Seminars in ultrasound, CT, and MR
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Semin. Ultrasound CT MR · Jun 2009
Multidetector row computed tomography in the management of penetrating neck injuries.
Penetrating neck trauma may occur from gun shots, stabbings, and accidental injury. Approximately 50% of gunshot and 10%-20% of stab-wound patients are reported as having severe injuries and the mortality from severe vascular injuries is reported as high as 50%. ⋯ Experience with interpreting and reconstructing computed tomography images, understanding the clinically important findings, and avoiding pitfalls is critical for successful patient care. Therefore, radiologists and clinicians who treat trauma patients need to familiarize themselves with the computed tomography angiography technique and appearances of vascular injury and know when to recommend further evaluation, such as interventional angiography or open surgery.
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Semin. Ultrasound CT MR · Jun 2009
Comparative StudyRole of multidetector computed tomography in the assessment of cervical spine trauma.
Clearing the cervical spine has relied on individual and center-based experience. Not long ago, the screening modality of choice was radiography. ⋯ Furthermore, clinical criteria have been validated to assess for cervical spine injuries and determine the need for imaging evaluation based on patient risk. Once imaging is deemed necessary to exclude cervical spine injury based on clinical predictors, multidetector computed tomography becomes the accepted modality of choice, providing accurate and rapid assessment and improving the understanding of injury patterns and stability determinants.
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Semin. Ultrasound CT MR · Jun 2009
Kinematic cervical spine magnetic resonance imaging in low-impact trauma assessment.
Kinematic magnetic resonance imaging can be implemented as a noninvasive adjunct examination for injuries in the cervical spine in the clinical assessment of ligamentous, disk, and soft-tissue injuries, as a basis for determining medical vs. surgical management, and in establishing the degree of functional clinical impairment. This article discusses the clinical indications and application of kinematic cervical spine magnetic resonance imaging method in the diagnosis and management of cervical spine injuries. The spectrum and grading classification of cervical spine injuries using kinematic magnetic resonance imaging is also discussed.
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Semin. Ultrasound CT MR · Jun 2009
Gunshot injuries in the neck area: ballistics elements and forensic issues.
The neck is an interesting structure as far as penetrating trauma is concerned because of the multiple vital structures that are concentrated in a small anatomic area. Gunshot wounding is an interaction between the penetrating projectile, the anatomy of the wounded subject, and the chance occurrences that determine the exact missile path. The mass and velocity of the projectile establish the upper limit of possible tissue damage. ⋯ The radiologist can contribute substantially to the successful treatment of the patient with a gunshot wound. Important analysis includes the assessment of the missile path in emergency conditions by using plain film and multidetector row computed tomography. The radiologist further evaluates the extent of wounding by determining missile fragmentation and secondary missile paths.
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Semin. Ultrasound CT MR · Jun 2009
Multidetector row computed tomography of the injured larynx after trauma.
Laryngeal trauma is rare and can occur as an isolated injury or as part of multitrauma. On the basis of airway patency, it is decided whether the patient needs rapid surgical intervention or whether the patient would profit from preoperative imaging done with multidetector row multislice thin section computed tomography with multiplanar reconstruction in the soft-tissue and bone window setting. Grading the fracture pattern from minor isolated to multiple dislocated fracture lines helps to plan individual treatment options and to prevent long-term voice complications.