Seminars in ultrasound, CT, and MR
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Semin. Ultrasound CT MR · Apr 2008
ReviewIs ultrasound the new gold standard for the diagnosis of ectopic pregnancy?
Ultrasound technology and in particular the use of transvaginal imaging has taken the guesswork out of ectopic pregnancy diagnosis. The vast majority of ectopic pregnancies can and should be diagnosed with a high degree of certainty before management is commenced. ⋯ There is more and more evidence to support the use of transvaginal ultrasound as the primary diagnostic tool for ectopic pregnancy. In this review we hoped to demonstrate that transvaginal ultrasound is the new gold standard for the diagnosis of ectopic pregnancy.
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Semin. Ultrasound CT MR · Jun 2007
Diagnostic imaging: magnetic resonance imaging, computed tomography, and ultrasound.
The temporomandibular joint (TMJ) is a synovial joint. The TMJ is a freely movable articulation between the condyle of the mandible and the squamous portion of the temporal bone at the base of the skull. The bilateral articulation of the mandible to the cranium implies that the left and right TMJs must act as a single unit. ⋯ The primary rationale for imaging the TMJ lies in the fact that mechanical internal derangement is treated differently from the multiple miscellaneous disorders. It is mandatory to have a correct knowledge of the joint anatomy and normal function that correlates with conventional and cross-sectional imaging studies. The TMJ is illustrated with an overview of imaging strategies and techniques, especially magnetic resonance imaging, computed tomography, and ultrasound.
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Semin. Ultrasound CT MR · Apr 2007
ReviewScreening for blunt cerebrovascular injuries: the essential role of computed tomography angiography.
The implementation of aggressive diagnostics refuted the thesis that blunt cerebrovascular injuries (BCVI) are rare events. Given the estimates from recent studies, the prevalence may be as high as 1 per 100 among blunt multiple trauma patients. The morbidity and mortality of unrecognized and untreated BCVI is exceptionally high and warrants distinct efforts to detect these injuries during the primary trauma survey. ⋯ Pooled data from six studies (1368 patients) published between 2002 and 2006 suggest a sensitivity of 79% and a specificity of 97% in the trauma setting. In the two largest investigations, no false negative results were observed. Further research is needed to determine the efficacy of CTA for disclosing BCVI, and to evaluate the potential benefits to patients.
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Sonography is widely used in the initial diagnostic assessment of blunt abdominal trauma in adults and children. It has been formally incorporated worldwide into the routine armamentarium available for emergency diagnosis and treatment as a means of rapid detection of free abdominal fluid, normally referred to as FAST (Focused Assessment with Sonography in Trauma). ⋯ Contrast-enhanced ultrasound performs better than the non-contrast-enhanced technique for the detection of abdominal solid organ injuries and can play an important role in the prompt evaluation of patients with blunt trauma. Furthermore, contrast-enhanced ultrasound can be used in the follow-up of patients who have solid organ lesions and are managed with nonoperative treatment, avoiding radiation and iodinated contrast medium exposure.
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Clearance of the traumatic cervical spine is a subject affecting most healthcare professionals dealing with trauma patients. There is a host of often contradictory literature making it hard for an interested reader to come to their own informed opinion based on the current evidence. This review aims to outline the relevant literature for the clearance of the traumatic cervical spine with the particular aim of highlighting the contradictions, controversies and unanswered questions still besetting this important subject. A brief, subjective opinion for a combined clinical and imaging protocol for clearance of the traumatic cervical spine is given.