AJR. American journal of roentgenology
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AJR Am J Roentgenol · Jul 2009
Acute toxic leukoencephalopathy: potential for reversibility clinically and on MRI with diffusion-weighted and FLAIR imaging.
Toxic leukoencephalopathy may present acutely or subacutely with symmetrically reduced diffusion in the periventricular and supraventricular white matter, hereafter referred to as periventricular white matter. This entity may reverse both on imaging and clinically. However, a gathering together of the heterogeneous causes of this disorder as seen on MRI with diffusion-weighted imaging (DWI) and an analysis of their likelihood to reverse has not yet been performed. Our goals were to gather causes of acute or subacute toxic leukoencephalopathy that can present with reduced diffusion of periventricular white matter in order to promote recognition of this entity, to evaluate whether DWI with apparent diffusion coefficient (ADC) values can predict the extent of chronic FLAIR abnormality (imaging reversibility), and to evaluate whether DWI can predict the clinical outcome (clinical reversibility). ⋯ Acute toxic leukoencephalopathy with reduced diffusion may be clinically reversible and radiologically reversible on DWI, and may also be reversible, but to a lesser degree, on FLAIR MRI. None of the imaging markers measured in this study appears to correlate with clinical outcome, which underscores the necessity for prompt recognition of this entity. Alerting the clinician to this potentially reversible syndrome can facilitate treatment and removal of the offending agent in the early stages.
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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.
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AJR Am J Roentgenol · Jul 2009
Improving patient safety: effects of a safety program on performance and culture in a department of radiology.
Emphasis is being placed on improving the safety performance of the health care delivery system. The purpose of this study was to evaluate the effects of a program on safety performance and culture in a pediatric radiology department. ⋯ The safety program had a positive effect on safety culture. Although it is early in the process and proving statistical significance for rare events such as serious safety events is difficult, the mean number of days between serious safety events has increased from 200 to 780. We conclude that the program is having a positive effect on safety performance.
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AJR Am J Roentgenol · Jun 2009
ReviewMRI findings in inflammatory muscle diseases and their noninflammatory mimics.
The purpose of this article is to provide a practical review of the spectrum of MRI findings in inflammatory muscle diseases and their noninflammatory mimics. ⋯ MRI is a highly sensitive tool for the diagnosis of muscle diseases. Although it has low specificity, awareness of the potential imaging findings in the various, sometimes rare, muscular disorders is helpful for accurate diagnosis.