AJR. American journal of roentgenology
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AJR Am J Roentgenol · Aug 2011
Automatic MDCT injectors: hygiene and efficiency of disposable, prefilled, and multidosing roller pump systems in clinical routine.
This study evaluated three different injection systems with regard to microbiological contamination, time efficiency, and user handling during a clinical routine. ⋯ Double-syringe injectors used with disposable or prefilled contrast agent syringes, as well as roller pump injectors, ensure hygienic conditions in clinical routine. However, time efficiency and handling are aspects that favor prefilled and roller pump systems.
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AJR Am J Roentgenol · Aug 2011
Screening cervical spine CT in a level I trauma center: overutilization?
The objective of our study was to analyze the use of screening cervical spine CT performed after trauma and establish the opportunity of potentially avoidable studies when evidence-based clinical criteria are applied before imaging. ⋯ The strict application of the NEXUS low-risk criteria could potentially reduce the number of screening cervical spine CT examinations in the setting of trauma in more than 20% of cases, thereby avoiding a significant amount of unnecessary radiation and significant cost.
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AJR Am J Roentgenol · Jul 2011
Clinical TrialRadiographic and CT evaluation of recombinant human bone morphogenetic protein-2-assisted spinal interbody fusion.
Bone morphogenetic proteins BMPs, when used in spinal fusion, hasten healing and initiate distinct imaging features. We undertook a study to record and analyze the radiographic and CT changes after the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in spinal fusion surgery. ⋯ Features observed on imaging that we attributed to the use of rhBMP-2 included an enhanced fusion rate and an increased incidence of prevertebral soft-tissue swelling in patients who underwent cervical fusion. Endplate resorption was observed in 100% of patients who underwent cervical fusion and in 82% of the lumbar levels. Subsidence of the cage resulting in narrowing of the disk space was seen in more than 50% of cases. Cage migration and heterotopic bone formation in the spinal canal and neural foramen occurred maximally in the lumbar spine of patients in whom a polyetheretherketone cage was placed using a transforaminal approach.
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AJR Am J Roentgenol · Jul 2011
Abnormal preprocedural international normalized ratio and platelet counts are not associated with increased bleeding complications after ultrasound-guided thoracentesis.
The objective of our study was to identify differences in hemorrhagic complications after ultrasound-guided thoracentesis on the basis of patient coagulation parameters. ⋯ The risk of bleeding after ultrasound-guided thoracentesis performed by radiologists is low even if the preprocedural INR and platelet count are abnormal. An approach in which no coagulation testing or correction is performed before thoracentesis may be justified.
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In this review, we attempt to address many of the issues that are related to ensuring patient benefit in body CT, balancing the use of ionizing radiation and iodinated contrast media. We attempt to not only summarize the literature but also make recommendations relevant to CT protocols, including the technical parameters of both the scanner and the associated contrast media. ⋯ Although CT is a powerful tool that has transformed the practice of medicine, the benefits are accompanied by important risks. Radiologists must understand these risks and the strategies available to minimize them as well as the risks associated with contrast medium delivery in abdominal CT.