Clinical radiology
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Several diverse neurological conditions may be seen during pregnancy and the post partum period. These usually require neuroimaging for definitive diagnosis and range from a predisposition to neurovascular abnormalities, such as acute ischaemic stroke and cerebral venous sinus thrombosis, through to more specific pregnancy-related conditions, such as eclampsia/posterior reversible leukoencephalopathy and post-partum angiopathy. ⋯ It is necessary that the radiologist has an awareness of these conditions to allow swift specific diagnoses or suggest the most appropriate diagnosis when imaging findings are non-specific. We describe epidemiological and radiological features to allow the radiologist to guide the clinician in management, and review guidelines for safe cranial imaging of the pregnant patient.
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Central venous catheters (CVCs) provide valuable vascular access. Complications associated with the insertion and maintenance of CVCs includes pneumothorax, arterial puncture, arrhythmias, line fracture, malposition, migration, infection, thrombosis, and fibrin sheath formation. Image-guided CVC placement is now standard practice and reduces the risk of complications compared to the blind landmark insertion technique. This review demonstrates the imaging of a range of complications associated with CVCs and discusses their management with catheter salvage techniques.
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Randomized Controlled Trial
Combining low tube voltage and iterative reconstruction for contrast-enhanced CT imaging of the chest-initial clinical experience.
To evaluate the image quality of contrast-enhanced chest computed tomography (CT) with low tube voltage settings using an iterative reconstruction algorithm (iDose4) and standard dose filtered back projection (FBP) CT in patients with normal body mass index (BMI). ⋯ Compared with standard FBP reconstruction, the iDose4 iterative reconstruction yields higher SNR, CNR, and better image quality in contrast-enhanced chest CT with low tube voltage settings.
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To examine current out-of-hours magnetic resonance imaging (MRI) provision through a snapshot survey of National Health Service (NHS) trusts and to assay how radiographer staffing cover was provided for out-of-hours services. ⋯ There is currently a paucity of information on the provision of out-of-hours MRI in the NHS. However, there is increasing pressure to provide complex imaging out of hours, and in the future, trauma centres may be required to provide MRI to assess spinal injury. The authors describe a system to provide access to MRI at no additional cost to the organization based on 20 years of experience. A minority of surveyed acute NHS trusts have full out-of-hours access to MRI. Demand for MRI provision out of core hours is likely to increase.
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To assess the quality, safety, and outcomes following computed tomography pulmonary angiography (CTPA) performed in elderly patients. ⋯ Patients aged >85 years undergoing CTPA have a low (6%) rate of CIN: this was not predicted by baseline renal function and did not impact on survival. CTPA in elderly patients is safe, facilitates active management of pulmonary emboli, and the discovery of additional disease entities informs survival.