Neuroimaging clinics of North America
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The paradox of the increased use of imaging without obvious evidence of improved health outcomes has led to calls for payment based on value rather than volume. Measurement of radiologists' performance is a key component of the measurement of value. The paradigm shift occurring in radiology and health care as a whole may seem daunting to the radiologist with the clamor for increasing accountability from payers and patients alike. However, it is through powerful tools such as performance measures in radiology and their accompanying incentive-based payment systems that practices can be improved and confidence of patients restored.
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Neuroimaging Clin. N. Am. · Aug 2012
ReviewEvidence-based imaging and effective utilization: lessons in neuroradiology.
Expensive advanced imaging, such as magnetic resonance (MR) imaging, contributes to the unsustainable growth of health care costs in the United States. Evidence-based imaging decreases costs and improves outcomes by guiding appropriate utilization of imaging. ⋯ Barriers to evidence-based imaging can be traced to patient- and physician-related factors. Radiologists have a critical role in addressing some of these barriers.
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Turf issues in medicine affect policy, practice, and, most importantly, patients. This article explores turf issues from several perspectives. ⋯ Finally, this article focuses on proposed strategies to successfully confront the questions, if not overcome the problems encountered. To better inform the deliberation and strengthen the credibility of any conclusions, the evidence and controversies must be regarded from beyond merely the radiology perspective.
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Diagnostic modalities for the diagnosis of acute stroke have increased in number and quality. Magnetic resonance imaging has increasingly become a central tool for the management of patients with stroke. ⋯ Recent additional sequences allow perfusion without contrast and susceptibility-weighted imaging can help identify early bleeding. These new techniques should provide more information about the on going ischemic process.
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Neuroimaging Clin. N. Am. · May 2012
ReviewVascular disorders: insights from arterial spin labeling.
The introduction of high-field magnetic imaging (≥3 T) has made noninvasive arterial spin labeling (ASL) a realistic clinical option for perfusion assessment in vascular disorders. Combined with the advances provided by territorial imaging of individual intracerebral arteries and the measurement of vascular reactivity, ASL is a powerful tool for evaluating vascular diseases of the brain. This article evaluates its use in chronic cerebrovascular disease, stroke, moyamoya disease, and arteriovenous malformation, but ASL may also find applications in related diseases such as vascular dementia.