AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2003
Multicenter Study Clinical Trial Controlled Clinical TrialMinimally invasive oxygen-ozone therapy for lumbar disk herniation.
Oxygen-ozone therapy is a minimally invasive treatment for lumbar disk herniation that exploits the biochemical properties of a gas mixture of oxygen and ozone. We assessed the therapeutic outcome of oxygen-ozone therapy and compared the outcome of administering medical ozone alone with the outcome of medical ozone followed by injection of a corticosteroid and an anesthetic at the same session. ⋯ Combined intradiscal and periganglionic injection of medical ozone and periganglionic injection of steroids has a cumulative effect that enhances the overall outcome of treatment for pain caused by disk herniation. Oxygen-ozone therapy is a useful treatment for lumbar disk herniation that has failed to respond to conservative management.
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AJNR Am J Neuroradiol · May 2003
Comparative StudyProspective evaluation of carotid artery stenosis: elliptic centric contrast-enhanced MR angiography and spiral CT angiography compared with digital subtraction angiography.
Although digital subtraction angiography (DSA) is the reference standard for assessing carotid arteries, it is uncomfortable for patients and has a small risk of disabling stroke and death. These problems have fueled the use of spiral CT angiography and MR angiography. We prospectively compared elliptic centric contrast-enhanced MR angiography and spiral CT angiography with conventional DSA for detecting carotid artery stenosis. ⋯ Elliptic centric contrast-enhanced MR angiography is more accurate than spiral CT angiography to adequately evaluate carotid stenosis. Furthermore, elliptic centric contrast-enhanced MR angiography appears to be adequate to replace conventional DSA in most patients examined.
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AJNR Am J Neuroradiol · May 2003
Comparative StudyMeasurement of cerebral blood flow in chronic carotid occlusive disease: comparison of dynamic susceptibility contrast perfusion MR imaging with positron emission tomography.
Our purpose was to evaluate the accuracy of cerebral blood flow (CBF) measurements obtained by using dynamic susceptibility contrast-enhanced MR imaging, including the influence of arterial input function (AIF) selection, compared with those obtained by using [(15)O]-H(2)O positron emission tomography (PET) for patients with chronic carotid occlusion. ⋯ Although linearly correlated with CBF values measured by PET, dynamic susceptibility contrast-enhanced MR imaging was not accurate for measuring absolute CBF values. AIF selection relative to the side of carotid occlusion did not significantly affect calculated MR imaging CBF values for six of the seven patients.
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AJNR Am J Neuroradiol · May 2003
Case ReportsDemonstration of an actively bleeding aneurysm by CT angiography.
We describe a case of an actively bleeding aneurysm demonstrated by CT angiography (CTA). The active hemorrhage was characterized by a nebulous attenuation in the subarachnoid space adjacent to the aneurysm. The measurements (HU) of the hemorrhage were equal to or slightly less than those of the contrast material in the arteries and diminished as one moved further from the aneurysm. As CTA is used more frequently in the diagnosis of cerebral aneurysms, it is important to understand imaging features of this potentially lethal condition.
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AJNR Am J Neuroradiol · May 2003
Preliminary experience with endovascular reconstruction for the management of carotid blowout syndrome.
Permanent balloon occlusion (PBO) of the carotid artery has been previously shown to be an effective means to treat carotid blowout syndrome (CBS). However, despite the effectiveness of this endovascular technique, concern remains regarding its potential for producing delayed cerebral ischemic complications in 15% to 20% of patients. This significant limitation of carotid PBO led our group to evaluate an alternative management strategy, consisting of endovascular reconstruction of the carotid artery (ERCA) in patients thought to be at particularly high risk for carotid occlusion (ie, provocative balloon test occlusion, angiographic documented incomplete circle of Willis, or contralateral carotid artery occlusion). ⋯ CBS managed with ERCA can be performed safely and with efficacy of outcomes at least equivalent to those previously reported in association with conventional carotid PBO, therefore representing an excellent alternative endovascular technique for patients who are at increased risk of stroke after PBO.