Radiologic clinics of North America
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Radiol. Clin. North Am. · Mar 2004
Review Comparative StudySonographic evaluation of first-trimester bleeding.
Vaginal bleeding is a leading cause of presentation for emergency care during the first trimester of the pregnancy. Clinical assessment of the pregnancy outcome at this stage is less reliable. ⋯ Diagnosis of a normal IUP at this stage not only assists the physician in an expectant management, but also gives a psychologic boost to the patient. With recent advances in US technology and the availability of high-frequency transvaginal transducers, reliable diagnosis of early pregnancy failure can be made even before the embryo is visible.
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Radiol. Clin. North Am. · Mar 2004
Review Comparative StudyThe role of ultrasound in pregnancy-related emergencies.
Most complications of pregnancy allow time for transfer to specialized obstetric ultrasound units, but many women present to the emergency room or the labor and delivery unit with signs and symptoms suggesting genuine acute medical emergencies, where successful outcome depends on prompt diagnosis of the disorder and rapid appropriate medical management. The use of ultrasound technology in obstetric emergencies is well established. Ultrasonography plays a major role in such cases as the most important tool clinicians are using to identify the correct etiology and diagnosis, whereas in other cases it helps limit the differential diagnosis. One of the goals of any advanced training program in obstetrics and gynecology and radiology is to allow the skilled physician to perform the proper ultrasound study in case of an obstetric emergency to facilitate the proper diagnosis, enabling the medical team to provide the best possible care.
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Radiol. Clin. North Am. · Jul 2003
ReviewUltrasonographic evaluation of the endometrium in postmenopausal vaginal bleeding.
Transvaginal ultrasound with SIS is a cost-minimizing screening tool for perimenopausal and postmenopausal women with vaginal bleeding. Its use decreases the need for invasive diagnostic procedures for women without abnormalities, and ultrasound increases the sensitivity of detecting abnormalities in women with pathologic conditions. Vaginal sonography is preferred over uniform biopsy of postmenopausal women with vaginal bleeding because it (1) is a less invasive procedure, (2) is generally painless, (3) has no complications, and (4) may be more sensitive for detecting carcinoma than blind biopsy. ⋯ It remains unproven whether certain patients at higher risk for carcinoma should proceed directly to invasive evaluation. Women on tamoxifen with persistent recurrent bleeding, women with significant risk factors for carcinoma, and women with life-threatening hemorrhage comprise this group. Further studies are still necessary to evaluate high-risk patients and determine whether ultrasound or biopsy is really the most cost-effective initial test.
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Radiol. Clin. North Am. · Dec 2002
ReviewComplications of acute pancreatitis: clinical and CT evaluation.
Mortality of acute pancreatitis is dependent on the development of potentially lethal complications that can coexist and occur at any time following an acute attack. The nature and clinical relevance of these complications differ, contingent on the time of occurrence following a severe episode of pancreatitis. They can be divided into (1), early complications that manifest at the onset or within the first 2 to 3 days, (2) intermediate complications that occur predominantly during the second to fifth week, and (3) late complications that usually manifest months or years following the resolution of an acute attack. ⋯ Intermediate complications are abdominal, pancreatic, and retroperitoneal, and are mostly septic in nature, associated with pancreatic or peripancreatic fat necrosis and pseudocysts. Late, life-threatening complications are mainly vascular or hemorrhagic in nature or involve the development of chronic pancreatic ascites. The early detection and objective evaluation of these complications by clinical and imaging methods leads to specific treatment options in the continuous attempt to decrease mortality rates in acute pancreatitis.
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Conventional radiographs in conjunction with clinical examination remains the primary method for evaluating the acute athletic injury. In most cases, suspected acute tendon and ligament injuries are initially treated based on physical examination. Magnetic resonance (MR) imaging, with its multiplanar capability and superb soft tissue contrast, is quickly becoming the method of choice for evaluating chronic foot and ankle pain and further defining the extent of tendon and ligament injuries. This article reviews the common acute and chronic (overuse) foot and ankle athletic injuries with an emphasis on imaging characteristics.