AJR. American journal of roentgenology
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AJR Am J Roentgenol · Nov 1994
Rotational injury of cervical facets: CT analysis of fracture patterns with implications for management and neurologic outcome.
Imaging studies of patients with rotational facet injuries of the cervical spine were retrospectively reviewed to determine the prevalence and pattern of associated fractures, to correlate injury pattern with recommended surgical stabilization, and to assess neurologic outcome. ⋯ Cervical rotational facet injuries are often accompanied by facet fractures and bilateral damage of the rotated vertebra. These injuries contribute to rotational instability and require specific internal fixation based on a precise delineation of all injuries. Facet dislocations without fractures have a significantly higher association with cord syndromes than do rotational facet injuries with fractures. CT, particularly with parasagittal reformations, is valuable in identifying all injuries of the rotated and subjacent vertebrae.
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AJR Am J Roentgenol · Nov 1994
Comparative Study Clinical Trial Controlled Clinical TrialProspective evaluation of extracranial carotid stenosis: MR angiography with maximum-intensity projections and multiplanar reformation compared with conventional angiography.
The purpose of this prospective study was to compare MR angiography of the carotid artery from the aortic arch through the circle of Willis using maximum-intensity projection (MIP) and multiplanar reformation (MPR) images with intraarterial angiography in the depiction of extracranial carotid atherosclerosis. ⋯ It is possible to image the entire carotid artery from the aortic arch through the circle of Willis with MR angiography in a clinically acceptable time. MPR of the 3D TOF MR angiogram reliably shows the percentage of carotid stenosis with no statistically significant difference compared with intraarterial angiography. The role of MR angiography in showing lesions in the circle of Willis or the aortic arch is promising, but the limited number of tandem lesions in this study makes it difficult to draw any conclusions.
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Nosocomial (i.e., originating or taking place in a hospital) pneumonia is the leading cause of death from acquired nosocomial infections. The estimated prevalence of nosocomial pneumonia in intensive care units ranges from 10% to 65%, with fatality rates of 13-55%. ⋯ Recent investigations have provided new insights into the pathogenesis of VAP, and improved techniques have been developed for its diagnosis. Most important, emerging clinical data now suggest that new management strategies for VAP, including more specific indications for antimicrobial use, may significantly improve patients' outcomes.
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AJR Am J Roentgenol · Nov 1994
Maturational changes in arterial impedance of the normal testis in boys: Doppler sonographic study.
The use of color Doppler sonography to diagnose scrotal disorders in children has been hampered by the small size of the vessels and the slow blood flow compared with those in adults. Spectral analysis is the best means available of confirming the vascular origin of questionable color-flow signals arising from testes of small volume. The range of normal and abnormal Doppler sonographic arterial waveforms arising from the testis in boys, as distinct from those in adults, has never been described. The purpose of our study was to establish the normal range of testicular arterial impedance, measured as resistive index (RI), in both prepubertal and pubertal/post pubertal boys. ⋯ Mean testicular RI in our samples of pubertal and postpubertal boys is decreased compared with the mean RI in prepubertal boys. Diastolic arterial flow may not be detectable in normal testes with volumes of 4 cm3 or less. Despite the existence of a statistically significant difference in mean RI between prepubertal and pubertal/postpubertal testes, substantial variability exists within each group, particularly among the prepubertal testes. Norms of testicular flow previously established for adults are therefore not routinely applicable to prepubertal boys with testicular volumes less than 4 cm3. However, RI values in normal pubertal and postpubertal boys where testicular volumes exceed 4 cm3 are comparable to those previously described in adults.