AJR. American journal of roentgenology
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AJR Am J Roentgenol · Sep 1992
ReviewNeoplastic diseases affecting the central skull base: CT and MR imaging.
Modern imaging techniques play a vital role in the diagnostic evaluation and follow-up of patients with neoplastic disease affecting the skull base. Many of these lesions have a high rate of recurrence if surgical removal is not complete. ⋯ Although these lesions are not common in clinical radiologic practice, the radiologist must be prepared to offer a reasonable differential diagnosis and a full evaluation of the extent of disease. This review presents some of the more commonly encountered tumors that can affect the skull base and describes their radiologic features, with emphasis on CT and MR imaging.
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Infection of the spine is a major category of spinal disease that is difficult to differentiate clinically from degenerative disease, noninfective inflammatory lesions, and spinal neoplasm. The infection can affect the vertebrae, intervertebral disks, paraspinal soft tissues, the epidural space, the meninges, and/or the spinal cord. ⋯ Imaging plays an important role in the overall evaluation of these lesions, and the ideal technique is expected to provide information that will help characterize and delineate the disease process, guide biopsy and/or drainage procedures, suggest method of treatment (medical vs surgical), and assess response to therapy. The aim of this article is to review the advantages and limitations of MR imaging in the management of spinal infections.
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AJR Am J Roentgenol · May 1992
ReviewDuplex Doppler evaluation of native kidney dysfunction: obstructive and nonobstructive disease.
Intrarenal duplex Doppler sonography can provide physiologic information reflecting the status of renal vascular resistance. Available data suggest 0.70 as a reasonable upper limit for normal intrarenal resistive index. Complete or significant partial urinary obstruction produces a prompt elevation in the resistive index that is not produced by purely nonobstructive dilatation; hence, Doppler imaging appears useful in evaluating the dilated, possibly obstructed kidney. ⋯ Recent biopsy series, although correlating certain pathologic findings with resistive index, also indicate that renal Doppler sonography is not sensitive or specific enough to replace renal biopsy. To date, Doppler study of renal medical disease has proved most useful in two types of applications: monitoring of patients with renal disease known to produce resistive index elevation and differentiating between renal diseases where one produces more marked Doppler changes than the other. Resistive index is clearly not identical to creatinine level; in some instances the resistive index may provide unique noninvasive information regarding renal arterial resistance not available from conventional laboratory parameters.
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CT and MR imaging allow earlier diagnosis and more specific characterization of anterior mediastinal masses than is possible with plain film radiographs. This review describes state-of-the-art CT and MR imaging of the anterior mediastinum. ⋯ Several masses such as thymolipomas, goiters, cysts, and lymphangiomas often do not require removal and now can be diagnosed with reasonable accuracy when imaging results are combined with clinical history. Detection, diagnosis, staging, and follow-up of malignant anterior mediastinal masses are important and have been improved with CT and MR imaging.
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AJR Am J Roentgenol · Oct 1991
ReviewPercutaneous procedures for the diagnosis and treatment of lower back pain: diskography, facet-joint injection, and epidural injection.
This review discusses the indications, techniques, complications, and results of three percutaneous procedures used to evaluate and treat lower back pain: diskography, facet-joint injection, and epidural injection. Diskography, performed by injection of contrast medium into the nucleus pulposus, is a technique used to determine the cause of lower back pain in patients in whom findings on other imaging studies are normal or conflicting. Injection of steroids and anesthetic into the facet joints of the lumbar spine is useful to diagnose or treat patients with facet syndrome (back pain caused by abnormalities of the facet joints). Injection of steroids and anesthetic agents into the epidural space provides short-term relief, and can sometimes provide permanent relief, of lower back pain.