Radiology
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To determine the effect of a computerized radiology order entry system rule that prevented nonclinician support staff from completing orders for outpatient computed tomographic, magnetic resonance imaging, and nuclear medicine examinations that received initial low-yield decision support scores in the order entry system. ⋯ A simple change in the business logic of the order entry system resulted in a substantially decreased rate of low-yield imaging examinations and a markedly increased percentage of tests personally ordered by clinicians.
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Randomized Controlled Trial Multicenter Study Comparative Study
Multicenter, double-blind, randomized, intraindividual crossover comparison of gadobenate dimeglumine and gadopentetate dimeglumine for MR angiography of peripheral arteries.
To prospectively compare the image quality and diagnostic performance achieved with doses of gadobenate dimeglumine and gadopentetate dimeglumine of 0.1 mmol per kilogram of body weight in patients undergoing contrast material-enhanced magnetic resonance (MR) angiography of the pelvis, thigh, and lower-leg (excluding foot) for suspected or known peripheral arterial occlusive disease. ⋯ Higher-quality vessel visualization, greater contrast enhancement, fewer technical failures, and improved diagnostic performance are obtained with gadobenate dimeglumine, relative to gadopentetate dimeglumine, when compared intraindividually at 0.1-mmol/kg doses in patients undergoing contrast-enhanced MR angiography for suspected peripheral arterial occlusive disease.
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To evaluate the use of time-resolved magnetic resonance (MR) angiography in the presurgical localization of the artery of Adamkiewicz prior to reimplantation of the feeding intercostal artery, lumbar artery, or both during aortic aneurysm repair. ⋯ The artery of Adamkiewicz and the anterior spinal artery can be identified and differentiated from the GARV even in patients with substantially altered hemodynamics by using time-resolved 3.0-T MR angiography.
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To systematically examine whether abandoning daily routine chest radiography would adversely affect outcomes, such as mortality and length of stay (LOS), and identify a subgroup in which daily routine chest radiography might be beneficial. ⋯ Systematic but unselective daily routine chest radiography can likely be eliminated without increasing adverse outcomes in adult patients in ICUs. Further studies are necessary to identify the specific patient population that would benefit from daily routine chest radiographs.
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To prospectively determine whether cardiac-gated multidetector computed tomography (CT) allows visualization of aortic valve leaflets after bioprosthetic aortic valve replacement (AVR), to provide an accurate method for measuring the aortic valve opening, and to provide morphologic and functional information regarding the mechanism underlying poor function of the bioprosthetic valve. ⋯ Sixty-four-section CT can help accurately measure AVA in bioprosthetic AVR compared with EOA at TTE. It can also show morphologic abnormalities and reduced leaflet motion in a dysfunctional bioprosthesis, thereby potentially unraveling the mechanism of dysfunction.