Radiologic clinics of North America
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Radiol. Clin. North Am. · Mar 2009
ReviewImaging-bronchoscopic correlations for interventional pulmonology.
The development and rapid advancement of both bronchoscopic, CT and ultrasound imaging technology has had considerable impact on the management of a wide variety of pulmonary diseases. The synergy between these newer imaging modalities and advanced interventional endoscopic procedures has led to a revolution in diagnostic and therapeutic options in patients with both central and peripheral airway disease. Given the broad clinical implications of these technological advances, only the most important areas of interventional pulmonology in which imaging has had a major impact will be selectively reviewed to highlight fundamental principles.
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In recent years, the media has focused on the potential danger of radiation exposure from CT, even though the potential benefit of a medically indicated CT far outweighs the potential risks. This attention has reminded the radiology community that doses must be as low as reasonably achievable (ALARA) while maintaining diagnostic image quality. To satisfy the ALARA principle, the dose reduction strategies described in this article must be well understood and properly used. The use of CT must also be justified for the specific diagnostic task.
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Though a myriad of vascular conditions affect the elderly, atherosclerosis remains the most common vascular disorder, followed by venous thromboembolism and varicose veins. In this article, the authors discuss the imaging of atherosclerosis affecting various vascular territories and pay special attention to the elderly population. The authors also discuss imaging findings of segmental arterial mediolysis, giant cell arteritis, and venous thromboembolism.
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Radiol. Clin. North Am. · May 2008
Review Comparative StudySpinal injection procedures: a review of concepts, controversies, and complications.
The field of spinal injection procedures is growing at a tremendous rate. Many disciplines are involved, including radiology, anesthesiology, orthopedics, physiatry and rehabilitation medicine, as well as other specialties. However, there remains tremendous variability in the assessment of patients receiving these therapies, methods for evaluation of outcome, and in the understanding of where these procedures belong in the triaging of those who require surgery. In this article, we attempt to highlight the biologic concepts on which these therapies are based, controversies that have arisen with their increasing use, and a description of complications that have been reported.
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Radiol. Clin. North Am. · May 2008
Review Comparative StudyPercutaneous vertebral augmentation: vertebroplasty, kyphoplasty and skyphoplasty.
Percutaneous vertebroplasty is a safe, inexpensive, and effective interventional vertebral augmentation technique that provides pain relief and stabilization in carefully selected patients with severe back pain due to vertebral compression. Complications from percutaneous vertebroplasty can be devastating, but are rare and avoidable with application of a meticulous technique. ⋯ Kyphoplasty is as effective and safe as vertebroplasty in treatment of painful vertebral compression fractures. Skyphoplasty, a modification of kyphoplasty, is a promising new technique.