Radiographics : a review publication of the Radiological Society of North America, Inc
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High-resolution magnetic resonance (MR) imaging with phased-array pelvic and endorectal coils has dramatically enhanced the ability to visualize abnormalities of the female urethra and periurethral tissues. These include developmental abnormalities (eg, urethral duplication, ectopic ureterocele), benign processes (eg, urethral diverticulum, caruncle, leiomyoma, trauma, and fistula; stress incontinence; paravaginal cyst), and malignant processes (eg, primary urethral carcinoma, secondary urethral malignancies). High-resolution MR imaging can be used to assess complications such as fistula formation and periurethral abscess, localize various entities, exclude pathologic processes whose presence could lead to an incorrect diagnosis, differentiate processes that might be confused at physical examination, and contribute to surgical planning and facilitate surgical correction.
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Gadolinium-enhanced ultrafast three-dimensional (3D) spoiled gradient-echo magnetic resonance (MR) imaging is a noninvasive method for evaluating the abdominal aorta and the visceral and iliac vessels. With an enhanced gradient system, 20-48 sections can be obtained during a single 18-32-second patient breath hold. ⋯ Gadolinium-enhanced ultrafast 3D spoiled gradient-echo MR imaging has been used instead of or in addition to conventional contrast material-enhanced MR angiography in patients who have chronic symptoms of mesenteric ischemia, who have abdominal aortic aneurysms, or who are at risk for iodinated contrast material-related renal dysfunction. This technique shows great promise for accurate and noninvasive evaluation of the abdominal aorta and the visceral and iliac vessels.
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Because most radiologists in the United States have been taught that fluoroscopy and computed tomography (CT) are the best guidance techniques for nonvascular interventional procedures, sonography has been greatly underused in this regard. Recently, sonography has been gaining recognition as a highly useful and versatile guidance technique. It has many advantages over CT and fluoroscopic guidance, including real-time imaging with vessel visualization, decreased procedure time and cost, portability, and lack of ionizing radiation. ⋯ Sonography should generally be used instead of CT for guidance of abdominal and pelvic biopsy and drainage. Sonographic guidance should replace CT and fluoroscopic guidance for biopsy and drainage of accessible peripheral thoracic and mediastinal masses. Use of sonographic guidance should be integrated into all interventional radiology suites to reduce radiation exposure and facilitate the performance of many nonvascular and some vascular interventional procedures that have traditionally been performed under fluoroscopic guidance.