Radiographics : a review publication of the Radiological Society of North America, Inc
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Benign lipomatous lesions involving soft tissue are common musculoskeletal masses that are classified into nine distinct diagnoses: lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma or lipoblastomatosis, angiolipoma, myolipoma of soft tissue, chondroid lipoma, spindle cell lipoma and pleomorphic lipoma, and hibernoma. Soft-tissue lipoma accounts for almost 50% of all soft-tissue tumors. Radiologic evaluation is diagnostic in up to 71% of cases. ⋯ Liposclerosing myxofibrous tumor is a rare intermixed histologic lesion commonly located in the medullary canal of the intertrochanteric femur. Benign lipomatous lesions may occur focally in a joint or tendon sheath or with diffuse villonodular proliferation in the synovium (lipoma arborescens) and are diagnosed based on location and identification of fat. Understanding the spectrum of appearances of the various benign musculoskeletal lipomatous lesions improves radiologic assessment and is vital for optimal patient management.
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Keyboard entry or correction of radiology reports by radiologists and transcriptionists remains necessary in many settings despite advances in computerized speech recognition. A report entry system that implements an automated phrase completion feature based on language modeling was developed and tested. The special text editor uses context to predict the full word or phrase being typed, updating the displayed prediction after each keystroke. ⋯ Performance was tested on 200 randomly selected reports outside of the training set. The phrase completion technique reduced the average number of keystrokes per report from 194 to 58; the average reduction factor was 3.3 (geometric mean) (95% confidence interval, 3.2-3.5). The algorithm significantly reduced the number of keystrokes required to generate a radiography report (P <.00005).
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Review
From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant.
Acute cholecystitis is the most common cause of acute pain in the right upper quadrant (RUQ), and urgent surgical removal of the gallbladder is the treatment of choice for uncomplicated disease. However, cross-sectional imaging is essential because more than one-third of patients with acute RUQ pain do not have acute cholecystitis. In addition, patients with complications of acute cholecystitis, such as perforation, are often best treated with supportive measures initially and elective cholecystectomy at a later date. ⋯ Magnetic resonance cholangiopancreatography is helpful in complicated ductal disease (eg, recurrent pyogenic cholangiohepatitis) when more detailed diagnostic information is required for treatment planning, whereas endoscopic retrograde cholangiopancreatography is used when biliary intervention is required (eg, treatment of choledocholithiasis). Successful imaging with all modalities requires familiarity with both the characteristic and the unusual features of a wide variety of pathologic conditions. In addition, potential pitfalls must be recognized and avoided.
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Imaging evaluation of patients suspected to have arterial injuries of the neck has traditionally been performed by using conventional angiography as an alternative to surgical exploration. However, there has been recent interest in and growing experience with use of noninvasive imaging techniques for the assessment of vascular injuries. Contrast material-enhanced helical computed tomographic (CT) angiography is increasingly being used to evaluate trauma patients in stable condition who are at risk for vascular injuries. ⋯ CT angiography may be limited by artifacts from metallic fragments and occasionally by abundant soft-tissue air or streak artifacts in the shoulders. In such cases, conventional angiography is necessary for optimal assessment of vascular injuries. CT angiography can be used as a noninvasive alternative to conventional angiography in patients suspected to have vascular injuries but without initial indications for surgical treatment.
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Effectiveness of an oral presentation depends on the ability of the speaker to communicate with the audience. An important part of this communication is focusing on two to five key points and emphasizing those points during the presentation. Every aspect of the presentation should be purposeful and directed at facilitating learners' achievement of the objectives. ⋯ It is first necessary to motivate and gain attention of the learner for learning to take place. This can be accomplished through appropriate use of humor, anecdotes, and quotations. Attention should be given to posture, body movement, eye contact, and voice when speaking, as how one appears to the audience will have an impact on their reaction to what is presented.