Radiology
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To evaluate the incidence and specificity of fracture of the first rib as an indicator of child abuse and to determine a mechanism of fracture. ⋯ Child abuse should be considered in cases of pediatric rib fracture, particularly fracture of the first rib. Possible mechanisms for first-rib fracture include impact force, compressive force, and shaking or acute axial load (slamming), which cause an indirect fracture.
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To evaluate the ability of fluoroscopic images obtained during air enemas to depict or exclude lead points of intussusceptions and other abnormalities that require surgical treatment in the absence of intussusception. ⋯ Successful reduction of an intussusception does not always rule out a lead point. Other imaging studies, the patient's condition, and laparotomy may also be necessary to diagnose and treat lead points and other lesions.
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Ultrasound (US)-guided peripheral venipuncture was performed for peripheral insertion of 222 central venous catheters over a 12-month period. Initial placement was successful in 218 patients but unsuccessful in eight; placement was successful in four the next day (success rate, 98%; complication rate, 5%). Catheters were in place from 3 days to 6 months (mean, 36 days). US guidance allowed successful venipuncture for placement of central venous catheters in children.
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Recent advances in computed tomography (CT) and fiberoptic bronchoscopy (FOB) have led to confusion concerning the optimal use of these modalities, especially with regard to each other. The present review summarizes the current understanding of the role of CT in relation to FOB. Emphasis is placed on optimization of CT technique and basic principles of interpretation of the images. In addition, an in-depth evaluation is presented of the advantages and limitations of CT and FOB in the analysis of both focal and diffuse diseases of the airways and lung parenchyma.
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To evaluate the accuracy of magnetic resonance (MR) and ultrasound (US) criteria for breast implant integrity. ⋯ MR imaging depicts implant integrity more accurately than US; neither method reliably depicts minimal leakage with shell collapse. Mammography is useful in screening bilumen implant integrity.