AJR. American journal of roentgenology
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AJR Am J Roentgenol · Aug 2009
D-dimers and efficacy of clinical risk estimation algorithms: sensitivity in evaluation of acute pulmonary embolism.
The goal of this study was to test the efficacy of clinical risk algorithms and a quantitative immunoturbidimetric D-dimer assay in the evaluation of patients undergoing pulmonary CT angiography for suspected acute pulmonary embolism. ⋯ The data appear to support the use of a quantitative D-dimer assay as a first-line test in evaluation for pulmonary embolism when the clinical probability of the presence of pulmonary embolism is low or intermediate. The sensitivity and negative predictive value were 100% for these cases. More than 26% of CT angiographic examinations might have been avoided if the D-dimer assay had been used as a first-line test in the care of patients at low or intermediate risk. Because of the small sample size, the D-dimer assay is not recommended as a first-line test in the evaluation of patients at high risk.
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AJR Am J Roentgenol · Aug 2009
Diffusion-weighted imaging of surgically resected hepatocellular carcinoma: imaging characteristics and relationship among signal intensity, apparent diffusion coefficient, and histopathologic grade.
The objective of our study was to determine the relationship between the signal intensity of hepatocellular carcinoma (HCC) assessed with diffusion-weighted imaging (DWI) and T2-weighted imaging and the apparent diffusion coefficient (ADC) with the histopathologic grade of each nodule. ⋯ The histopathologic grade of HCC had no correlation with the ADC, but HCC tumors tended to show a higher signal on DWI as the histopathologic grade rose. However, predicting the correct histopathologic grade of each HCC before surgery on the basis of DWI findings was difficult because of the large overlap among histopathologic grades.
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AJR Am J Roentgenol · Jul 2009
Controlled Clinical TrialDiagnosis of acute appendicitis with sliding slab ray-sum interpretation of low-dose unenhanced CT and standard-dose i.v. contrast-enhanced CT scans.
The purpose of this study was to compare low-dose unenhanced CT with standard-dose i.v. contrast-enhanced CT in the diagnosis of appendicitis. ⋯ Low-dose unenhanced CT is potentially useful in the diagnosis of appendicitis.
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AJR Am J Roentgenol · Jul 2009
Low-risk patients with chest pain in the emergency department: negative 64-MDCT coronary angiography may reduce length of stay and hospital charges.
The current standard-of-care workup of low-risk patients with chest pain in an emergency department takes 12-36 hours and is expensive. We hypothesized that negative 64-MDCT coronary angiography early in the workup of such patients may enable a shorter length of stay and reduce charges. ⋯ In low-risk patients with chest pain, discharge from the emergency department based on negative cardiac CT, enzyme tests, and ECG may significantly decrease both length of stay and hospital charges compared with the standard of care.