European radiology
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The value of contrast-enhanced ultrasound (CEUS) in differential diagnosis between benign and malignant gallbladder diseases was investigated. Thirty-three patients with gallbladder carcinomas and 47 with benign gallbladder diseases underwent CEUS. The lesion enhancement time, enhancement extent, pattern, dynamic change of enhancement and the intactness of gallbladder wall were evaluated. ⋯ Destruction of gallbladder wall intactness on CEUS yielded the highest capability in differential diagnosis, with sensitivity, specificity, and Youden's index of 84.8% (28/33), 100% (47/47), and 0.85, respectively. Conventional US made correct original diagnoses in 55 (68.8%) patients, whereas CEUS in 77 (96.3%). Thus, CEUS is useful in differential diagnosis between malignant and benign gallbladder diseases.
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Our objective is to underline the place of FAST (focus assessment by sonography for trauma) ultrasonography (US) in the investigation of blunt abdominal trauma. We retrospectively examined the ultrasound findings in 1,999 haemodynamically stable adult patients. These people were admitted to the emergency room (ER) for possible blunt abdominal trauma. ⋯ Among them, 102 had free peritoneal fluid, and in 58 examinations, ruptures, lacerations or haematomas were demonstrated. Despite its limitations, such as in cases involving uncooperative patients, excessive bowel gas, obesity and empty bladder, the FAST technique seems to be an accurate method to evaluate the possibility of abdominal blunt trauma in stable patients. Because of the high negative predictive value of the FAST technique in stable patients with blunt abdominal trauma, we recommend that a stable patient with negative ultrasound results at admission remain under close observation for at least 12 or preferably 24 h before being discharged.
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We sought to prospectively evaluate the accuracy of 3.0-Tesla whole-body magnetic resonance imaging (WB-MRI) and integrated fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (FDG-PETCT), and their combined interpretation for the assessment of distant-site status in 150 patients with untreated nasopharyngeal carcinoma (NPC). Eighteen (12%) patients were diagnosed as having distant malignancies (15 patients had distant metastases, and three distant synchronous tumours). ⋯ Combined interpretation of WB-MRI and FDGPET-CT showed no significant benefit over either technique alone. In conclusion, 3.0-Tesla WB-MRI is a feasible, non-ionising technique that showed similar diagnostic capacity to FDG-PET-CT in assessing distant-site status in patients with untreated NPC and can be recommended as the first-line imaging technique for comprehensive evaluation of such patients.
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Minimally invasive resection of brain tumours aims at removing as much pathological tissue as possible while preserving essential brain functions. Therefore, the precise spatial relationship between the lesion and adjacent functionally essential brain parenchyma needs to be known. Functional magnetic resonance imaging (fMRI) is increasingly being used for this purpose because of its non-invasiveness, its relatively high spatial resolution and the preoperative availability of the results. ⋯ Further, several practical aspects associated with fMRI for motor and language functioning are summarised, and the validation of the fMRI results with standard invasive mapping techniques is addressed. Next, several important pitfalls and limitations that warrant careful interpretations of the fMRI results are highlighted. Finally, two important future perspectives of presurgical fMRI are emphasised.
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Review Meta Analysis Comparative Study
The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review.
The aim of this study was to assess the role of postmortem computed tomography (PMCT) as an alternative for autopsy in determining the cause of death and the identification of specific injuries in trauma victims. A systematic review was performed by searching the EMBASE and MEDLINE databases. Articles were eligible if they reported both PMCT as well as autopsy findings and included more than one trauma victim. ⋯ This systematic review provides inconsistent evidence as to whether PMCT is a reliable alternative for autopsy in trauma victims. PMCT has promising features in postmortem examination suggesting PMCT is a good alternative for a refused autopsy or a good adjunct to autopsy because it detects extra injuries overseen during autopsies. To examine the value of PMCT in trauma victims there is a need for well-designed and larger prospective studies.