Radiologic clinics of North America
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Percutaneous vertebral augmentation techniques performed with vertebroplasty or kyphoplasty are safe and effective for the treatment of osteoporotic vertebral compression fractures, primary or secondary spine tumors, and selected traumatic fractures. This article compares the procedures and outlines their advantages and disadvantages. It concludes that vertebroplasty should be performed in most cases, but kyphoplasty is preferable in selected cases.
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With the increasing use of multidetector CT, small nodules are being detected more often. Although most incidentally discovered nodules are benign, usually the sequelae of pulmonary infection and malignancy, either primary or secondary, remains an important consideration in the differential diagnosis of solitary pulmonary nodules. This article reviews the role of imaging in the detection and characterization of solitary pulmonary nodules. Strategies for evaluating and managing solitary pulmonary nodules are also discussed.
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Recent technological advances in multidetector computed tomography (CT) have led to the introduction of dual-source CT, which allows acquisition of CT data at the same energy or at 2 distinct tube voltage settings during a single acquisition. The advantage of the former is improvement of temporal resolution, whereas the latter offers new options for CT imaging, allowing tissue characterization and functional analysis with morphologic evaluation. ⋯ The material decomposition achievable opens up new options for recognizing substances poorly characterized by single-energy CT. Although it is too early to draw definitive conclusions on dual-energy CT applications, this article reviews the results already reported with the first generation of dual-source CT systems.
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Many clinical applications of thoracic computed tomography (CT) require contrast medium to enhance and delineate vascular, mediastinal, hilar, and cardiac structures, and differentiate normal and pathologic vascular or tumoral conditions. Multidetector row computed tomography (MDCT) is superior to single-detector row CT (SDCT) because MDCT permits more efficient and flexible use of intravenous contrast medium to achieve enhancement. However, to fully reap the benefits of MDCT contrast enhancement, the technical challenges associated with optimizing enhancement and scan timing in MDCT need to be solved. This article reviews the basic principles of CT contrast enhancement and discusses common clinical considerations and the protocol design modifications that are necessary to achieve optimal contrast enhancement in thoracic MDCT.
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Radiol. Clin. North Am. · Sep 2009
ReviewHow to avoid nephrogenic systemic fibrosis: current guidelines in Europe and the United States.
Views vary about how to avoid nephrogenic systemic fibrosis (NSF). In Europe, it is contraindicated to use gadodiamide, gadopentetate dimeglumine, and gadovertisamide in patients who have a glomerular filtration rate (GFR) of less than 30 mL/min, and these agents may only be used with caution in patients who have a GFR between 30 and 60 mL/min. ⋯ In the United States, the US Food and Drug Administration introduced a class ban and warned about the use of gadolinium-based contrast agents in patients who have reduced renal function. However, European and American guidelines about how to avoid NSF are generally not very different.