Radiology
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Review
Diffusion-tensor MR imaging and tractography: exploring brain microstructure and connectivity.
Diffusion magnetic resonance (MR) imaging is evolving into a potent tool in the examination of the central nervous system. Although it is often used for the detection of acute ischemia, evaluation of directionality in a diffusion measurement can be useful in white matter, which demonstrates strong diffusion anisotropy. ⋯ However, optimal utilization of the wide range of data provided with directional diffusion MR measurements requires careful attention to acquisition and postprocessing. This article will review the principles of diffusion contrast and anisotropy, as well as clinical applications in psychiatric, developmental, neurodegenerative, neoplastic, demyelinating, and other types of disease.
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Compared with mammography and breast ultrasonography, contrast material-enhanced magnetic resonance (MR) imaging is a breast imaging technique that offers not only information on lesion cross-sectional morphology but also on functional lesion features such as tissue perfusion and enhancement kinetics. After an enthusiastic start to clinical breast MR imaging in the early 1990s, a variety of difficulties and obstacles were identified that hampered the transfer of the modality into clinical practice, including a lack of standardization regarding image acquisition and interpretation guidelines, a lack of MR-compatible interventional materials, and a lack of evidence regarding its diagnostic accuracy--particularly specificity and positive predictive value, as well as sensitivity for ductal carcinoma in situ. This article is the first of two on the current status of breast MR imaging. ⋯ Advantages and disadvantages of different pulse sequence parameters are discussed to help radiologists make a balanced and informed decision regarding choice of image acquisition protocol. Imaging findings in common benign and malignant changes are described, and current concepts for differential diagnosis, including the MR Breast Imaging Reporting and Data System lexicon, are discussed. Furthermore, obstacles that impeded the technique's transfer into clinical practice are discussed, and the progress made in recent years, especially regarding the development of guidelines, procedural standardization, and MR-guided interventions are outlined.
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To perform a systematic review of the literature regarding the natural course of ligamentous and meniscal knee lesions detected at magnetic resonance (MR) imaging. ⋯ The ACL and PCL can regain continuity after partial or complete rupture. On the basis of this review, no conclusions can be drawn about the natural course of meniscal or collateral ligament injury seen at MR imaging.
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Review
Assessing cervical spine stability in obtunded blunt trauma patients: review of medical literature.
To review the current medical literature on dynamic fluoroscopic and magnetic resonance (MR) imaging assessment of cervical spine stability in obtunded patients who sustained blunt trauma. ⋯ Review of the current medical literature provided no clear evidence of the superiority of either MR imaging or dynamic fluoroscopy in the diagnosis of unstable ligamentous injury, although other relative advantages of MR imaging indicate that it is preferred for assessing cervical spine stability in obtunded blunt trauma patients.
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Opportunities for funded radiologic research are greater than ever, and the amount of federal funding coming to academic radiology departments is increasing. Even so, many medical school-based radiology departments have little or no research funding. ⋯ The consensus panel included radiologists who have leadership roles in some of the best-funded research departments, radiologists who direct other funded research programs, and radiologists with related expertise. The goals of the consensus panel were to identify the attributes associated with successful research programs and to develop an action plan for radiology research based on these characteristics.