AJR. American journal of roentgenology
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AJR Am J Roentgenol · May 1992
ReviewDuplex Doppler evaluation of native kidney dysfunction: obstructive and nonobstructive disease.
Intrarenal duplex Doppler sonography can provide physiologic information reflecting the status of renal vascular resistance. Available data suggest 0.70 as a reasonable upper limit for normal intrarenal resistive index. Complete or significant partial urinary obstruction produces a prompt elevation in the resistive index that is not produced by purely nonobstructive dilatation; hence, Doppler imaging appears useful in evaluating the dilated, possibly obstructed kidney. ⋯ Recent biopsy series, although correlating certain pathologic findings with resistive index, also indicate that renal Doppler sonography is not sensitive or specific enough to replace renal biopsy. To date, Doppler study of renal medical disease has proved most useful in two types of applications: monitoring of patients with renal disease known to produce resistive index elevation and differentiating between renal diseases where one produces more marked Doppler changes than the other. Resistive index is clearly not identical to creatinine level; in some instances the resistive index may provide unique noninvasive information regarding renal arterial resistance not available from conventional laboratory parameters.
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A prospective study of 170 patients with suspected appendicitis was performed to assess the value of sonography in detecting the normal and abnormal appendix. The wall thickness (normal, less than or equal to 3 mm), compressibility of the appendix, and echogenicity of surrounding fat were the primary criteria used to determine the status of the appendix. Of 60 patients who underwent surgery, appendicitis was proved in 45. ⋯ The predictive value of a positive test was 86%; that of a negative test was 98%. Ruptured appendicitis was predicted in all cases (11/11). Sonography is useful in detecting acute appendicitis and can clearly show the normal appendix more frequently than previously reported.
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AJR Am J Roentgenol · Mar 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.
Six hundred patients were prospectively randomized and given either diatrizoate meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to compare image quality, contrast reactions, and the number of aborted studies or studies in which images had to be repeated. Three hundred two patients received iohexol 300, and 298 patients received diatrizoate meglumine 60. Thirty-nine percent (119/302) of the patients given iohexol 300 and 63% (188/298) of the patients given diatrizoate meglumine 60 had at least one adverse reaction thought to be related to contrast material during, or within 24 hr of, the body CT scan. ⋯ The CT study was repeated because of movement during the contrast injection or aborted because of contrast-related reactions in 0.7% of the patients given iohexol 300 and in 3.0% of the patients given diatrizoate meglumine 60. This difference was statistically significant (p = .04). Our results suggest that the difference in image quality, number of adverse reactions, and number of aborted/repeated CT scans performed with iohexol 300 or diatrizoate meglumine 60 are not sufficiently different to warrant conversion to nonionic agents for body CT scans.