Neuroimaging clinics of North America
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Certificate of Need (CON) programs represent a patchwork of state regulatory programs across the United States that regulate the availability of selected health care services. Thirty-six states maintain laws designed to ensure access to health care services, maintain or improve quality, and control capital expenditures on health care services and facilities by limiting unnecessary health facility construction and checking the acquisition of major medical equipment. This article discusses the history of CON and explores controversies surrounding the current state of CON regulations.
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Neuroimaging Clin. N. Am. · Aug 2012
ReviewNational initiatives for measuring quality performance for the practicing neuroradiologist.
This article provides an overview of the national initiatives developed for monitoring and reporting quality performance measures. Included is a review of the Physician Quality Reporting System, the Hospital Outpatient Quality Data Reporting Program, and the Hospital Outpatient Prospective Payment System, with specific emphasis on how these programs affect radiology practice. A practical review of these programs allows radiologists to gain further understanding of the economic and political influences on the daily practice of radiology today. The background and relevant features of each program are presented in this article.
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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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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.
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Multiple sclerosis (MS) is the most common inflammatory demyelinating disorder of the central nervous system (CNS). MS has been subject to high-field magnetic resonance (MR) imaging research to a great extent during the past years, and much data has been collected that might be helpful in the investigation of other inflammatory CNS disorders. This article reviews the value of high-field MR imaging in examining inflammatory MS abnormalities. Furthermore, possibilities and challenges for the future of high-field MR imaging in MS are discussed.