Radiology
-
The growth in medical imaging over the past 2 decades has yielded unarguable benefits to patients in terms of longer lives of higher quality. This growth reflects new technologies and applications, including high-tech services such as multisection computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET). Some part of the growth, however, can be attributed to the overutilization of imaging services. ⋯ These include the payment mechanisms and financial incentives in the U. S. health care system; the practice behavior of referring physicians; self-referral, including referral for additional radiologic examinations; defensive medicine; missed educational opportunities when inappropriate procedures are requested; patient expectations; and duplicate imaging studies. Summit participants suggested several areas for improvement to reduce overutilization, including a national collaborative effort to develop evidence-based appropriateness criteria for imaging; greater use of practice guidelines in requesting and conducting imaging studies; decision support at point of care; education of referring physicians, patients, and the public; accreditation of imaging facilities; management of self-referral and defensive medicine; and payment reform.
-
To evaluate the efficacy of dual-energy computed tomography (CT) in the differentiation of intracerebral hemorrhage (ICH) from iodinated contrast material in patients who received contrast material via intraarterial or intravenous delivery. ⋯ Dual-energy CT can help differentiate ICH from iodinated contrast material staining with high sensitivity and specificity in patients who have recently received intraarterial or intravenous iodinated contrast material.
-
To report on a series of self-embedding behavior (SEB), demonstrate the effectiveness and clinical effect of image-guided foreign body removal (IGFBR) in the treatment of embedded soft-tissue foreign bodies (STFBs), and evaluate the role of the radiologist in the clinical management of SEB. ⋯ Greater awareness of SEB may result in radiologists being the first physicians to identify SEB and rapidly mobilize an interdisciplinary team for early and effective intervention and treatment. Percutaneous radiologic treatment of self-imbedded STFBs is safe, precise, and effective for radiopaque and nonradiopaque foreign bodies.
-
To evaluate the feasibility of sodium 7-T magnetic resonance (MR) imaging in repaired tissue and native cartilage of patients after matrix-associated autologous chondrocyte transplantation (MACT) and compare results with delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) at 3 T. ⋯ With the modified 3D GRE sequence at 7 T, a sufficiently high SNR in sodium images was achieved, allowing for differentiation of repaired tissue from native cartilage after MACT. A strong correlation was found between sodium imaging and dGEMRIC in patients after MACT.