Radiologic clinics of North America
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Barotrauma remains a significant complication of mechanical ventilation, particularly in ARDS. A number of alternative techniques for mechanical ventilation are being investigated with the purpose of minimizing ventilator-related lung injury and air leak phenomena while maintaining adequate oxygenation. Among them pressure-controlled inverse-ratio ventilation and extracorporeal carbon dioxide removal have not resulted in a definite reduction of barotrauma thus far. The radiologist plays an important role in the early recognition of barotrauma and may assist in the treatment of its sequelae.
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Radiol. Clin. North Am. · Nov 1995
ReviewWhy question screening mammography for women in their forties?
Groups that do not recommend mammography for all women in their forties do so with reason. Even after seven randomized controlled trials and participation by over 170,000 women it is not clear whether screening women in this age group for breast cancer saves lives. It is clear that in contrast to older women, in women in their forties there is no effect for several years after screening begins, and an uncertain marginal effect after a decade. ⋯ When a health care intervention is recommended for every person in our society, costs mount fast. At any time, but particularly in an era of cost constraints, it is not only reasonable but incumbent on all involved in health care to look carefully at how much benefit there is for the expenditure and how strong is the scientific evidence. Second, many persons who consider prevention activities argue that there is an ethical reason.(ABSTRACT TRUNCATED AT 400 WORDS)
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By acquiring a volumetric data set helical CT has advanced many established applications of conventional CT. The most important advantages of helical CT over conventional CT are (1) the shorter examination time, which decreases image degradation from motion artifact, even in infants and young children; (2) the capability for retrospective image reconstruction, which decreases image degradation from volume averaging; and (3) improved multiplanar reconstructions. ⋯ Continued clinical experience will advance the pediatric applications of helical CT in the evaluation of thoracic, abdominal, and musculoskeletal pathology. Because of its advantages over conventional CT, helical CT has the potential to become the preferred method of CT imaging in children.
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Radiol. Clin. North Am. · Jul 1995
ReviewRole of CT and MR imaging in the management of tuberculous spondylitis.
Tuberculous spondylitis is an infection involving one or more of the components of the spine, namely the vertebral body, intervertebral disc and ligaments, paravertebral soft tissues, and the epidural space. The causative organism belongs to one of the different strains of Mycobacterium tuberculosis. ⋯ The possible impact of HIV infection on the number of reported cases and their mode of presentation also is considered. The need for prompt diagnosis is emphasized.
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Radiol. Clin. North Am. · Jul 1995
ReviewMR imaging and CT of central nervous system tuberculosis in the patient with AIDS.
CNS TB represents a disease that complicates AIDS with an increasing incidence in endemic areas as well as in developed countries in those patients who have some risk factors such as intravenous drug abuse. Although TB infection of the CNS in AIDS patients may follow a rapidly progressive course, the imaging findings otherwise are similar to those of the nonimmunosuppressed population. Meningeal enhancement, hydrocephalus, parenchymal granulomata, and infarcts are seen frequently and are often observed in combination with one another. ⋯ Spinal TB usually is seen in the form of epidural abscess secondary to tuberculous spondylitis, although it may be seen in isolation of spinal column involvement. The differential diagnosis includes spinal lymphoma or pyogenic abscess formation. Radiculomyelitis or isolated spinal cord tuberculomata are much less frequently observed and can be suspected on imaging only if there is concomitant evidence of the classic findings of intracranial TB.