Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Aug 2003
ReviewInfection of the facial area, oral cavity, oropharynx, and retropharynx.
Radiologists play an important role in the evaluation of upper neck infections. Although most oral cavity infections arise from diseased teeth, several other sources of infection need to be considered. The distinction between abscess and phlegmon is of particular importance. Cross-sectional imaging is frequently used to identify complications of the initial infection.
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Because the diagnosis of mandibular ORN can often essentially be based on clinical grounds, radiology is used for confirmation and evaluation of the extent of the bone involvement. The localization and extent of the bone destruction can be better evaluated with CT than with conventional occlusal or panoramic films. Nevertheless, plain films often provide sufficient information for patient management. Based on the clinical evaluation and plain imaging findings, a decision can be made to treat patients conservatively or surgically.
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Neuroimaging Clin. N. Am. · May 2003
ReviewNeuroimaging in Alzheimer disease: an evidence-based review.
Current clinical criteria (DSM-IIIR and NINCDS-ADRDA) for the diagnosis of dementia and AD are reliable; however, these criteria remain to be validated by clinicians of different levels of expertise at different clinical settings. Structural neuroimaging has an important role in initial evaluation of dementia for ruling out potentially treatable causes. Although CT is the appropriate choice when brain tumors, subdural hematoma, or normal pressure hydrocephalus is suspected, MR imaging is more sensitive to the white-matter changes in vascular dementia. ⋯ These neuroimaging markers may be useful for monitoring symptomatic progression in groups of patients with AD for drug trials. Furthermore, antemortem MR-based hippocampal volumes correlate with the pathologic stage of AD, and the rate of hippocampal volume loss on MR imaging correlates with clinical disease progression in the cognitive continuum from normal aging to MCI and to AD. Hence, as an in vivo correlate of pathologic involvement, structural imaging measures are potential surrogate markers for disease progression in patients with established AD and in patients with prodromal AD, who will benefit most from disease-modifying therapies underway.
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Neuroimaging Clin. N. Am. · May 2003
ReviewAdults and children with headache: evidence-based diagnostic evaluation.
Headache represents one of the most common complaints in the outpatient and emergency room setting [1]. Most causes of headache are benign and do not require emergent imaging or intervention. The authors' review of the diagnostic tests does not offer absolute indications for neuroimaging because most of the evidence is based on studies that are not randomized controlled trials. ⋯ In high-risk patients, MR imaging is the test of choice whereas in low-risk patients, close clinical observation with periodic reassessment is the best strategy [44]. Clinical diagnosis will always play a key role in the evaluation of headache disorders; however, for the small subset of patients who present with headache secondary to an intracranial space-occupying lesion, bleeding, or SAH, making the diagnosis is crucial to decreasing morbidity and mortality. CT, MR imaging, and lumbar puncture play important roles in the assessment of headache disorders, but their future roles will continue to evolve as the technology becomes more sophisticated and robust, and physicians become more expert with their use [1].
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Neuroimaging Clin. N. Am. · May 2003
ReviewAmyotrophic lateral sclerosis and primary lateral sclerosis: evidence-based diagnostic evaluation of the upper motor neuron.
Magnetic resonance imaging and MR spectroscopy are important tools in the diagnostic evaluation of patients with suspected motor neuron disease. Further investigation is needed to determine and to compare the utility of various neuroimaging markers for diagnosis and disease progression [112]. Newer MR tools, such as diffusion tensor imaging, magnetization transfer imaging, and functional MR imaging, have substantial promise as scientific and clinical tools in this ongoing endeavor.