European journal of radiology
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A retrospective study of 624 lumbar myelographic and CT myelographic procedures was undertaken to evaluate the frequency, radiographic and clinical relevance of contrast medium outside the dural sac. Our findings indicate that epidural contrast is frequently identified on CT scans with highly sensitive window settings (in 35.4% of all CT myelographic studies). ⋯ Subdural contrast is far less often encountered (in 2.4% of CT myelographic studies and in 3.2% of standard myelographic films). We believe leakage of contrast to occur through the puncture site into the epidural and subdural space.
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Professional Relative Value Units (RVUs) quantifying productivity of radiologists in the United States were used to study trends from 1973 to 1989 in the distribution of productivity among the various imaging techniques. Data from a 1989 survey were used to estimate the distribution of radiology examinations among techniques for 1989. A difficulty index (RVUs per examination) was calculated for each technique weighted by actual CPT-code occurrences reported in that survey. ⋯ The percentage of procedures and RVUs represented by vascular/interventional has remained relatively constant. The overall difficulty index has risen by 18% from 1973 to 1989. These trends should influence the allocation of space, equipment, and human resources in radiology department planning and management.
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Maple Syrup Urine Disease (MSUD) is an inherited metabolic disorder characterized by a severe, usually lethal, neonatal course in the early stages with pseudotumor cerebri and pathologically documented increased cerebral water content. CT and MRI studies in MSUD are few and the data are overlapping. This study reports CT features before and after dietary treatment in three patients; two with classical MSUD and one with an intermediate variant of MSUD. ⋯ Furthermore, these CT changes are present both in the acute phase of classical MSUD and in an intermediate variant of the disease. The observed abnormalities evolve favorably under dietary treatment, simultaneously with clinical and neurological improvement. It is concluded that the observed CT changes indicate a diagnosis of MSUD and are relevant findings in the neuroradiologic differential diagnosis in acutely ill newborns, in which a metabolic disease may be not immediately suspected.