Radiologic clinics of North America
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Radiol. Clin. North Am. · Nov 2000
ReviewAnatomy of the extradural compartments of the lumbar spinal canal. Peridural membrane and circumneural sheath.
The development of newer and more accurate methods of identifying the structures within the spinal canal has given a much better understanding of the soft tissue structures that lie between the dura and the surrounding bone of the vertebral canal. One anatomic structure of special importance, but seldom spoken of, is the peridural membrane. Although it was mentioned in the writings of Fick14 as early as 1904, it was Dommissee12,13 who first described it accurately and who named it the peridural membrane. ⋯ At this same point the dural sleeve becomes adherent to the nerve and henceforth is called the epineurium. For this 1- to 2- cm segment of spinal nerve from the dura to just beyond the ganglion we propose the name dural root sleeve. After all, it is a sleeve, it is made of dura, and it covers two nerve roots.
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Radiol. Clin. North Am. · Sep 2000
ReviewThe thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings.
Thyroid imaging approach is based on the preliminary clinical evaluation. Lesions that are smaller than 2 cm should be assessed with US, which is capable of discriminating masses as small as 2 mm and distinguishing solid from cystic nodules. US-guided FNAB provides tissue for cytologic examination of thyroid nodules. ⋯ Ectopic adenomas, particularly if they are located in the mediastinum, are preferrably investigated with CT and MR imaging with gadolinium and fat suppression. Carcinomas and parathyroid cysts are optimally evaluated by CT and MR imaging. On MR imaging adenomas are low in signal intensity on T1-weighted images, high in signal intensity on T2-weighted images, and enhance post introduction of gadolinium.
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Radiol. Clin. North Am. · Sep 2000
ReviewCT and MR imaging evaluation of neck infections with clinical correlations.
Infection of the neck is a common clinical problem in all age groups, especially children and young adults. The clinical symptoms and signs are often suggestive of the diagnosis. ⋯ Conventional films consisting of an anteroposterior and lateral view were the examination before the introduction of CT in 1972. Conventional films can still be used for a preliminary survey, especially of the retropharyngeal space when there is a question of a retropharyngeal phlegmon or abscess.
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Radiol. Clin. North Am. · Mar 2000
ReviewImage-guided management of complicated pleural fluid collections.
Percutaneous image-guided catheter drainage with adjunctive ICFT has become the mainstay in the treatment of complicated pleural fluid collections. There are six basic principles of image-guided drainage and ICFT that must be understood to maximize the efficacy and safety of the procedure. 1. There must be a basic understanding of why traditional nonguided thoracostomy drainage fails in a significant percentage of patients. ⋯ Effective closed drainage carries lower morbidity, mortality, and cost than does open surgical drainage. For radiologists and clinicians alike it does not suffice simply to place one or more thoracostomy tubes, round daily, and hope that the occasional use of fibrinolytic agents does the rest. Without a more aggressive approach to catheter position and management the efficacy is no greater than that historically seen with nonguided closed drainage and surgeons will continue to plead for earlier effective open drainage.