Radiology
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Recent advances in computed tomography (CT) and fiberoptic bronchoscopy (FOB) have led to confusion concerning the optimal use of these modalities, especially with regard to each other. The present review summarizes the current understanding of the role of CT in relation to FOB. Emphasis is placed on optimization of CT technique and basic principles of interpretation of the images. In addition, an in-depth evaluation is presented of the advantages and limitations of CT and FOB in the analysis of both focal and diffuse diseases of the airways and lung parenchyma.
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Bedside chest radiography is one of the most frequently performed radiologic examinations, yet it is the examination with the most variation in image quality. The need to improve the quality of this examination has long been recognized, but it is a difficult problem to solve. Critically ill patients must undergo bedside chest radiography almost daily. ⋯ When grids are used, the image quality is improved; acceptance has been slow, however, because the grid is frequently misaligned. Storage phosphor imaging/computed radiography with grids is a technology improvement that almost completely solves this problem. Radiologists should be sure to optimize the current techniques, as well as provide prompt examination reporting.
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Changes in imaging sinonasal inflammatory disease have paralleled changes in the treatment of chronic sinusitis. As functional endoscopic sinus surgery has become a more widespread technique, coronal computed tomography (CT) has become the primary imaging modality, replacing plain radiography. Knowledge of the plethora of sinonasal anatomic variations and the inherent surgical implications is critical to the interpretation of the CT scans and to the safe performance of endoscopic surgery. Currently, the role of magnetic resonance imaging is restricted to the evaluation of complicated sinusitis, intraorbital and intracranial manifestations of aggressive sinusitis, and sinonasal neoplasms.