Radiology
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Radiologic studies of 57 solitary vertebral hemangiomas (VHs) were reviewed to find radiographic and computed tomographic (CT) criteria by which to distinguish asymptomatic lesions from those compressing the spinal cord. Six features were seen significantly more often in those compressing the cord: location between T-3 and T-9, involvement of the entire vertebral body, extension to the neural arch, an expanded cortex with indistinct margins, an irregular honeycomb pattern, and soft-tissue mass. ⋯ In patients with a VH and back pain of uncertain origin, the presence of three or more of these signs may indicate a potentially symptomatic VH. In such patients, spinal angiography and, in some cases, embolization, are indicated.
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A retrospective study of 5,134 consecutive pediatric patients undergoing computed tomographic (CT) evaluation from January 1983 through December 1985 was conducted to analyze the need for sedation in a pediatric population; the safety, efficacy, and efficiency of various sedation regimens; and the pediatric radiologists' changing preference for certain sedatives. A marked preference for intravenous administration of pentobarbital sodium (Nembutal) evolved over the 3-year period analyzed. ⋯ Recovery times were reduced, and patient convenience was augmented. There were only two sedation failures in the 419 patients sedated with intravenous Nembutal, and there were no sedation-related complications.