Der Radiologe
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Acute extracranial internal carotid artery (ICA) occlusions resulting in ischemic stroke are different from other forms of acute occlusions of cerebral vessels. The pathophysiological process involved in occlusion of the extracranial ICA is similar to processes observed in acute occlusion of the coronary arteries. ⋯ In these patients primary stenting of acute extracranial occlusions of the ICA is a treatment option with good clinical results. This review discusses the endovascular treatment of acute extracranial ICA occlusions.
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The management of acute stroke patients suffers from several major problems in the daily clinical routine. In order to achieve optimal treatment a complex diagnostic work-up and rapid initiation of therapy are necessary; however, most patients arrive at hospital too late for any type of acute stroke treatment, although all forms of treatment are highly time-dependent according to the generally accepted "time is brain" concept. ⋯ Currently, mobile stroke units are in operation in various countries and should lead to an improvement in stroke treatment; nevertheless, intensive research is still needed to analyze the best framework settings for prehospital stroke management.
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Interest in functional renal magnetic resonance imaging (MRI) has significantly increased in recent years. This review article provides an overview of the most important functional imaging techniques and their potential clinical applications for assessment of native and transplanted kidneys, with special emphasis on the clarification of renal tumors.
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In clinically suspected fractures taking radiographs is the standard procedure but the indications should be strictly limited. Ultrasound offers a safe and radiation-free alternative for fracture diagnostics. ⋯ Sonographic algorithms for fracture evaluation (SAFE) offer a safe diagnosis and guidance of the therapeutic course of certain pediatric fractures, thereby reducing unnecessary radiation exposure.
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Fluoroscopy-guided interventions on facet joints have been used for decades for the symptomatic management of pain in spinal disorders. A large number of imaging techniques are used to achieve a precise and safe needle placement in interventional procedures. Pulsed fluoroscopy is one of the most widely used and well-accepted tools for these procedures. This article presents a technical overview of commonly used fluoroscopy-guided interventions on the facet joints of the cervical and lumbar spine, such as facet joint injection, blockade of the medial nerve branches and radiofrequency ablation.