AJR. American journal of roentgenology
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AJR Am J Roentgenol · May 2009
CT hypotension complex (shock bowel) is not always due to traumatic hypovolemic shock.
The purpose of our study was to review the clinical and CT findings in a substantial series of 41 patients with the shock bowel sign to determine if there is an association between shock bowel (and other CT signs of hypotension) and conditions other than post-traumatic hypovolemic shock. ⋯ The shock bowel sign and the CT hypotension complex are frequently associated with hypotension from causes other than trauma-induced hypovolemic shock, such as severe head or spine injury, cardiac arrest, septic shock, bacterial endocarditis, and diabetic ketoacidosis. Other elements of the CT hypotension complex such as flattening of the inferior vena cava and aorta, abnormal pancreatic enhancement and peripancreatic fluid, and hypoperfusion of the spleen and liver are variably associated with shock bowel whether due to posttraumatic hypovolemia or other causes of hypotension. The CT hypotension complex (shock bowel) has important prognostic and therapeutic implications and can probably be distinguished from bowel trauma and other forms of bowel injury in most cases.
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AJR Am J Roentgenol · May 2009
Preoperative T staging of urinary bladder cancer: does diffusion-weighted MRI have supplementary value?
The objective of our study was to evaluate whether diffusion-weighted MRI has supplementary value in the preoperative T staging of urinary bladder cancer. ⋯ Our results suggest that diffusion-weighted MRI might have high specificity for the detection of invasive urinary bladder tumors. Patients with suspected urinary bladder carcinomas may well be evaluated by MRI including diffusion-weighted imaging for better preoperative T staging.
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AJR Am J Roentgenol · May 2009
Safety and effectiveness of analgesia with remifentanil for percutaneous transhepatic biliary drainage.
The purpose of this study was to evaluate the safety and effectiveness of analgesia with remifentanil for percutaneous transhepatic biliary drainage. ⋯ Remifentanil is safe and highly effective for pain control during percutaneous transhepatic biliary drainage. This drug is a suitable option for analgesia during painful interventional radiology procedures.
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AJR Am J Roentgenol · May 2009
Do emergency physicians use serum D-dimer effectively to determine the need for CT when evaluating patients for pulmonary embolism? Review of 5,344 consecutive patients.
The purpose of our study was to investigate whether D-dimer screening is being used effectively to determine the need for MDCT in diagnosing acute pulmonary embolism (PE) in emergency department patients. ⋯ D-dimer screening is not used according to established diagnostic algorithms to determine the need for MDCT in diagnosing acute pulmonary embolism in our emergency department.
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AJR Am J Roentgenol · May 2009
Radiologist-supervised ketamine sedation for solid organ biopsies in children and adolescents.
Pediatric interventional radiologists are frequently challenged when faced with organ biopsies. Because of the need for patient immobility and the potential risk of morbidity with patient movement during biopsies, many radiologists prefer general anesthesia to sedation. We present our experience with radiologist-supervised ketamine sedation in pediatric patients undergoing renal and hepatic biopsies. ⋯ Interventional radiologists performing solid organ biopsies in the pediatric population often use general anesthesia to ensure immobility, adequate analgesia, and safe conditions. Our experience suggests that interventional radiologists may supervise a nurse-administered ketamine protocol to provide safe, effective analgesia and sedation for liver and renal biopsies.