Neuroimaging clinics of North America
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Over the last two decades, there has been a marked increase in the number of computed tomography (CT) studies performed in the United States, with a resultant increase in the radiation dose delivered to patients. Hence there is an urgent need to optimize CT protocols and to get familiar with the factors affecting the CT radiation dose and with available dose reduction options. This article discusses the basic physics related to CT technique and describes current and future methods of dose reduction. Also briefly described are other CT techniques applicable in the maxillofacial region, such as three-dimensional CT, cone beam CT, and dual-energy CT.
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This article reviews the importance of particular radiologic findings related to facial trauma and their implications for clinical and surgical management. An emphasis is placed on critical imaging signs that warrant immediate surgical attention.
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In the clinical assessment of orbital trauma, visual acuity and extraocular muscle motility are critical for rapid evaluation of injury severity. However, assessment of these parameters may be limited by edema and concomitant injuries. ⋯ This review focuses on orbital soft-tissue injuries that can exist with or without orbital fracture. Imaging techniques and soft-tissue injuries, including those involving the anterior chamber, iris and ciliary body, lens, globe, posterior segment, and optic nerve, are reviewed, in addition to intraocular foreign bodies and cavernous-carotid fistulas.
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Basilar skull fractures are a relatively frequent occurrence in significant head trauma, and their detection is important, as even linear nondisplaced fractures can be associated with critical complications. The management of skull base fractures depends on the location and extent of these associated complications. This article reviews skull base anatomy; morphology of the common fracture patterns within the anterior, central, and posterior skull base; associated complications; imaging findings; and possible pitfalls in imaging of skull base trauma.
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Significant progress has been made recently in the recognition, screening, diagnosis, and treatment of blunt cerebrovascular vascular injury (BCVI). Although controversy still exists as to optimal screening algorithms and best diagnostic modality, the vital and growing role of noninvasive imaging in identifying patients at high risk for BCVI and in characterizing the injury itself has been clearly established. There has been promising early work in stratifying BCVI patients into risk categories by initially evaluating them with high-resolution head, maxillofacial, and cervical computed tomographic examinations with the ultimate goal of maximizing diagnostic yield and enabling prompt initiation of therapy.