Seminars in ultrasound, CT, and MR
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Vasculitis is a destructive inflammatory process affecting blood vessels. Pulmonary vasculitis may develop secondary to other conditions or constitute a primary idiopathic disorder. Thoracic involvement is most common in primary idiopathic large-vessel vasculitides (Takayasu arteritis, giant cell arteritis, Behçet disease) and primary antineutrophil cytoplasmic autoantibody-associated small-vessel vasculitides (Wegener granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome). ⋯ The radiologic findings in primary pulmonary vasculitis vary widely and can include vessel wall thickening, nodular or cavitary lesions, ground-glass opacities, and consolidations, among others. Diffuse alveolar hemorrhage usually results from primary small-vessel vasculitis in the lungs. To diagnose vasculitis, medical teams must recognize characteristic combinations of clinical, radiologic, laboratory, and histopathologic features.
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Pulmonary hypertension (PH) is the remarkable hemodynamic consequence of widespread structural and functional changes within the pulmonary circulation. Elevated pulmonary vascular resistance leads to increased mean pulmonary arterial pressure and, ultimately, right ventricular dysfunction. PH carries a poor prognosis and warrants timely and accurate diagnosis for appropriate intervention. ⋯ Radiologic imaging is an essential tool in the detection and diagnostic evaluation of patients with PH. Echocardiography, ventilation-perfusion scintigraphy, multidetector computed tomography, and cardiac magnetic resonance imaging provide insights into vascular morphology, pulmonary parenchymal status, cardiac function, and underlying etiology of the disorder. Emerging techniques of functional pulmonary and cardiac imaging hold great promise for the assessment and monitoring of these patients in the future.
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Semin. Ultrasound CT MR · Oct 2012
ReviewRole of imaging in the assessment of impacted foreign bodies in the hypopharynx and cervical esophagus.
Impaction of foreign bodies in the upper digestive tract is a serious pathologic condition in ear, nose, and throat practice and is particularly common in children, prisoners, and psychiatric patients. Commonly found objects include fish bones, chicken bones, pieces of glass, dental prostheses, coins, and needles. The goals of the initial patient assessment are to identify the type of object, its location in the gastrointestinal tract, the presence of any associated complications, and the presence of any underlying esophageal conditions. ⋯ Plain films of the neck and chest commonly will show the location of radiopaque objects, such as coins. Both anteroposterior and lateral views are necessary, as some radiopaque objects overlying the vertebral column may only be visible on the lateral view. Multidetector row computed tomography is superior to plain radiographs for the detection of pharyngoesophageal foreign bodies and provide additional crucial information for the management of complicated cases especially related to sharp or pointed ingested foreign bodies.
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Semin. Ultrasound CT MR · Aug 2012
Errors in the radiological evaluation of the alimentary tract: part I.
Physicians are subjected to an increasing number of medical malpractice claims, and radiology is one of the specialties most liable to claims of medical negligence The etiology of radiological error is multifactorial, deriving by poor technique, failures of perception, lack of knowledge, and misjudgments. Reducing errors will improve patient care, may reduce costs, and will improve the image of the hospital. The main reason for studying medical errors is to try to prevent them. This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors, and highlights the malpractice issues in methods for functional alimentary tract examination: swallowing act study, 3-dimensional endoanal ultrasound, defecography, and defecography in magnetic resonance.
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There is evidence that emergencies in pregnancy are subject to mismanagement; however, the percentage of error in the diagnosis of emergencies in pregnancies has not been studied in-depth. The purpose of this article is to review the most common emergencies in pregnancies, focusing the attention on errors in images. The topics covered are divided into gynecological and nongynecological, and for each pathology, the possible errors in the diagnostic pathway, the possible technical errors in the execution of the examination, and in the end, the possible errors in interpretation of the images have been dealt with. These last two entities are often connected, in the fact that a substandard examination can stem interpretation errors, but the systemization of the error is a valid approach in helping to learn from these errors, reducing the possibility that the same error can represent itself.