AJR. American journal of roentgenology
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AJR Am J Roentgenol · Aug 1994
ReviewThe role of sonography in the placement and management of jugular and subclavian central venous catheters.
Placement of large-bore central venous catheters via a jugular or subclavian vein is becoming increasingly common. Although the great majority of these catheters are successfully placed by clinicians using anatomic landmark techniques, this procedure is neither innocuous nor always successful. ⋯ The patient may experience considerable discomfort when multiple needle passes are made. Sonographic imaging of the jugular and subclavian veins can significantly improve the safety, speed, and comfort of the procedure by defining the vascular anatomy of the jugular and subclavian veins before puncture, showing complications from prior attempts or placements of central venous catheters in these vessels, and providing guidance for needle puncture of the jugular and subclavian veins.
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AJR Am J Roentgenol · Aug 1994
Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue.
Video-assisted thoracic surgery (VATS) is a new procedure that makes it possible to see the intrathoracic organs and to resect pulmonary nodules without thoracotomy. Preoperative localization of small nodules that may not be visible or palpable during VATS is desirable. Percutaneous placement of spring hookwires is widely used to localize pulmonary nodules before VATS; infrequently, the adjacent lung parenchyma is also stained with methylene blue. The purpose of this study was to evaluate the effectiveness of methylene blue staining of pulmonary nodules without placement of a hookwire. ⋯ Percutaneous staining of pulmonary nodules is an accurate technique for localizing nodules before VATS. The procedure is easily and safely performed, and it obviates wire-related complications, such as severe pleuritic pain.
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AJR Am J Roentgenol · Jul 1994
Comparative StudyMR imaging of head and neck tumors: comparison of T1-weighted contrast-enhanced fat-suppressed images with conventional T2-weighted and fast spin-echo T2-weighted images.
The purpose of this study was to determine the value of three MR pulse sequences for the detection of tumors and abnormal lymph nodes in the head and neck. This was accomplished by quantifying differences in contrast between tumor, lymph node, and respective adjacent tissue on contrast-enhanced fat-suppressed T1-weighted MR images, conventional spin-echo T2-weighted images, and fast spin-echo fat-suppressed T2-weighted images in a group of patients with head and neck tumors. ⋯ Our results show that fat-suppressed contrast-enhanced T1-weighted images provide the highest contrast-to-noise ratio for head and neck tumors and abnormal lymph nodes. However, head and neck tumors encompass a broad range of neoplasms that are distributed in a complicated anatomic area. Therefore, in some patients, a combination of contrast-enhanced fat-suppressed T1- and T2-weighted images, preferably fast spin-echo fat-suppressed images, is useful for detection of these tumors and nodal metastases.
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AJR Am J Roentgenol · Jul 1994
Comparative StudyEvaluation of tibial plateau fractures: efficacy of MR imaging compared with CT.
CT is often used after plain films to evaluate fractures of the tibial plateau. Because MR imaging can show associated soft-tissue injuries as well as fractures, we hypothesize that MR is superior to CT for imaging these injuries. Accordingly, we compared the efficacy of MR imaging and CT in 22 patients with tibial plateau fractures. ⋯ MR imaging was equivalent or superior to two-dimensional CT reconstruction for depiction of fracture configuration in most patients. In addition, MR showed significant soft-tissue injuries. We believe that MR imaging is the preferable imaging technique for most patients with fractures of the tibial plateau.
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AJR Am J Roentgenol · Jul 1994
Comparative StudyMR detection of leakage from silicone breast implants: value of a silicone-selective pulse sequence.
The purpose of this study was to determine the value of MR imaging with a silicone-selective pulse sequence for detecting leakage from silicone breast implants. ⋯ Silicone-selective MR imaging is highly effective for detecting leakage from silicone breast implants. Accuracy is improved when mammographic and MR findings are considered together.