Seminars in ultrasound, CT, and MR
-
Semin. Ultrasound CT MR · Aug 1998
ReviewAmniotic fluid and the umbilical cord: the fetal milieu and lifeline.
Amniotic fluid volume should be routinely assessed in every second and third trimester case. A review of amniotic fluid physiology and techniques for ultrasound evaluation of fluid volume is presented. The causes and significance of oligohydramnios and polyhydramnios are stressed. ⋯ The clinical significance of some common umbilical cord abnormalities such as a two-vessel cord and nuchal cord are discussed. Other, more uncommon entities such as cord mass lesions are also reviewed. Finally, the role of cord Doppler interrogation in determining fetal well-being is discussed.
-
Semin. Ultrasound CT MR · Oct 1997
ReviewChronic thromboembolic pulmonary hypertension: the disease, the diagnosis, and the treatment.
Chronic thromboembolic pulmonary hypertension is a disease of unknown etiology, the diagnosis and treatment of which has changed dramatically in the past decade. Increased clinical awareness and recent developments in imaging techniques combine to promote earlier and less invasive diagnosis. Improved surgical thromboendarterectomy techniques and decreased perioperative mortality have enabled remarkable cures for most patients with this previously fatal condition. This article reviews current understanding of the disease process, imaging modalities used in diagnosis, and surgical treatment of patients with chronic thromboembolism.
-
Recent technical advances in CT have led to the ability to scan a volume in a shorter period with optimal contrast opacification of blood vessels, including the pulmonary arteries. Initially, there were isolated instances of an accidental detection of a filling defect because of pulmonary embolus in the pulmonary arteries. Gradually, directed examinations were introduced to diagnose or exclude pulmonary embolus. ⋯ Radiologists and clinicians now are turning to fast CT for this purpose for a variety of reasons, including the proven accuracy and reliability of the method and the relative deficiencies of traditional noninvasive methods. Accurate interpretation of CT scans for possible pulmonary embolus depends on the ability to conduct a high-quality examination and to recognize the spectrum of findings for both acute and chronic emboli. This article reviews the history of fast CT pulmonary angiography, and it presents both technical and diagnostic information germaine to the performance of this technique.
-
The burst fracture is an injury characterized by anterior vertebral body height loss and retropulsion of the posterior aspect of the vertebral body into the spinal canal. The vertebral body injury frequently is associated with fractures through the neural arch. Using a three-column concept of spinal stability, the division of these fractures into stable and unstable injuries is difficult. ⋯ This structure is best evaluated by MR examination. Confirmation of posterior ligamentous disruption occurring in conjunction with the burst fracture leads to reevaluation of the presumed mechanism of injury. This article discusses the many issues surrounding the division of burst fractures into stable and unstable injuries and reexamines the common classification systems of thoracolumbar spine injuries.
-
Semin. Ultrasound CT MR · Apr 1996
ReviewCT in blunt chest trauma: pulmonary, tracheobronchial, and diaphragmatic injuries.
Routine use of CT in the initial evaluation of blunt chest trauma is controversial. CT however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the CT findings in patients with pulmonary, tracheobronchial, and diaphragmatic injuries after blunt chest trauma.