrater reliability of Modic changes among a potential basivertebral nerve ablation population: why AC1 may be preferred to kappa. J Orthop Res. 2023;41(5):1123–30.CrossRefPubMed
26.
Zurück zum Zitat Banitalebi H, Espeland A, Anvar M, Hermansen E, Hellum C, Brox JI, et al. Reliability of preoperative MRI findings in patients with lumbar spinal stenosis. BMC Musculoskelet Disord. 2022;23(1):51–4.CrossRefPubMedPubMedCentral Banitalebi H, Espeland A, Anvar M, Hermansen E, Hellum C, Brox JI, et al. Reliability of preoperative MRI findings in patients with lumbar spinal stenosis. BMC Musculoskelet Disord. 2022;23(1):51–4.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Kaliya-Perumal A, Ariputhiran-Tamilselvam S, Luo C, Thiagarajan S, Selvam U, Sumathi-Edirolimanian R. Revalidating Pfirrmann’s magnetic resonance image-based grading of lumbar nerve root compromise by calculating reliability among orthopaedic residents. Clin Orthop Surg. 2018;10(2):210–5.CrossRefPubMedPubMedCentral Kaliya-Perumal A, Ariputhiran-Tamilselvam S, Luo C, Thiagarajan S, Selvam U, Sumathi-Edirolimanian R. Revalidating Pfirrmann’s magnetic resonance image-based grading of lumbar nerve root compromise by calculating reliability among orthopaedic residents. Clin Orthop Surg. 2018;10(2):210–5.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Weber C, Rao V, Gulati S, Kvistad KA, Nygaard ØP, Lønne G. Inter- and intraobserver agreement of morphological grading for central lumbar spinal stenosis on magnetic resonance imaging. Global Spine J. 2015;5(5):406–10.CrossRefPubMedPubMedCentral Weber C, Rao V, Gulati S, Kvistad KA, Nygaard ØP, Lønne G. Inter- and intraobserver agreement of morphological grading for central lumbar spinal stenosis on magnetic resonance imaging. Global Spine J. 2015;5(5):406–10.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat O’Brien JJ, Stormann J, Roche K, Cabral-Goncalves I, Monks A, Hallett D, et al. Optimizing MRI logistics: focused process improvements can increase throughput in an Academic Radiology Department. Am J Roentgenol. 2017;208(2):W38–44.CrossRef O’Brien JJ, Stormann J, Roche K, Cabral-Goncalves I, Monks A, Hallett D, et al. Optimizing MRI logistics: focused process improvements can increase throughput in an Academic Radiology Department. Am J Roentgenol. 2017;208(2):W38–44.CrossRef
30.
Zurück zum Zitat Koontz NA. Wiggins RH3, Mills MK, McLaughlin MS, Pigman EC, Anzai Y, et al. Less is more: efficacy of rapid 3D-T2 SPACE in ED patients with acute atypical low back pain. Acad Radiol. 2017;24(8):988–94.CrossRefPubMed Koontz NA. Wiggins RH3, Mills MK, McLaughlin MS, Pigman EC, Anzai Y, et al. Less is more: efficacy of rapid 3D-T2 SPACE in ED patients with acute atypical low back pain. Acad Radiol. 2017;24(8):988–94.CrossRefPubMed
31.
Zurück zum Zitat Sollmann N, Rüther C, Schön S, Zimmer C, Baum T, Kirschke JS. Implementation of a sagittal T2-weighted DIXON turbo spin-echo sequence may shorten MRI acquisitions in the emergency setting of suspected spinal bleeding. Eur Radiol Exp. 2021;5(1):19–5.CrossRefPubMedPubMedCentral Sollmann N, Rüther C, Schön S, Zimmer C, Baum T, Kirschke JS. Implementation of a sagittal T2-weighted DIXON turbo spin-echo sequence may shorten MRI acquisitions in the emergency setting of suspected spinal bleeding. Eur Radiol Exp. 2021;5(1):19–5.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Yang S, Lassalle L, Mekki A, Appert G, Rannou F, Nguyen C, et al. Can T2-weighted Dixon fat-only images replace T1-weighted images in degenerative disc disease with Modic changes on lumbar spine MRI? Eur Radiol. 2021;31(12):9380–9.CrossRefPubMed Yang S, Lassalle L, Mekki A, Appert G, Rannou F, Nguyen C, et al. Can T2-weighted Dixon fat-only images replace T1-weighted images in degenerative disc disease with Modic changes on lumbar spine MRI? Eur Radiol. 2021;31(12):9380–9.CrossRefPubMed
33.
Zurück zum Zitat Saifuddin A, Rajakulasingam R, Santiago R, Siddiqui M, Khoo M, Pressney I. Comparison of lumbar degenerative disc disease using conventional fast spin echo T(2)W MRI and T(2) fast spin echo dixon sequences. Br J Radiol. 2021;94(1121):20201438.CrossRefPubMedPubMedCentral Saifuddin A, Rajakulasingam R, Santiago R, Siddiqui M, Khoo M, Pressney I. Comparison of lumbar degenerative disc disease using conventional fast spin echo T(2)W MRI and T(2) fast spin echo dixon sequences. Br J Radiol. 2021;94(1121):20201438.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Rafiee F, Mehan WA, Rincon S, Rohatgi S, Rapalino O, Buch K. Diagnostic utility of 3D gradient-echo MR imaging sequences through the filum compared with spin-echo T1 in children with concern for tethered cord. AJNR Am J Neuroradiol. 2023;44(3):323–7.CrossRefPubMedPubMedCentral Rafiee F, Mehan WA, Rincon S, Rohatgi S, Rapalino O, Buch K. Diagnostic utility of 3D gradient-echo MR imaging sequences through the filum compared with spin-echo T1 in children with concern for tethered cord. AJNR Am J Neuroradiol. 2023;44(3):323–7.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Chazen JL, Tan ET, Fiore J, Nguyen JT, Sun S, Sneag DB. Rapid lumbar MRI protocol using 3D imaging and deep learning reconstruction. Skeletal Radiol. 2023;52(7):1331–8.CrossRefPubMed Chazen JL, Tan ET, Fiore J, Nguyen JT, Sun S, Sneag DB. Rapid lumbar MRI protocol using 3D imaging and deep learning reconstruction. Skeletal Radiol. 2023;52(7):1331–8.CrossRefPubMed
36.
Zurück zum Zitat Fujiwara M, Kashiwagi N, Matsuo C, Watanabe H, Kassai Y, Nakamoto A, et al. Ultrafast lumbar spine MRI protocol using deep learning-based reconstruction: diagnostic equivalence to a conventional protocol. Skeletal Radiol. 2023;52(2):233–41.CrossRefPubMed Fujiwara M, Kashiwagi N, Matsuo C, Watanabe H, Kassai Y, Nakamoto A, et al. Ultrafast lumbar spine MRI protocol using deep learning-based reconstruction: diagnostic equivalence to a conventional protocol. Skeletal Radiol. 2023;52(2):233–41.CrossRefPubMed
37.
Zurück zum Zitat Oei MW, Evens AL, Bhatt AA, Garner HW. Imaging of the aging spine. Radiol Clin North Am. 2022;60(4):629–40.CrossRefPubMed Oei MW, Evens AL, Bhatt AA, Garner HW. Imaging of the aging spine. Radiol Clin North Am. 2022;60(4):629–40.CrossRefPubMed
38.
Zurück zum Zitat Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. 2015;36(4):811.CrossRefPubMedPubMedCentral Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. 2015;36(4):811.CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Rosman DA, Duszak R, Wang W, Hughes DR, Rosenkrantz AB. Changing utilization of noninvasive diagnostic imaging over 2 decades: an examination family–focused analysis of medicare claims using the Neiman imaging types of service categorization system. Am J Roentgenol. 2018;210(2):364–8.CrossRef Rosman DA, Duszak R, Wang W, Hughes DR, Rosenkrantz AB. Changing utilization of noninvasive diagnostic imaging over 2 decades: an examination family–focused analysis of medicare claims using the Neiman imaging types of service categorization system. Am J Roentgenol. 2018;210(2):364–8.CrossRef
40.
Zurück zum Zitat D’Aprile P, Nasuto M, Tarantino A, Cornacchia S, Guglielmi G, Jinkins JR. Magnetic resonance imaging in degenerative disease of the lumbar spine: fat saturation technique and contrast medium. Acta Biomed. 2018;89(1-S):208–19.PubMedPubMedCentral D’Aprile P, Nasuto M, Tarantino A, Cornacchia S, Guglielmi G, Jinkins JR. Magnetic resonance imaging in degenerative disease of the lumbar spine: fat saturation technique and contrast medium. Acta Biomed. 2018;89(1-S):208–19.PubMedPubMedCentral
Metadaten
Titel
Axial T1-weighted imaging of the lumbar spine: a redundancy or an asset?
verfasst von
Ali Ghasemi
Rodrigo Luna
Arvin Kheterpal
Patrick Debs
Laura Fayad
Publikationsdatum
02.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 6/2024
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-023-04522-1

Weitere Artikel der Ausgabe 6/2024

Skeletal Radiology 6/2024 Zur Ausgabe

Test Yourself: Question

Question—painful index finger

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.