AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jun 2008
Randomized Controlled TrialEffects of diagnostic information, per se, on patient outcomes in acute radiculopathy and low back pain.
We conducted a prospective randomized study of patients with acute low back pain and/or radiculopathy to assess the effect of knowledge of diagnostic findings on clinical outcome. The practice of ordering spinal imaging, perhaps unintentionally, includes a large number of patients for whom the imaging test is performed for purposes of reassurance or because of patient expectations. If this rationale is valid, one would expect to see a measurable effect from diagnostic information, per se. ⋯ Patient knowledge of imaging findings do not alter outcome and are associated with a lesser sense of well-being.
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AJNR Am J Neuroradiol · Jun 2008
An acute ischemic stroke classification instrument that includes CT or MR angiography: the Boston Acute Stroke Imaging Scale.
A simple classification instrument based on imaging that predicts outcomes in patients with acute ischemic stroke is lacking. We tested the hypotheses that the Boston Acute Stroke Imaging Scale (BASIS) classification instrument effectively predicts patient outcomes and is superior to the Alberta Stroke Program Early CT Score (ASPECTS) in predicting outcomes in acute ischemic stroke. ⋯ The BASIS classification instrument is effective and appears superior to ASPECTS in predicting outcomes in acute ischemic stroke.
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AJNR Am J Neuroradiol · Jun 2008
ReviewPosterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features.
Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique CT or MR imaging appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune disease and high dose chemotherapy) the imaging, clinical and laboratory features of this toxic state are becoming better elucidated. This review summarizes the basic and advanced imaging features of PRES, along with pertinent features of the clinical and laboratory presentation and available histopathology. Many common imaging/clinical/laboratory observations are present among these patients, despite the perception of widely different associated clinical conditions.
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AJNR Am J Neuroradiol · Jun 2008
Controlled Clinical TrialCT perfusion identifies increased salvage of tissue in patients receiving intravenous recombinant tissue plasminogen activator within 3 hours of stroke onset.
In spite of the advent of thrombolytic therapy, CT-perfusion imaging is currently not fully used for clinical decision-making and not included in published clinical guidelines for management of ischemic stroke. We investigated whether lesion volumes on cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps predict final infarct volume and whether all these parameters are needed for triage to intravenous recombinant tissue plasminogen activator (rtPA). We also investigated the effect of intravenous rtPA on affected brain by measuring salvaged tissue volume in patients receiving intravenous rtPA and in controls. ⋯ Within 3 hours of stroke onset, CBV lesion volume does not necessarily represent dead tissue. MTT lesion volume alone can be used to identify the upper limit of the size of abnormally perfused brain. More brain is salvaged in patients with intravenous rtPA than in controls.