AJR. American journal of roentgenology
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AJR Am J Roentgenol · Aug 2008
Cost-effectiveness of coronary MDCT in the triage of patients with acute chest pain.
Patients at low risk for acute coronary syndrome (ACS) who present to the emergency department complaining of acute chest pain place a substantial economic burden on the U.S. health care system. Noninvasive 64-MDCT coronary angiography may facilitate their triage, and we evaluated its cost-effectiveness. ⋯ CT coronary angiography-based triage for patients with low-risk chest pain is modestly more effective than the SOC. It is also cost-saving in women and associated with low cost-effectiveness ratios in men.
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The purpose of this study was to assess the appropriate use of CT angiography (CTA) in the diagnostic evaluation of acute pulmonary embolism (PE). ⋯ Our data showed suboptimal use of the Wells criteria and subjective overestimation of the probability of PE before ordering of CTA. Although a definitive acceptable PE positivity rate for CTA has not been established, the 10% yield represents overuse of CTA as a screening rather than a diagnostic examination.
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AJR Am J Roentgenol · Jul 2008
Comparative StudyIntraindividual comparison of contrast media concentrations for combined abdominal and thoracic MDCT.
The purpose of this study was an intraindividual comparison of the degrees of MDCT contrast enhancement achieved with agents containing 300 and 370 mg I/mL. ⋯ Given equivalent iodine load and delivery rate, the use of 300 mg I/mL contrast medium results in better contrast enhancement than use of 370 mg I/mL contrast medium in CT of the chest. For the portal venous phase of CT of the abdomen, there was no significant difference in contrast enhancement for the two concentrations of iodine.
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AJR Am J Roentgenol · Jul 2008
Does a combination of dose modulation with fast gantry rotation time limit CT image quality?
The objective of our study was to determine the degree to which CT tube current saturates (tube current reaching its maximal capacity) if dose modulation and fast gantry rotation speeds are used when imaging the abdomen and pelvis and to determine whether saturated tube current affects image quality. ⋯ On the MDCT scanners investigated, when dose modulation is combined with fast tube rotation times, tube current saturation occurs with weaker x-ray tubes resulting in deterioration of image quality.
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AJR Am J Roentgenol · Jun 2008
Comparative StudyBlood patch rates after lumbar puncture with Whitacre versus Quincke 22- and 20-gauge spinal needles.
The objective of our study was to compare the incidence of blood patch as the best objective indicator of postdural puncture headache after elective fluoroscopic lumbar puncture with the use of a 22-gauge Whitacre (pencil point) needle versus standard 22- and 20-gauge Quincke (bevel-tip) needles and to determine the best level of puncture. ⋯ The Whitacre needle is associated with a significantly lower incidence of blood patch rate after lumbar puncture. The highest level of puncture (L1-L2) also provides the lowest level of blood patch rate.