AJR. American journal of roentgenology
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AJR Am J Roentgenol · Feb 2016
ReviewHow to Manage Allergic Reactions to Contrast Agent in Pregnant Patients.
This article reviews optimal treatment of allergic reactions to iodinated contrast material in pregnant patients. Initial evaluation and treatment of a pregnant patient is similar to that for a nonpregnant patient. However, additional steps, including assessment for uterine cramping, using left uterine displacement to improve venous return, and maintaining blood pressure to ensure placental perfusion, may be required. ⋯ Adequate preparation and a team approach will provide optimal care for a pregnant patient who has an allergic reaction to a contrast agent.
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AJR Am J Roentgenol · Feb 2016
Reducing Patient Radiation Exposure From CT Fluoroscopy-Guided Lumbar Spine Pain Injections by Targeting the Planning CT.
CT fluoroscopy-guided lumbar spine pain injections typically include a preprocedural planning CT that contributes considerably to patient dose. The purpose of this study was to quantify the degree of radiation exposure reduction achieved by modifying only the planning CT component of the examination. ⋯ A nearly fivefold reduction in radiation exposure can be achieved in CT fluoroscopy-guided lumbar spine pain injections through modifications to the planning CT alone.
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The goals of the 2010 Patient Protection and Affordable Care Act (ACA) can be summed up by the Triple Aim, as defined by the Institute for Healthcare Improvement: Improve population health, optimize the patient experience, and reduce the costs of care. ⋯ Despite recent reimbursement reductions, radiologists have increasing opportunities to participate in value-based payment programs and should leverage those opportunities.
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AJR Am J Roentgenol · Jan 2016
ReviewImaging of Cerebrovascular Disease in Pregnancy and the Puerperium.
The purpose of this article is to review the unique physiologic changes that characterize pregnancy and the puerperium, some that substantially affect the cerebrovascular system. Conditions that can cause neurologic deterioration and share features with preeclampsia-eclampsia include postpartum angiopathy, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, and amniotic fluid embolism. Other conditions not specific to this patient group include cerebral venous thrombosis, cervicocephalic arterial dissection, ischemic stroke, and hemorrhagic stroke, which can pose specific diagnostic and therapeutic challenges. ⋯ Radiologists must be familiar with the imaging findings of cerebrovascular complications and pathologic entities encountered during pregnancy and the puerperium. Ongoing improvements in understanding of molecular changes during pregnancy and the puerperium and advances in diagnostic tests should allow radiologists to continue to make important contributions to the care of this patient population.
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AJR Am J Roentgenol · Jan 2016
Posterior Radioscaphoid Angle as a Predictor of Wrist Degenerative Joint Disease in Patients With Scapholunate Ligament Tears.
The purpose of this study is to determine whether the posterior radioscaphoid angle, a marker of posterior displacement of the scaphoid, is associated with degenerative joint disease in patients with scapholunate ligament tears. ⋯ Posterior radioscaphoid angles were strongly associated with degenerative wrist disease, with potential prognostic implications in patients with wrist trauma and scapholunate ligament ruptures.