AJR. American journal of roentgenology
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AJR Am J Roentgenol · Jun 2014
Randomized Controlled Trial Multicenter Study Comparative StudyPreoperative breast MRI for early-stage breast cancer: effect on surgical and long-term outcomes.
The purpose of this study was to evaluate the effect of the use of preoperative breast MRI on surgical and long-term outcomes among women with early-stage breast cancer undergoing breast conservation therapy. ⋯ Reexcision rates among patients with early breast cancer undergoing conservation therapy were lower among women who underwent preoperative breast MRI. There was no statistically significant effect of the use of preoperative MRI on rates of locoregional recurrence or disease-free survival.
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AJR Am J Roentgenol · Jun 2014
Efficacy and safety of flow-directed pulmonary artery catheter thrombolysis for treatment of submassive pulmonary embolism.
The purpose of this study was to assess the efficacy and safety of flow-directed catheter thrombolysis for treatment of submassive pulmonary embolism (PE). ⋯ Among a small patient cohort, flow-directed catheter thrombolysis with alteplase effectively dissolved submassive PE and reduced PA pressure. Postprocedure short-term survival was high, and patients undergoing thrombolysis required close observation for bleeding events.
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AJR Am J Roentgenol · Jun 2014
Hemodynamic response to fluid management in children undergoing dexmedetomidine sedation for MRI.
Dexmedetomidine is administered for pediatric sedation for MRI studies. It has the advantage of preserving respiratory function and producing a sedation state identical to that of natural sleep. It can, however, cause a dose-dependent decrease in systemic blood pressure in children. The purpose of this study was to investigate whether i.v. fluid loading with normal saline solution before the initiation of dexmedetomidine administration would affect the frequency of hypotension. ⋯ Administration of 10 mL/kg of normal saline solution before the initiation of dexmedetomidine administration for pediatric MRI sedation is effective in decreasing the incidence of observed hypotension.
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The purpose of this video article is to demonstrate sonographic anatomy at the posterior hip and to describe a number of diagnostic and therapeutic interventions that may be performed at this location with sonographic guidance. Injection techniques at the piriformis muscle, ischial bursa, hamstring origin, and ischiofemoral space are described and demonstrated. ⋯ Ultrasound is well adapted to the evaluation and treatment of conditions encountered at the posterior hip. Sonographic guidance is a useful tool that allows a trained operator to safely and effectively perform a range of injections.
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AJR Am J Roentgenol · May 2014
Multicenter StudyCT angiography (CTA) and diagnostic performance of noninvasive fractional flow reserve: results from the Determination of Fractional Flow Reserve by Anatomic CTA (DeFACTO) study.
Fractional flow reserve (FFR) computed from standard coronary CT scans (FFRCT) is a novel noninvasive method for determining the functional significance of coronary artery lesions. Compared with CT alone, FFRCT significantly improves diagnostic accuracy and discrimination for patients with and without hemodynamically significant coronary artery stenoses. To date, the impact of CT image quality on diagnostic performance of FFRCT is unknown. We evaluated the impact of patient preparation, CT scan protocol, and factors related to image quality on the diagnostic accuracy of FFRCT. ⋯ Use of β-blockade and nitroglycerin administration before CT improve diagnostic performance of FFRCT. Diagnostic accuracy of FFRCT is significantly reduced in the setting of misalignment artifacts.