AJR. American journal of roentgenology
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AJR Am J Roentgenol · Dec 2003
Incorporating patient-centered outcomes in the analysis of cost-effectiveness: imaging strategies for renovascular hypertension.
Our aim was to assess the contribution of patient-centered short-term disutilities and quality-of-life measures in the cost-effectiveness analysis of CT angiography, MR angiography, and conventional angiography in patients with medication-resistant hypertension. ⋯ In the evaluation and treatment of medication-resistant hypertension, strategies that included preliminary imaging saved more lives than did the immediate institution of enhanced medical therapy at a lesser cost.
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AJR Am J Roentgenol · Nov 2003
Comparative StudyEfficacy of epidural injections of Kenalog and Celestone in the treatment of lower back pain.
Epidural corticosteroid injections have been used extensively to treat lower back pain, but the relative effectiveness of one corticosteroid versus another has never been reported in a large patient series. We retrospectively reviewed 597 patients who had epidural corticosteroid injections to determine any difference in Kenalog or Celestone efficacy. ⋯ The epidural injection of Celestone Soluspan and Kenalog reduced lower back and radicular pain in more than half the patients, although Kenalog reduced pain in a significantly larger number of patients than Celestone Soluspan at 1 and 2 weeks after injection.
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AJR Am J Roentgenol · Nov 2003
Using superparamagnetic iron oxide-enhanced MRI to differentiate metastatic hepatic tumors and nonsolid benign lesions.
We evaluated the ability of superparamagnetic iron oxide (SPIO)-enhanced MRI to differentiate solid metastatic tumors and nonsolid benign lesions by clarifying the characteristic signal-intensity pattern of each lesion on SPIO-enhanced T2-weighted and heavily T1-weighted gradient-echo images. ⋯ When evaluating metastatic liver tumors on SPIO-enhanced MRI, we recommend that heavily T1- and T2-weighted gradient-echo images be obtained with our parameters to exclude hemangiomas or cysts.
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AJR Am J Roentgenol · Oct 2003
Comparative StudyPrediction of clinical response after renal angioplasty: respective value of renal Doppler sonography and scintigraphy.
The goal of our study was to compare Doppler sonography and renal scintigraphy as tools for predicting the therapeutic response in patients after undergoing renal angioplasty. SUBJECTS AND METHODS. Seventy-four hypertensive patients underwent clinical examination, Doppler sonography, and renal scintigraphy before and after receiving captopril in preparation for renal revascularization. The patients were evaluated for the status of hypertension 3 months after the procedure. The predictive values of the findings of clinical examination, Doppler sonography, renal scintigraphy, and angiography were assessed. ⋯ Measurements of kidney length and unilateral and bilateral resistive indexes before and after captopril administration were useful in predicting the outcome after renal angioplasty. Renal scintigraphy had no significant predictive value.
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AJR Am J Roentgenol · Oct 2003
Usefulness of the simultaneous acquisition of spatial harmonics technique during MRI of the shoulder.
The simultaneous acquisition of spatial harmonics (SMASH) technique is a parallel imaging technique that uses fewer echoes than conventional techniques to obtain the desired resolution. Production of images occurs more quickly with parallel imaging than with conventional imaging. This study assesses the usefulness of the SMASH technique for MRI of the shoulder. SUBJECTS AND METHODS. Five experienced musculoskeletal radiologists prospectively interpreted MRIs of the shoulder in 50 consecutive patients. All patients underwent a complete MRI examination of the shoulder on a 1.5-T commercially available scanner. Axial fat-saturated proton density-weighted, coronal T1-weighted, and coronal and sagittal fat-saturated T2-weighted sequences were performed. Patients also underwent SMASH T2-weighted imaging in the coronal and sagittal planes. Coronal and sagittal SMASH T2-weighted imaging took approximately 50% as long to complete compared with conventional T2-weighted imaging. Each radiologist interpreted MRIs of the shoulder without knowing whether the images were obtained using the SMASH or the fat-saturated T2-weighted technique. Twenty-eight of the 50 patients also underwent subsequent arthroscopy, and the results were compared with MRI interpretations based on SMASH and fat-saturated T2-weighted images. ⋯ SMASH imaging allows significant time savings compared with fat-saturated T2-weighted MRI. We found that the use of the SMASH technique did not affect the MRI interpretation or the clinical outcome of patients.