Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2003
ReviewImaging evaluation of sinusitis: diagnostic performance and impact on health outcome.
Sinusitis is a highly prevalent disease, with a significant impact on the health care economy. Sinus CT is the primary imaging modality for evaluation of acute and chronic sinusitis. ⋯ Although sinus CT has been criticized for lack of specificity and correlation with patients' clinical symptoms, sinus CT may provide pivotal objective information that affects treatment decisions for acute and chronic sinusitis. This article provides a clinical overview and reviews the role of imaging studies in diagnosis and treatment of sinusitis.
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Neuroimaging Clin. N. Am. · May 2003
ReviewPercutaneous vertebroplasty: rationale, clinical outcomes, and future directions.
Percutaneous transpediculate vertebroplasty is an innovative and successful treatment of painful osteoporotic and pathologic compression fractures that are refractory to medical therapy. Large-scale clinical series have shown that vertebroplasty can provide significant pain relief with very low complication rates. Expectations of positive results of the ongoing randomized trials are high. With the accumulation of scientific data, technological advancements, and acceptance by the general community, vertebroplasty may be become the standard of care for treatment of painful vertebral body compression fractures.
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Society is increasingly demanding proof that imaging has an impact on patient outcome and questioning its cost on the health care delivery system. Radiologists should provide the following three key components in their research publications: (1) the statistical power and confidence intervals of the results obtained; (2) the diagnostic performance of the tests, including sensitivity, specificity, and ROC curves; and (3) comprehensive decision analysis and cost-effectiveness analysis to determine the impact that imaging has on health outcome, cost, and quality of life. Strict adherence to these evidence-based medicine principles would help advance the field and provide the best health care for patients.
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Neuroimaging Clin. N. Am. · May 2003
ReviewHow different MR imaging criteria relate to the diagnosis of multiple sclerosis and its outcome.
This article reviews the evolution of MR imaging criteria used to diagnose multiple sclerosis (MS) over the past decade and a half to help demonstrate how these changes have influenced the sensitivity and specificity of diagnosing and treating patients with MS. The article discusses the benefits and drawbacks of making very specific diagnoses versus sensitive but less specific diagnoses. In addition, the application of these various diagnostic criteria to patient outcomes and clinical trials is reviewed.
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Neuroimaging Clin. N. Am. · May 2003
ReviewBrain neoplasms: epidemiology, diagnosis, and prospects for cost-effective imaging.
Currently, the literature lacks a solid body of research on decision and cost-effectiveness analysis of imaging strategies for adults and children suspected of having a brain neoplasm. This article describes the epidemiology and clinical presentation of brain neoplasms, reviews current diagnostic strategies, highlights gaps in the literature on decision and cost-effectiveness analysis, and suggests directions for future research.