Current problems in diagnostic radiology
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Curr Probl Diagn Radiol · Jul 2006
ReviewPositron emission tomography/computed tomography in the management of Hodgkin's disease and non-Hodgkin's lymphoma.
The incidence of Hodgkin's disease (HD) and Non-Hodgkin's lymphoma (NHL) is around 8% of all malignancies. Fortunately, HD and NHL are among the few malignancies that are potentially curable with current existing treatment modalities, even in advanced or recurrent disease. Accurate staging, early therapy monitoring, and posttreatment evaluation of lymphomas are important for optimum management of these patients. ⋯ Pitfalls and diagnostic difficulties are analyzed. PET/CT is a new imaging technology that improves the evaluation of lymphoma. This review will help the reader to better understand the imaging findings and applications of PET/CT in the management of lymphoma.
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Curr Probl Diagn Radiol · Mar 2004
Magnetic resonance imaging of osteoarticular infections in children.
Magnetic resonance imaging has become a common tool for the diagnosis and management of osteoarticular infections in children. We retrospectively review the MRI findings in 57 children (age range 4 months to 16 years; mean 6.3 years) diagnosed with osteoarticular infection. Thirty-eight cases were osteomyelitis, 4 were septic arthritis, 6 were spondylodiscitis, 7 were soft-tissue infections, 2 were pyomyositis, and 2 were chronic multifocal osteomyelitis. ⋯ Currently available imaging techniques are reviewed, and advantages and disadvantages are discussed. Magnetic resonance imaging indications and findings are shown. The most adequate magnetic resonance imaging sequences, as well as the usefulness of intravenous contrast material, are stressed.
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Curr Probl Diagn Radiol · May 2002
ReviewMagnetic resonance imaging of intraspinal cystic lesions: a pictorial review.
Magnetic resonance imaging is the imaging modality of choice for the evaluation of diseases of the spinal cord and its coverings primarily because of improved lesion detection and characterization. The differentiation of intramedullary pathologic conditions (arising within the spinal cord) from extramedullary lesions (lying either within the thecal sac (intradural) or outside it (extradural) is usually straightforward. ⋯ This pictorial review discusses the imaging findings and distinguishing features of a variety of intramedullary and extramedullary intraspinal cystic lesions with the use of magnetic resonance imaging. The imaging appearances are correlated with histologic findings where available.
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Scrotal pathology in pediatrics ranges from the more benign hydrocele and varicocele to acute testicular torsion requiring emergent surgery. Malignant testicular tumors can be insidious in onset or may present acutely when trauma brings a swollen scrotum to the patient's or physician's attention. Three common conditions can present as an acute scrotum, all of which can suggest testicular torsion clinically. ⋯ Doppler technology has tremendously increased the radiologist's ability to assess flow within the prepubertal testicle, which allows assessment of viability in the undescended testis as well as in neonatal torsion. The ability of ultrasound to diagnose the pathogenesis of the acute scrotum is unsurpassed by any other imaging modality. Ultrasound is a readily available, noninvasive examination without radiation that provides excellent anatomic detail and serves as an important and tremendously helpful imaging modality in all types of pediatric scrotal pathology.
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Venous thromboembolism (VTE) is a common disorder that is difficult to diagnose clinically but carries significant morbidity and mortality if untreated. Additionally, although demonstrated to be of benefit in cases of proven deep vein thrombosis (DVT) and pulmonary embolism (PE), anticoagulation therapy is not without risk. Because the clinical exam is known to be unreliable for the detection of both DVT and PE, many imaging modalities have been used in the diagnostic imaging algorithm for the detection of VTE, including chest radiography, ventilation/perfusion (V/Q) scintigraphy, pulmonary angiography, and recently, spiral computed tomography (CT) and magnetic resonance imaging (MRI). ⋯ Although these methods have not been as thoroughly evaluated as CU, studies thus far have indicated encouraging results, and further investigations are warranted. Pulmonary angiography has been the gold standard for the diagnosis of PE for decades. Studies have indicated that angiography has probably been underutilized by referring physicians for the evaluation of suspected PE, likely because of the perception of significant morbidity and mortality associated with the procedure. (ABSTRACT TRUNCATED)