European radiology
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Comparative Study
Value of negative spiral CT angiography in patients with suspected acute PE: analysis of PE occurrence and outcome.
The aim of this study was to analyze pulmonary embolism (PE) occurrence and retrospective clinical outcome in patients with clinically suspected acute PE and a negative spiral CT angiography (SCTA) of the pulmonary arteries. Within a 35-month period, 485 consecutive patients with clinical symptoms of acute PE underwent SCTA of the pulmonary arteries. Patients with a negative SCTA and without anticoagulation treatment were followed-up and formed the study group. ⋯ The PE did not occur in any other patient. In patients with suspected PE and negative SCTA without anticoagulant therapy, the risk of recurrent PE in this study was less than 1% and similar to that in patients after a negative pulmonary angiogram. Therefore, we conclude that patients can be managed safely without anticoagulation therapy; however, this approach may not be appropriate for critically ill patients and those with persistent high clinical suspicion of acute PE.
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Comparative Study
Comparison of whole-body MRI with automatic moving table technique and bone scintigraphy for screening for bone metastases in patients with breast cancer.
The aim of this study was presentation of a whole-body MRI technique with a moving table as a screening tool for bone metastases in patients with breast cancer. Twenty-two patients with breast carcinoma underwent both a planar whole-body bone scintigraphy and whole-body MRI at 1.5 T. The MRI images were acquired with a moving table at six different anatomical positions within a measurement time of 20 min. ⋯ Whole-body MRI was superior to bone scintigraphy in predicting lesion origin with a sensitivity of 92% (bone scintigraphy 83%), a specificity of 90% (scintigraphy 80%) and an accuracy of 91% (scintigraphy 82%). The MRI showed additional findings such as metastases of the lung and liver. Whole-body MRI with moving table technique may be an effective method of total body screening for bone in selected patients with breast carcinoma and a high risk of distant metastases, although with the higher costs of MRI bone scintigraphy must still be considered as the first method for screening patients with breast cancer.
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Comparative Study
Suspected ureteral colic: plain film and sonography vs unenhanced helical CT. A prospective study in 66 patients.
The aim of this study was to compare the sensitivity and specificity of plain abdominal films plus ultrasound, vs nonenhanced CT for the diagnosis of ureteral colic in patients with acute flank pain. During a 4-month period, 66 patients (mean age 48 years) with acute flank pain were prospectively studied by means of plain abdominal film, US, and unenhanced CT. The presence of lithiasis and of obstructive uropathy signs were determined. ⋯ The 11 lithiasis not detected by US were passed spontaneously (10 were <5 mm). Both techniques showed similar extraurinary pathology. Computed tomography is the most accurate technique for the detection of ureteral lithiasis; however, the combination of plain film and US is an alternative to nonenhanced CT with a lower sensitivity and radiation dose that has a good practical value.
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Carcinoid heart disease is a frequent complication of the carcinoid syndrome, usually presenting as right-sided valvular heart disease. Although the diagnosis is most often made with cardiac ultrasound, MRI and CT are valuable techniques for diagnosing carcinoid heart disease.
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Mammography is the only useful examination in screening for breast cancer. Mortality from breast cancer can be reduced if women go regularly for a screening mammography. Moreover, it is still the key examination in diagnosis of breast diseases and in the follow-up of patients treated for breast cancer. ⋯ In this study we evaluate the impact of the "radiographer" on the pain risk during mammography by analysing questionnaires filled in by women and radiographers. Study results reveal that the opinion of the radiographer, the information and communication during the examination and the number of years of experience are important factors in pain and discomfort experience. The attitude of the radiographer plays an important role in the pain experience.