European radiology
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Body packing is a distinct method for smuggling drugs. What radiologists need to know is discussed in this pictorial review. Radiologists are confronted with diagnostic imaging of body packers because of two main reasons: complications of body packing and identifying drug packets within the gastrointestinal tract. ⋯ Ultrasound and MR imaging do not play an important role in that field. Depending on the purity of the drug, three different forms of attenuation have been described: hashish is denser than stool; cocaine appears similar to stool; and heroin has a gaseous transparence. The packets are of a round to oval form, usually of a particular uniformity and rarely confused with scybala if arranged like a pearl chain; therefore, plain X-ray is the method of choice to detect drug-filled packets within the gastrointestinal tract of body packers.
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Case Reports
Intraoperative functional MRI as a new approach to monitor deep brain stimulation in Parkinson's disease.
This article deals with technical aspects of intraoperative functional magnetic resonance imaging (fMRI) for monitoring the effect of deep brain stimulation (DBS) in a patient with Parkinson's disease. Under motor activation, therapeutic high-frequency stimulation of the subthalamic nucleus was accompanied by an activation decrease in the contralateral primary sensorimotor cortex and the ipsilateral cerebellum. Furthermore, an activation increase in the contralateral basal ganglia and insula region were detected. These findings demonstrate that fMRI constitutes a promising clinical application for investigating brain activity changes induced by DBS.
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The purpose of the present study was to assess incidence, fracture type, and location of spine fractures due to falls. All emergency room CT requests during a time period of 26 months were reviewed retrospectively. Patients who had fallen or jumped and were initially examined with multidetector CT (MDCT) were included. ⋯ Burst fracture is the most common fracture type and most frequently seen in the thoracolumbar junction. Multiple-level fractures were seen in 32% of the cases, of which 29% were seen at noncontinuous levels. Serious spine fractures are seen in all falling height and age groups.
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Review Comparative Study
Current imaging concepts in pediatric osteomyelitis.
The diagnosis of osteomyelitis remains a difficult diagnostic dilemma. In this article, which is particularly aimed at those whose practice does not include a large paediatric population, we review the pathophysiology of paediatric osteomyelitis and contrast it with the available imaging modalities. ⋯ The most useful imaging findings to look for and their significance are assessed and we evaluate their usefulness in each case. Close cooperation between clinicians and imagers remains the key to early and adequate diagnosis of paediatric osteomyelitis.
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Appendicitis is the commonest acute surgical emergency of childhood, and occurs in approximately 2-4 per 1000 infants. It is usually seen in infants older than 5 years but can occur at any age. Atypical clinical findings are seen in 30-50% of children, especially the younger ones, and often leads to a delayed diagnosis. ⋯ The reported sensitivity of US varied between 87 and 95%, vs 95-97% for helical CT, while the specificity ranged between 85 and 98% for US and 94 and 97% for helical CT. Only one truly randomised study was found, showing that compared with US alone, a combination of US and helical CT increased the sensitivity from 86 to 99%, while the specificity decreased from 95 to 89%. We conclude that imaging should be performed in all children with suspected appendicitis and that US should be the initial procedure with CT as a complementary tool.