Radiologic clinics of North America
-
Radiol. Clin. North Am. · Mar 2000
ReviewImage-guided management of complicated pleural fluid collections.
Percutaneous image-guided catheter drainage with adjunctive ICFT has become the mainstay in the treatment of complicated pleural fluid collections. There are six basic principles of image-guided drainage and ICFT that must be understood to maximize the efficacy and safety of the procedure. 1. There must be a basic understanding of why traditional nonguided thoracostomy drainage fails in a significant percentage of patients. ⋯ Effective closed drainage carries lower morbidity, mortality, and cost than does open surgical drainage. For radiologists and clinicians alike it does not suffice simply to place one or more thoracostomy tubes, round daily, and hope that the occasional use of fibrinolytic agents does the rest. Without a more aggressive approach to catheter position and management the efficacy is no greater than that historically seen with nonguided closed drainage and surgeons will continue to plead for earlier effective open drainage.
-
Health care has changed dramatically over the last decade. Clinicians constantly are faced with decisions regarding the most cost-effective treatment while they maintain high-quality care. ⋯ Ultrasound is an excellent imaging modality because it is fast, noninvasive, and does not have inherent side effects. This article conceptualizes the use of diagnostic musculoskeletal ultrasound for the clinician treating changes in their patients' function secondary to musculoskeletal injuries.
-
Chest radiographs remain the initial imaging modality to rapidly screen patients with blunt chest trauma. Spiral CT is more sensitive and specific in diagnosing most thoracic pathology seen in blunt trauma patients. This article reviews the major clinical and radiologic findings that occur with blunt injuries to the chest, excluding mediastinal vascular injuries.
-
Radiol. Clin. North Am. · May 1999
ReviewHelical CT of cervical spine and soft tissue injuries of the neck.
Helical CT of the neck has revolutionized the diagnostic evaluation of trauma and emergency room patients. This comprehensive examination, with high resolution and fast acquisition times, allows the radiologist to make expeditious diagnoses concerning cervical spine fractures, vascular injuries, and aero-digestive tract lesions. This allows for the more rapid triaging and treatment of various injuries resulting in improved patient priate radiographic examination for each clinical scenario.
-
Complex orbital rim and fractures of the internal orbital skeleton (orbital walls) are best analyzed by high-resolution axial CT. Optic canal fractures are optimally visualized with thin 1-mm section high-resolution CT scanning. Spiral CT may be used in the acutely injured patient because of its rapid scan technique. ⋯ Another advantage of spiral CT is the capability of CT angiography. MR imaging usually is not the initial modality for the assessment of orbital trauma, but it is helpful in evaluating vascular injuries such as carotid-cavernous sinus fistulas or post-traumatic pseudoaneurysms. In general, CT with contrast injection is not necessary except when traumatic vascular anomalies, such as carotid cavernous, dural fistulas, or thrombosis of the superior ophthalmic vein, are considered in the differential diagnosis.