Link to journal
Patel, Santosh I. Souter, Michael J.
Equipment-related Electrocardiographic Artifacts: Causes, Characteristics, Consequences, and Correction
Anesthesiology. 108(1):138-148, January 2008.
Abstract
Interference of the monitored or recorded electrocardiogram is common within operating room and intensive care unit environments. Artifactual signals, which corrupt the normal cardiac signal, may arise from internal or external sources. Electrical devices used in the clinical setting can induce artifacts by various different mechanisms. Newer diagnostic and therapeutic modalities may generate artifactual changes. These artifacts may be nonspecific or may resemble serious arrhythmia. Clinical signs, along with monitored waveforms from other simultaneously monitored parameters, may provide the clues to differentiate artifacts from true changes on the electrocardiogram. Simple measures, such as proper attention to basic principles of electrocardiographic measurement, can eliminate some artifacts. However, in persistent cases, expert help may be required to identify the precise source and minimize interference on the electrocardiogram. Technological advancements in processing the electrocardiographic signal may be useful to detect and eliminate artifacts. Ultimately, an improved understanding of the artifacts generated by equipment, and their identifying characteristics, is important to avoid misinterpretation, misdiagnosis, and iatrogenic complication.
Monday 17 November 2008
Left Atrial Fibroma in Gardner Syndrome: Real-Time 3-Dimensional Transesophageal Echo Imaging
Link to journal
Yang, Hyun Suk; Arabia, Francisco A. ; Chaliki, Hari P. ; De Petris, Giovanni et al
Left Atrial Fibroma in Gardner Syndrome: Real-Time 3-Dimensional Transesophageal Echo Imaging
Circulation. 118(20):e692-e696, November 11, 2008.
Yang, Hyun Suk; Arabia, Francisco A. ; Chaliki, Hari P. ; De Petris, Giovanni et al
Left Atrial Fibroma in Gardner Syndrome: Real-Time 3-Dimensional Transesophageal Echo Imaging
Circulation. 118(20):e692-e696, November 11, 2008.
Radiology Management 2008 Vol 30 Part 5
Publishing for All
Murphy , D . L .
Page: 6-7 Vol/Issue: 2008 ; VOL 30 ; PART 5
Self - Improve U
Lipcamon , J . D .
Page: 8-9 Vol/Issue: 2008 ; VOL 30 ; PART 5
An Analysis of the CRA Credential
Hughes , M . R .
Page: 10-14 Vol/Issue: 2008 ; VOL 30 ; PART 5
Knowledge Management and the Radiologic Technologist
Kumar , V . K .
Page: 15-17 Vol/Issue: 2008 ; VOL 30 ; PART 5
Oh No , the Families Are Here !
Mulaik , M . W .
Page: 18-25 Vol/Issue: 2008 ; VOL 30 ; PART 5
Console to Council : Challenges Facing New Radiologic Managers
McDonald , A . P .
Page: 26-34 Vol/Issue: 2008 ; VOL 30 ; PART 5
A Comprehensive PET / CT Database for Tracking Patient Variables
David , G . ; Gibbs , D . ; Williams , H .
Page: 35-39 Vol/Issue: 2008 ; VOL 30 ; PART 5
Removing the Mystique of the Monitoring Report
Durbin , J .
Page: 40-49 Vol/Issue: 2008 ; VOL 30 ; PART 5
The Crisis of Radiology Succession
Kroken , P .
Maximizing Patient Safety Utilizing Effective Patient Identification and Image Labeling Practices
Aloisio , J . J .
Page: 54-59 Vol/Issue: 2008 ; VOL 30 ; PART 5
A Brief from the Chief
Boyd , G .
Page: 60-61 Vol/Issue: 2008 ; VOL 30 ; PART 5
Performance Improvement Using Lean Methodology : A Case Study
Harmelink , S .
Page: 62-65 Vol/Issue: 2008 ; VOL 30 ; PART 5
Pharmacy Review of Contrasted Studies
Yoder , E . ; Wysock , G
Page: 66-71 Vol/Issue: 2008 ; VOL 30 ; PART 5
Appreciating What You Have
Tye , G . A .
Page: 72-72 Vol/Issue: 2008 ; VOL 30 ; PART 5
Murphy , D . L .
Page: 6-7 Vol/Issue: 2008 ; VOL 30 ; PART 5
Self - Improve U
Lipcamon , J . D .
Page: 8-9 Vol/Issue: 2008 ; VOL 30 ; PART 5
An Analysis of the CRA Credential
Hughes , M . R .
Page: 10-14 Vol/Issue: 2008 ; VOL 30 ; PART 5
Knowledge Management and the Radiologic Technologist
Kumar , V . K .
Page: 15-17 Vol/Issue: 2008 ; VOL 30 ; PART 5
Oh No , the Families Are Here !
Mulaik , M . W .
Page: 18-25 Vol/Issue: 2008 ; VOL 30 ; PART 5
Console to Council : Challenges Facing New Radiologic Managers
McDonald , A . P .
Page: 26-34 Vol/Issue: 2008 ; VOL 30 ; PART 5
A Comprehensive PET / CT Database for Tracking Patient Variables
David , G . ; Gibbs , D . ; Williams , H .
Page: 35-39 Vol/Issue: 2008 ; VOL 30 ; PART 5
Removing the Mystique of the Monitoring Report
Durbin , J .
Page: 40-49 Vol/Issue: 2008 ; VOL 30 ; PART 5
The Crisis of Radiology Succession
Kroken , P .
Maximizing Patient Safety Utilizing Effective Patient Identification and Image Labeling Practices
Aloisio , J . J .
Page: 54-59 Vol/Issue: 2008 ; VOL 30 ; PART 5
A Brief from the Chief
Boyd , G .
Page: 60-61 Vol/Issue: 2008 ; VOL 30 ; PART 5
Performance Improvement Using Lean Methodology : A Case Study
Harmelink , S .
Page: 62-65 Vol/Issue: 2008 ; VOL 30 ; PART 5
Pharmacy Review of Contrasted Studies
Yoder , E . ; Wysock , G
Page: 66-71 Vol/Issue: 2008 ; VOL 30 ; PART 5
Appreciating What You Have
Tye , G . A .
Page: 72-72 Vol/Issue: 2008 ; VOL 30 ; PART 5
MRSA in MRI suites
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Dear AuntMinnie Member,
In addition to radiation dose, contrast reactions, and other imaging-related perils, you can add methicillin-resistant Staphylococcus aureus (MRSA) to the list. While MRSA hasn't yet grabbed headlines, lax infection control practices in many MRI suites could make it a growing problem.
That's according to an article by Dr. Peter A. Rothschild that we're featuring this week in our MRI Digital Community. In the article, Dr. Rothschild explains how many MRI facilities fail to take even the most basic precautions to avoid MRSA contamination.
Some facilities don't wipe down equipment after use, while others don't replace padding that's become worn or ripped -- creating environments ripe for MRSA colonization. It particularly is a problem given that some 1% of the U.S. population is colonized with MRSA, and even asymptomatic patients can spread the bacteria.
Fortunately, Dr. Rothschild offers an 11-step program that MRI facilities can implement to reduce the risk of MRSA contamination. Find out how by clicking here, or visit our MRI Digital Community at mri.auntminnie.com.
Dear AuntMinnie Member,
In addition to radiation dose, contrast reactions, and other imaging-related perils, you can add methicillin-resistant Staphylococcus aureus (MRSA) to the list. While MRSA hasn't yet grabbed headlines, lax infection control practices in many MRI suites could make it a growing problem.
That's according to an article by Dr. Peter A. Rothschild that we're featuring this week in our MRI Digital Community. In the article, Dr. Rothschild explains how many MRI facilities fail to take even the most basic precautions to avoid MRSA contamination.
Some facilities don't wipe down equipment after use, while others don't replace padding that's become worn or ripped -- creating environments ripe for MRSA colonization. It particularly is a problem given that some 1% of the U.S. population is colonized with MRSA, and even asymptomatic patients can spread the bacteria.
Fortunately, Dr. Rothschild offers an 11-step program that MRI facilities can implement to reduce the risk of MRSA contamination. Find out how by clicking here, or visit our MRI Digital Community at mri.auntminnie.com.
Wednesday 5 November 2008
Articles from Spine journal November 2008
Link to journal
Niemelainen, Riikka ; Battie, Michele C. ; Gill, Kevin ; Videman, Tapio
The Prevalence and Characteristics of Thoracic Magnetic Resonance Imaging Findings in Men
Spine. 33(23):2552-2559, November 1, 2008.
Abstract
Study Design. A cross-sectional study of thoracic magnetic resonance image (MRI) findings.Objective. To examine the prevalence of different thoracic MRI findings for T6-T12 and their associations with age and one another by level.Summary of Background Data. There is a dearth of descriptive epidemiology of thoracic MRI findings in the general population.Methods. Thoracic MRIs of 524 men were assessed qualitatively and quantitatively for a variety of findings, including disc bulging, height and signal, vertebral deformities, endplate irregularities, osteophytes, and hemangiomas. Descriptive statistics, correlation coefficients and STATA's survey analysis were used.Results. In the lower thoracic spine, 5.4% to 9.5% of the discs, depending on level, were qualitatively assessed as moderately to severely narrowed. Anterior bulging was more common than posterior, which was relatively rare and mild when present. Signal was lower in the midthoracic than lower discs. At least 1 moderate or severe vertebral deformity was found in 6.1% of the subjects, suggesting fracture, and hemangiomas were identified in 2.3% of subjects. Disc signal correlated most highly with age (r = 0.31-0.42). Qualitatively assessed disc height narrowing (r = 0.29-0.46) and quantitative disc height (r = 0.11-0.29) were associated with disc signal. Upper and lower endplate irregularities were associated with one another (r = 0.17-0.32), as were bulging and osteophytes, anteriorly (r = 0.35-0.61) and posteriorly (r = 0.26-0.45).Conclusion. Degenerative MRI findings beyond a mild grade were not commonly observed in the thoracic spine among 35-70-year-old men. Posterior bulges, in particular, were rare. The highest correlation with age existed for disc signal. Different MRI findings were associated with one another, but the magnitude of association varied by level. The effects of individual judgments and disc level on prevalence rates were apparent.(C) 2008 Lippincott Williams & Wilkins, Inc.
Matsunaga, Shunji ; Nakamura, Kozo ; Seichi, Atsushi ; Yokoyama, Toru ; Toh, Satoshi et al
Radiographic Predictors for the Development of Myelopathy in Patients With Ossification of the Posterior Longitudinal Ligament: A Multicenter Cohort Study
Spine. 33(24):2648-2650, November 15, 2008.
Abstract
Study Design. A multicenter cohort study was performed retrospectively.Objective. To identify radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligaments (OPLL).Summary of Background Data. The pathomechanism of myelopathy in the OPLL remains unknown. Some patients with large OPLL have not exhibited myelopathy for a long periods of time. Predicting the course of future neurologic deterioration in asyptomatic patients with OPLL is difficult at their initial visit.Methods. A total of 156 OPLL patients from 16 spine institutes with an average of 10.3 years of follow-up were reviewed. Subjects underwent a plain roentgenogram, computed tomography (CT), and magnetic resonance imaging of the cervical spine during the follow-up. The trauma history of the cervical spine, maximum percentage of spinal canal stenosis in a plain roentgenogram and CT, range of motion of the cervical spine, and axial ossified pattern in magnetic resonance imaging or CT were reviewed in relation to the existence of myelopathy.Results. All 39 patients with greater than 60% spinal canal stenosis on the plain roentgenogram exhibited myelopathy. Of 117 patients with less than 60% spinal canal stenosis, 57 (49%) patients exhibited myelopathy. The range of motion of the cervical spine was significantly larger in patients with myelopathy than in those of without it. The axial ossified pattern could be classified into 2 types: a central type and a lateral deviated type. The incidence of myelopathy in patients with less than 60% spinal canal stenosis was significantly higher in the lateral deviated-type group than in the central-type group. Fifteen patients of 156 subjects developed trauma-induced myelopathy. Of the 15 patients, 13 had mixed-type OPLL and 2 had segmental-type OPLL.Conclusion. Static and dynamic factors were related to the development of myelopathy in OPLL.
Niemelainen, Riikka ; Battie, Michele C. ; Gill, Kevin ; Videman, Tapio
The Prevalence and Characteristics of Thoracic Magnetic Resonance Imaging Findings in Men
Spine. 33(23):2552-2559, November 1, 2008.
Abstract
Study Design. A cross-sectional study of thoracic magnetic resonance image (MRI) findings.Objective. To examine the prevalence of different thoracic MRI findings for T6-T12 and their associations with age and one another by level.Summary of Background Data. There is a dearth of descriptive epidemiology of thoracic MRI findings in the general population.Methods. Thoracic MRIs of 524 men were assessed qualitatively and quantitatively for a variety of findings, including disc bulging, height and signal, vertebral deformities, endplate irregularities, osteophytes, and hemangiomas. Descriptive statistics, correlation coefficients and STATA's survey analysis were used.Results. In the lower thoracic spine, 5.4% to 9.5% of the discs, depending on level, were qualitatively assessed as moderately to severely narrowed. Anterior bulging was more common than posterior, which was relatively rare and mild when present. Signal was lower in the midthoracic than lower discs. At least 1 moderate or severe vertebral deformity was found in 6.1% of the subjects, suggesting fracture, and hemangiomas were identified in 2.3% of subjects. Disc signal correlated most highly with age (r = 0.31-0.42). Qualitatively assessed disc height narrowing (r = 0.29-0.46) and quantitative disc height (r = 0.11-0.29) were associated with disc signal. Upper and lower endplate irregularities were associated with one another (r = 0.17-0.32), as were bulging and osteophytes, anteriorly (r = 0.35-0.61) and posteriorly (r = 0.26-0.45).Conclusion. Degenerative MRI findings beyond a mild grade were not commonly observed in the thoracic spine among 35-70-year-old men. Posterior bulges, in particular, were rare. The highest correlation with age existed for disc signal. Different MRI findings were associated with one another, but the magnitude of association varied by level. The effects of individual judgments and disc level on prevalence rates were apparent.(C) 2008 Lippincott Williams & Wilkins, Inc.
Matsunaga, Shunji ; Nakamura, Kozo ; Seichi, Atsushi ; Yokoyama, Toru ; Toh, Satoshi et al
Radiographic Predictors for the Development of Myelopathy in Patients With Ossification of the Posterior Longitudinal Ligament: A Multicenter Cohort Study
Spine. 33(24):2648-2650, November 15, 2008.
Abstract
Study Design. A multicenter cohort study was performed retrospectively.Objective. To identify radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligaments (OPLL).Summary of Background Data. The pathomechanism of myelopathy in the OPLL remains unknown. Some patients with large OPLL have not exhibited myelopathy for a long periods of time. Predicting the course of future neurologic deterioration in asyptomatic patients with OPLL is difficult at their initial visit.Methods. A total of 156 OPLL patients from 16 spine institutes with an average of 10.3 years of follow-up were reviewed. Subjects underwent a plain roentgenogram, computed tomography (CT), and magnetic resonance imaging of the cervical spine during the follow-up. The trauma history of the cervical spine, maximum percentage of spinal canal stenosis in a plain roentgenogram and CT, range of motion of the cervical spine, and axial ossified pattern in magnetic resonance imaging or CT were reviewed in relation to the existence of myelopathy.Results. All 39 patients with greater than 60% spinal canal stenosis on the plain roentgenogram exhibited myelopathy. Of 117 patients with less than 60% spinal canal stenosis, 57 (49%) patients exhibited myelopathy. The range of motion of the cervical spine was significantly larger in patients with myelopathy than in those of without it. The axial ossified pattern could be classified into 2 types: a central type and a lateral deviated type. The incidence of myelopathy in patients with less than 60% spinal canal stenosis was significantly higher in the lateral deviated-type group than in the central-type group. Fifteen patients of 156 subjects developed trauma-induced myelopathy. Of the 15 patients, 13 had mixed-type OPLL and 2 had segmental-type OPLL.Conclusion. Static and dynamic factors were related to the development of myelopathy in OPLL.
Value of Three-Dimensional C T A in the Diagnosis and Treatment of Vascular Lesions
Leng, Tingting ; Wang, Ximing ; Huo, Ran ; Cheng, Zhaoping ; Feng, Yongqiang et al
The Value of Three-Dimensional Computed Tomographic Angiography in the Diagnosis and Treatment of Vascular Lesions
Plastic & Reconstructive Surgery. 122(5):1417-1424, November 2008.
Abstract
Background: The accurate classification of vascular lesions is important because treatment and prognosis vary from type to type. Diagnoses are based on a combination of clinical symptoms using many imaging techniques, including ultrasound, magnetic resonance imaging, and three-dimensional computed tomographic angiography, which is a relatively new technique. Until now, however, few studies on the clinical use of three-dimensional computed tomographic angiography reformations in vascular lesions have been published. The authors' study was designed to evaluate the value of three-dimensional computed tomographic angiography in the diagnosis and treatment of vascular lesions.Methods: Therapeutic plans of 16 patients with vascular lesions were made based on their three-dimensional computed tomographic angiography images. Pathologic examinations were also performed to verify the authors' diagnoses after surgery.Results: Three-dimensional computed tomographic angiography accurate distinguished hemangiomas and vascular malformations, which was proven pathologically. The information aided much in therapeutic planning. All patients underwent complete treatment without complications.Conclusions: The authors' study suggests that three-dimensional computed tomographic angiography is helpful in differential diagnosis of hemangiomas and vascular malformations and provides a global overview of the lesions. Three-dimensional computed tomographic angiography aids significantly in therapeutic planning.
The Value of Three-Dimensional Computed Tomographic Angiography in the Diagnosis and Treatment of Vascular Lesions
Plastic & Reconstructive Surgery. 122(5):1417-1424, November 2008.
Abstract
Background: The accurate classification of vascular lesions is important because treatment and prognosis vary from type to type. Diagnoses are based on a combination of clinical symptoms using many imaging techniques, including ultrasound, magnetic resonance imaging, and three-dimensional computed tomographic angiography, which is a relatively new technique. Until now, however, few studies on the clinical use of three-dimensional computed tomographic angiography reformations in vascular lesions have been published. The authors' study was designed to evaluate the value of three-dimensional computed tomographic angiography in the diagnosis and treatment of vascular lesions.Methods: Therapeutic plans of 16 patients with vascular lesions were made based on their three-dimensional computed tomographic angiography images. Pathologic examinations were also performed to verify the authors' diagnoses after surgery.Results: Three-dimensional computed tomographic angiography accurate distinguished hemangiomas and vascular malformations, which was proven pathologically. The information aided much in therapeutic planning. All patients underwent complete treatment without complications.Conclusions: The authors' study suggests that three-dimensional computed tomographic angiography is helpful in differential diagnosis of hemangiomas and vascular malformations and provides a global overview of the lesions. Three-dimensional computed tomographic angiography aids significantly in therapeutic planning.
Articles from Stroke journal November 2008
Link to journal
Schaefer, Pamela W. ; Barak, Elizabeth R. ; Kamalian, Shahmir ; Gharai, Leila Rezai et al
Quantitative Assessment of Core/Penumbra Mismatch in Acute Stroke: CT and MR Perfusion Imaging Are Strongly Correlated When Sufficient Brain Volume Is Imaged
Stroke. 39(11):2986-2992, November 2008.
Abstract
Background and Purpose-: Our purpose was to determine (1) the correlation between quantitative CT and MR measurements of infarct core, penumbra, and mismatch; and (2) whether the difference between these measurements would alter patient selection for stroke clinical trials.Methods-: We studied 45 patients with acute middle cerebral artery stroke imaged a mean of 3.8 hours after onset (range, 0.48 to 8.35 hours) who underwent CT perfusion and MR diffusion (DWI)/perfusion imaging within 3 hours of each other. The DWI and MR-mean transit time (MTT) abnormalities were visually segmented using a semiautomated commercial analysis program. The CT-cerebral blood volume) and CT-MTT lesions were automatically segmented using a relative cerebral blood volume threshold of 0.56 and a relative MTT threshold of 1.50 on commercially available software. Percent mismatch was defined as [(MTT-DWI)/DWI volume]x100. Pearson correlation coefficients were calculated.Results-: There were significant correlations for DWI versus CT-cerebral blood volume lesion volumes (r2=0.88, P<0.001), r2="0.86," r2="0.81,">=100 mL in 41 of 45 (91.1%); (2) MTT lesion size <>2 cm diameter in 42 of 45 (93.3%); (3) mismatch <>20% in 41 of 45 (91.1%); and (4) inclusion versus exclusion from trial enrollment in 38 of 45 (84.4%) patients. Six of 7 disagreements were due to inadequate CT coverage.Conclusion-: Advanced MR and CT perfusion imaging measurements of core/penumbra mismatch for patient selection in stroke trials are highly correlated when CT perfusion coverage is sufficient to include most of the ischemic region. Although MR is currently the preferred imaging method for determining core and penumbra, CT perfusion is comparable and potentially more available.
Ward, R Parker ; Lammertin, Georgeanne; Virnich, Daniel E. ; Polonsky, Tamar S. ; Lang, Roberto M. et al
Use of Carotid Intima-Media Thickness to Identify Patients With Ischemic Stroke and Transient Ischemic Attack With Low Yield of Cardiovascular Sources of Embolus on Transesophageal Echocardiography
Stroke. 39(11):2969-2974, November 2008.
Abstract
Background and Purpose-: Carotid intima-media thickness (CIMT) is associated with systemic atherosclerosis and cardioembolic conditions and predicts the risk of recurrent strokes. We sought to establish the relationship between CIMT and cardiovascular sources of embolus (CSE) on transesophageal echocardiography (TEE) and hypothesized that a noninvasive strategy of CIMT assessment and transthoracic echocardiography bubble study would identify patients with ischemic stroke or transient ischemic attack in whom TEE would provide little incremental diagnostic yield.Methods-: In 180 patients with ischemic stroke or transient ischemic attack of undetermined origin referred for TEE, we prospectively performed CIMT measurement/plaque screen (Phase 1, n=96) or CIMT measurement/plaque screen and transthoracic echocardiography bubble study (Phase 2, n=84) before TEE. Phase 1 results were used to construct receiver operating characteristic curves to demonstrate the ability of CIMT to detect CSE on TEE and to identify the optimal CIMT cutoff value for prospective strategy testing (Phase 2).Results-: In Phase 1, CIMT was found to correlate with TEE markers of aortic atherosclerosis, including complex aortic plaques, and combined CSE. The optimal CIMT cutoff for detection of CSE on TEE was 0.78 mm. In Phase 2, a positive noninvasive strategy test (CIMT >=0.78 mm, +carotid plaque, and/or a positive transthoracic echocardiography bubble study) was present in 61%. The prevalence of CSE on TEE was significantly higher among those with a positive compared with a negative noninvasive strategy test (65% versus 9%, P<0.001),>
Schaefer, Pamela W. ; Barak, Elizabeth R. ; Kamalian, Shahmir ; Gharai, Leila Rezai et al
Quantitative Assessment of Core/Penumbra Mismatch in Acute Stroke: CT and MR Perfusion Imaging Are Strongly Correlated When Sufficient Brain Volume Is Imaged
Stroke. 39(11):2986-2992, November 2008.
Abstract
Background and Purpose-: Our purpose was to determine (1) the correlation between quantitative CT and MR measurements of infarct core, penumbra, and mismatch; and (2) whether the difference between these measurements would alter patient selection for stroke clinical trials.Methods-: We studied 45 patients with acute middle cerebral artery stroke imaged a mean of 3.8 hours after onset (range, 0.48 to 8.35 hours) who underwent CT perfusion and MR diffusion (DWI)/perfusion imaging within 3 hours of each other. The DWI and MR-mean transit time (MTT) abnormalities were visually segmented using a semiautomated commercial analysis program. The CT-cerebral blood volume) and CT-MTT lesions were automatically segmented using a relative cerebral blood volume threshold of 0.56 and a relative MTT threshold of 1.50 on commercially available software. Percent mismatch was defined as [(MTT-DWI)/DWI volume]x100. Pearson correlation coefficients were calculated.Results-: There were significant correlations for DWI versus CT-cerebral blood volume lesion volumes (r2=0.88, P<0.001), r2="0.86," r2="0.81,">=100 mL in 41 of 45 (91.1%); (2) MTT lesion size <>2 cm diameter in 42 of 45 (93.3%); (3) mismatch <>20% in 41 of 45 (91.1%); and (4) inclusion versus exclusion from trial enrollment in 38 of 45 (84.4%) patients. Six of 7 disagreements were due to inadequate CT coverage.Conclusion-: Advanced MR and CT perfusion imaging measurements of core/penumbra mismatch for patient selection in stroke trials are highly correlated when CT perfusion coverage is sufficient to include most of the ischemic region. Although MR is currently the preferred imaging method for determining core and penumbra, CT perfusion is comparable and potentially more available.
Ward, R Parker ; Lammertin, Georgeanne; Virnich, Daniel E. ; Polonsky, Tamar S. ; Lang, Roberto M. et al
Use of Carotid Intima-Media Thickness to Identify Patients With Ischemic Stroke and Transient Ischemic Attack With Low Yield of Cardiovascular Sources of Embolus on Transesophageal Echocardiography
Stroke. 39(11):2969-2974, November 2008.
Abstract
Background and Purpose-: Carotid intima-media thickness (CIMT) is associated with systemic atherosclerosis and cardioembolic conditions and predicts the risk of recurrent strokes. We sought to establish the relationship between CIMT and cardiovascular sources of embolus (CSE) on transesophageal echocardiography (TEE) and hypothesized that a noninvasive strategy of CIMT assessment and transthoracic echocardiography bubble study would identify patients with ischemic stroke or transient ischemic attack in whom TEE would provide little incremental diagnostic yield.Methods-: In 180 patients with ischemic stroke or transient ischemic attack of undetermined origin referred for TEE, we prospectively performed CIMT measurement/plaque screen (Phase 1, n=96) or CIMT measurement/plaque screen and transthoracic echocardiography bubble study (Phase 2, n=84) before TEE. Phase 1 results were used to construct receiver operating characteristic curves to demonstrate the ability of CIMT to detect CSE on TEE and to identify the optimal CIMT cutoff value for prospective strategy testing (Phase 2).Results-: In Phase 1, CIMT was found to correlate with TEE markers of aortic atherosclerosis, including complex aortic plaques, and combined CSE. The optimal CIMT cutoff for detection of CSE on TEE was 0.78 mm. In Phase 2, a positive noninvasive strategy test (CIMT >=0.78 mm, +carotid plaque, and/or a positive transthoracic echocardiography bubble study) was present in 61%. The prevalence of CSE on TEE was significantly higher among those with a positive compared with a negative noninvasive strategy test (65% versus 9%, P<0.001),>
Ultrasound in Obstetrics and Gynecology Volume 32, Issue 6, 2008.
Pages: 729-731
Echogenic fetal lung lesions
A. Benachi
Pages: 732-739
Maternal serum placental growth factor at 11 + 0 to 13 + 6 weeks of gestation in the prediction of pre-eclampsia
R. Akolekar, E. Zaragoza, L. C. Y. Poon, S. Pepes, K. H. Nicolaides
Pages: 740-743
Is severe macrosomia manifested at 11-14 weeks of gestation?
R. Hackmon, K. B. Le Scale, J. Horani, A. Ferber, M. Y. Divon
Pages: 744-750
Three-dimensional inversion rendering in the first- and early second-trimester fetal brain: its use in holoprosencephaly
I. E. Timor-Tritsch, A. Monteagudo, R. Santos
Pages: 751-754
Prenasal thickness in trisomy-21 fetuses at 16-24 weeks of gestation
N. Persico, M. Borenstein, F. Molina, G. Azumendi, K. H. Nicolaides
Pages: 755-761
Normal and abnormal development of the fetal anterior fontanelle: a three-dimensional ultrasound study
D. Paladini, M. Vassallo, G. Sglavo, G. Pastore, C. Lapadula, C. Nappi
Pages: 762-768
?Big-eyed frog? sign on spatiotemporal image correlation (STIC) in the antenatal diagnosis of transposition of the great arteries
J. C. Shih, M. K. Shyu, Y. N. Su, Y. C. Chiang, C. H. Lin, C. N. Lee
Pages: 769-783
Prenatal diagnosis and outcome of echogenic fetal lung lesions
P. Cavoretto, F. Molina, S. Poggi, M. Davenport, K. H. Nicolaides
Pages: 784-792
Isolated or non-isolated duodenal obstruction: perinatal outcome following prenatal or postnatal diagnosis
T. E. Cohen-Overbeek, E. W. M. Grijseels, N. D. Niemeijer, W. C. J. Hop, J. W. Wladimiroff, D. Tibboel
Pages: 793-799
Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia
J. Jani, M. Cannie, P. Sonigo, Y. Robert, O. Moreno, A. Benachi, P. Vaast, E. Gratacos, K. H. Nicolaides, J. Deprest
Pages: 800-806
Umbilical venous volume flow in twin-twin transfusion syndrome
S. Gungor, P. Glosemeyer, A. Huber, K. Hecher, A. A. Baschat
Pages: 807-812
Fetal cardiac output in monochorionic twins
M. Sueters, J. M. Middeldorp, E. Lopriore, R. B÷kenkamp, D. Oepkes, K. A. Teunissen, H. H. H. Kanhai, S. Le Cessie, F. P. H. A. Vandenbussche
Pages: 813-818
Validation of Quintero stage III sub-classification for twin-twin transfusion syndrome based on visibility of donor bladder: characteristic differences in pathophysiology and prognosis
T. Murakoshi, K. Ishii, M. Nakata, H. Sago, et al and The Japan Fetoscopy Group
Pages: 819-827
Evaluation of pelvic ultrasonography in the diagnosis and differentiation of various forms of sexual precocity in girls
M. Badouraki, A. Christoforidis, I. Economou, A. S. Dimitriadis, G. Katzos
Pages: 828-831
Real-time ultrasound vs. evaluation of static images in the preoperative assessment of adnexal masses
C. Van Holsbeke, J. Yazbek, T. K. Holland, A. Daemen, B. De Moor, A. C. Testa, L. Valentin, D. Jurkovic, D. Timmerman
Pages: 832-834
Dizygotic monochorionic twin pregnancy conceived following intracytoplasmic sperm injection treatment and complicated by twin-twin transfusion syndrome and blood chimerism
C. K. Ekelund, L. Skibsted, K. S°gaard, K. M. Main, M. H. Dziegiel, M. Schwartz et al
Pages: 835-837
Changing findings in pentalogy of Cantrell in fetal life
V. Zidere, L. D. Allan
Pages: 838-839
Three-dimensional ultrasound diagnosis of ruptured subcapsular liver hematoma caused by HELLP syndrome
F. Raga, M. Sanz-CortĪs, F. Bonilla-Musoles
Pages: 839-840
Regression of fetal heart block and myocardial echogenicity with steroid therapy in maternal Sj÷gren's syndrome
L. L. Adams, S. Gungor, M. Salim, C. R. Harman, A. A. Baschat
Echogenic fetal lung lesions
A. Benachi
Pages: 732-739
Maternal serum placental growth factor at 11 + 0 to 13 + 6 weeks of gestation in the prediction of pre-eclampsia
R. Akolekar, E. Zaragoza, L. C. Y. Poon, S. Pepes, K. H. Nicolaides
Pages: 740-743
Is severe macrosomia manifested at 11-14 weeks of gestation?
R. Hackmon, K. B. Le Scale, J. Horani, A. Ferber, M. Y. Divon
Pages: 744-750
Three-dimensional inversion rendering in the first- and early second-trimester fetal brain: its use in holoprosencephaly
I. E. Timor-Tritsch, A. Monteagudo, R. Santos
Pages: 751-754
Prenasal thickness in trisomy-21 fetuses at 16-24 weeks of gestation
N. Persico, M. Borenstein, F. Molina, G. Azumendi, K. H. Nicolaides
Pages: 755-761
Normal and abnormal development of the fetal anterior fontanelle: a three-dimensional ultrasound study
D. Paladini, M. Vassallo, G. Sglavo, G. Pastore, C. Lapadula, C. Nappi
Pages: 762-768
?Big-eyed frog? sign on spatiotemporal image correlation (STIC) in the antenatal diagnosis of transposition of the great arteries
J. C. Shih, M. K. Shyu, Y. N. Su, Y. C. Chiang, C. H. Lin, C. N. Lee
Pages: 769-783
Prenatal diagnosis and outcome of echogenic fetal lung lesions
P. Cavoretto, F. Molina, S. Poggi, M. Davenport, K. H. Nicolaides
Pages: 784-792
Isolated or non-isolated duodenal obstruction: perinatal outcome following prenatal or postnatal diagnosis
T. E. Cohen-Overbeek, E. W. M. Grijseels, N. D. Niemeijer, W. C. J. Hop, J. W. Wladimiroff, D. Tibboel
Pages: 793-799
Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia
J. Jani, M. Cannie, P. Sonigo, Y. Robert, O. Moreno, A. Benachi, P. Vaast, E. Gratacos, K. H. Nicolaides, J. Deprest
Pages: 800-806
Umbilical venous volume flow in twin-twin transfusion syndrome
S. Gungor, P. Glosemeyer, A. Huber, K. Hecher, A. A. Baschat
Pages: 807-812
Fetal cardiac output in monochorionic twins
M. Sueters, J. M. Middeldorp, E. Lopriore, R. B÷kenkamp, D. Oepkes, K. A. Teunissen, H. H. H. Kanhai, S. Le Cessie, F. P. H. A. Vandenbussche
Pages: 813-818
Validation of Quintero stage III sub-classification for twin-twin transfusion syndrome based on visibility of donor bladder: characteristic differences in pathophysiology and prognosis
T. Murakoshi, K. Ishii, M. Nakata, H. Sago, et al and The Japan Fetoscopy Group
Pages: 819-827
Evaluation of pelvic ultrasonography in the diagnosis and differentiation of various forms of sexual precocity in girls
M. Badouraki, A. Christoforidis, I. Economou, A. S. Dimitriadis, G. Katzos
Pages: 828-831
Real-time ultrasound vs. evaluation of static images in the preoperative assessment of adnexal masses
C. Van Holsbeke, J. Yazbek, T. K. Holland, A. Daemen, B. De Moor, A. C. Testa, L. Valentin, D. Jurkovic, D. Timmerman
Pages: 832-834
Dizygotic monochorionic twin pregnancy conceived following intracytoplasmic sperm injection treatment and complicated by twin-twin transfusion syndrome and blood chimerism
C. K. Ekelund, L. Skibsted, K. S°gaard, K. M. Main, M. H. Dziegiel, M. Schwartz et al
Pages: 835-837
Changing findings in pentalogy of Cantrell in fetal life
V. Zidere, L. D. Allan
Pages: 838-839
Three-dimensional ultrasound diagnosis of ruptured subcapsular liver hematoma caused by HELLP syndrome
F. Raga, M. Sanz-CortĪs, F. Bonilla-Musoles
Pages: 839-840
Regression of fetal heart block and myocardial echogenicity with steroid therapy in maternal Sj÷gren's syndrome
L. L. Adams, S. Gungor, M. Salim, C. R. Harman, A. A. Baschat
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