Seminars in ultrasound, CT, and MR
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Semin. Ultrasound CT MR · Dec 2002
ReviewClinical evaluation of postoperative sinonasal surgical patients.
Rhinosinusitis is a very common upper respiratory illness. Functional endoscopic sinus surgery has been successfully utilized in the surgical treatment of medically refractory rhinosinusitis. The endoscopic approach has also been extended to various skull base lesion and sinonasal neoplasms. ⋯ Judicious use of nasal endoscopy and importance of CT imaging of the sinuses are discussed. Emphasis is placed on establishing communication between the sinus surgeon and radiologist to facilitate evaluation of the sinonasal surgical patients. liming and specific types of imaging studies before any revision sinus surgery are discussed. Major complications associated with endoscopic sinus surgery are reviewed.
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Fluoroscopically guided diagnostic and interventional procedures have become much more commonplace over the last decade. Current fluoroscopes are easily capable of producing dose rates in the range of 0.2 Gy (20 rads) per minute. The dose rate often changes dramatically with patient positioning and size. ⋯ In some cases skin doses have been in excess of 60 Gy (6000 rads). In many instances the procedures have been performed by physicians with little training in radiation effects, little appreciation of the radiation injuries that are possible or the strategies that could have been used to reduce both patient and staff doses. Almost all of the severe injuries that have occurred were avoidable.
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Semin. Ultrasound CT MR · Jun 2002
ReviewImaging of the glossopharyngeal, vagus, and accessory nerves.
The origination and course of the glossopharyngeal, vagus and accessory cranial nerves explains their function and localizes pathology. Abnormalities of these lower cranial nerves may be intrinsic or extrinsic and is due to a multiplicity of disease processes. The clinical presentation of the involved cranial nerve helps to guide imaging evaluation. Magnetic resonance imaging without and with contrast is the mainstay of imaging of cranial nerves IX, X and XI pathology, but computed tomography provides substantial information as well.
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Semin. Ultrasound CT MR · Aug 2001
ReviewClearance of the cervical spine in multitrauma patients: the role of advanced imaging.
The cervical spine is injured in 3% of major trauma patients. Radiographic clearance for injury must be provided efficiently and accurately. There are numerous choices for clearance that are now in clinical practice: lateral radiograph only, 3-view or 5-view cervical-spine (c-spine) series, flexion-extension radiographs, computed tomography (CT) with multiplanar reformations, and magnetic resonance imaging (MRI). ⋯ MRI is also much less sensitive than CT to fractures of the posterior elements of the spine, and to injuries of the craniocervical junction. The causes of missed cervical spine injury and delayed instability are discussed and shown in this article. An algorithm for the use of advanced imaging is proposed.
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Over the past 15 years there have been dramatic changes in the approach to imaging acute cervical spine trauma. This article addresses the current thoughts and controversies regarding the most appropriate techniques to evaluate the patient with cervical spine trauma, with an emphasis on the role of computed axial tomography (CT) and magnetic resonance imaging (MRI). The issue of clinical versus radiographic evaluation of low-risk patients is also discussed.