Current problems in diagnostic radiology
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Curr Probl Diagn Radiol · May 2012
ReviewArterial bleeding in pelvic trauma: priorities in angiographic embolization.
Vascular injuries are a major source of morbidity and mortality in patients with blunt pelvic trauma. Up to 40% of patients with pelvic fractures related to blunt traumatic injury experience intra-abdominal or intrapelvic bleeding, which is the major determining factor of mortality. Sources of hemorrhage within the pelvis include injuries to major pelvic arterial and venous structures and vascular damage related to osseous fractures. ⋯ Angiography is the gold standard for the treatment of pelvic arterial hemorrhage associated with pelvic fractures. Transcatheter techniques provide direct identification of sources of bleeding. Selective catheterization and flow-directed particulate emboli can control bleeding from small arteries at sites of injury.
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Curr Probl Diagn Radiol · May 2012
ReviewBleeding due to pelvic fractures in female patients: pictorial review of multidetector computed tomography imaging.
Pelvic bone fractures in female patients are a result of high-energy trauma and are a significant cause of morbidity and mortality. Their classification is based on the mechanism of the traumatic impact force and the evaluation of stability or instability of pelvic ring fracture. Vascular hemorrhage is frequently associated with pelvic bone disruption and is the main cause of death in polytrauma female patients. ⋯ The potential sites of hemorrhage include the pelvic bone, the pelvic venous plexus, the major iliac veins, the major iliac arteries, and their peripheral branches. MDCT multiphase protocol can accurately differentiate arterial from venous hemorrhage. This article discusses the use of multiphase contrast medium enhanced MDCT in detecting and characterizing vascular pelvic injuries associated with pelvic fractures in trauma female patients.
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Curr Probl Diagn Radiol · Sep 2010
ReviewSpinal cord stimulation: the types of neurostimulation devices currently being used, and what radiologists need to know when evaluating their appearance on imaging.
Neural stimulation is increasingly used as a treatment for chronic pain. Common indications for spinal cord stimulation include chronic neuropathic and oncological pain, intractable angina, or chronic pain secondary to vascular disease. ⋯ Because radiography and computed tomography are the primary imaging modalities used to evaluate the proper positioning of these devices, radiologists should be familiar with their appearance. The purpose of this article is to discuss the types of neurostimulation devices currently being used and to demonstrate their respective imaging appearances.
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Curr Probl Diagn Radiol · Jul 2010
ReviewMagnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review.
Magnetic resonance imaging is the current imaging modality of choice in the evaluation of patients presenting with myelopathic symptoms in the search for spinal cord lesions. It is important for the radiologist to recognize and differentiate nonneoplastic from the neoplastic process of the spinal cord as the differentiation of the 2 entities is extremely crucial to the neurosurgeon. ⋯ The clinical presentation and magnetic resonance signal characteristics as well as the differential diagnosis of the intramedullary lesions are discussed. The potential pitfalls in the differentiation of tumors from nonneoplastic disease of the spinal cord are also elucidated.
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Curr Probl Diagn Radiol · May 2010
ReviewHow's your disk? Illustrative glossary of degenerative disk lesions using standardized lexicon.
The growing demand for structured reporting in radiology requires acceptance and familiarity of standard terms. This article clearly summarizes and illustrates the standard lexicon and classification scheme for degenerative lumbar disk pathology. ⋯ We provide an example-based illustrated glossary that contains diagrams and referenced descriptive explanations to illustrate disk lesions in the current standardized lexicon. Collected cross-sectional imaging of the spine from our tertiary care institution provides a clear patient-based representation of elements in the lexicon.