AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2005
Randomized Controlled Trial Comparative StudyIntraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study.
Reports about steroids and oxygen-ozone therapy to treat lower back pain have been increasing. The purpose of our study was to compare the clinical outcomes in patients treated with infiltrations of O(2)-O(3) gas or steroids at short-, medium-, and long-term follow-up. ⋯ Oxygen-ozone treatment was highly effective in relieving acute and chronic lower back pain and sciatica. The gas mixture can be administered as a first treatment to replace epidural steroids.
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We compared the diagnostic accuracy of lumbar facet blocks guided by either conventional fluoroscopy or CT fluoroscopy (CTF). Seventy-one blocks were performed with conventional fluoroscopy, and 58 were performed using CTF. ⋯ The CTF group had a greater percentage decrease in pain (79.5% +/- 31.1%) than did the conventional fluoroscopy group (55.5% +/- 38.0%; P < .0005). We conclude lumbar facet blocks by using CTF guidance results in greater diagnostic accuracy than do conventional fluoroscopy.
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AJNR Am J Neuroradiol · May 2005
Comparative StudyDiffusion-weighted imaging of fungal cerebral infection.
Diffusion-weighted imaging (DWI) is useful in diagnosing bacterial brain abscesses, but DWI features of fungal brain abscesses have not been characterized. Because fungal abscesses are not purulent, we hypothesized that their DWI characteristics are distinct from those of bacterial abscesses. ⋯ Fungal cerebral abscesses may have central restricted diffusion similar to that of bacterial abscesses but with histologic features of acute or chronic inflammation and necrosis rather than suppuration. Altered water diffusion in these lesions likely reflects highly proteinaceous fluid and cellular infiltration.
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AJNR Am J Neuroradiol · May 2005
Comparative StudyIntracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography.
Although digital subtraction angiography (DSA) provides excellent visualization of the intracranial vasculature, it has several limitations. Our purpose was to evaluate the ability of helical CT angiography (CTA) to help detect and quantify intracranial stenosis and occlusion compared with DSA and MR angiography (MRA). ⋯ CTA has a higher sensitivity and positive predictive value than MRA and is recommended over TOF MRA for detection of intracranial stenosis and occlusion. CTA has a high interoperator reliability. CTA is superior to DSA in the evaluation of posterior circulation steno-occlusive disease when slow flow is present. CTA results had a significant effect on patient clinical management.
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AJNR Am J Neuroradiol · May 2005
Case ReportsActive hemorrhage into a postresection cavity detected by neuro-CT angiography.
We describe a case demonstrating active extravasation of contrast material into a hematoma resection cavity during CT angiography (CTA) that necessitated emergent reexploration, decompression, and hemostatic control. Our case highlights the value of neuro-CTA in the immediate postoperative setting and describes another scenario where CTA has added value. Prompt recognition of contrast extravasation is critical to the diagnosis and ultimately affects the quality of patient care.