Link to journal online
O'Connor, Maeve; Coleman, Margaret; Wallis, Fintan ; Harmon, Dominic
An Anatomical Study of the Parasacral Block Using Magnetic Resonance Imaging of Healthy Volunteers.
Anesthesia & Analgesia. 108(5):1708-1712, May 2009.
Abstract
BACKGROUND: The parasacral approach to sciatic blockade is reported to be easy to learn and perform, with a high success rate and few complications.METHODS: Using magnetic resonance imaging, we evaluated the accuracy of a simulated needle (perpendicular to skin) in contacting the sacral plexus with this approach in 10 volunteers. Intrapelvic structures encountered during the simulated parasacral blocks were also recorded.RESULTS: The sacral plexus was contacted by the simulated needle in 4 of the 10 volunteers, and the sciatic nerve itself in one volunteer. The plexus was accurately located adjacent to a variety of visceral structures, including small bowel, blood vessels, and ovary. In the remaining five volunteers (in whom the plexus was not contacted on first needle pass), small bowel, rectum, blood vessels, seminal vesicles, and bony structures were encountered. Historically, when plexus is not encountered, readjustment of the needle insertion point more caudally has been recommended. We found that such an adjustment resulted in simulated perforation of intrapelvic organs or the perianal fossa.CONCLUSIONS: These findings question the reliability of the anatomical landmarks of the parasacral block and raise the possibility of frequent visceral puncture using this technique.
Wachtel, Ruth E. ; Dexter, Franklin ; Dow, Angella J.
Growth Rates in Pediatric Diagnostic Imaging and Sedation.
Anesthesia & Analgesia. 108(5):1616-1621, May 2009.
Abstract
BACKGROUND: Workload has increased greatly over the past decade for anesthesia providers administering general anesthesia and/or sedation for pediatric diagnostic imaging.METHODS: Data from an academic medical center were studied over a 12-yr period. Growth in the number of children 0-17 yr of age undergoing magnetic resonance imaging (MRI) and/or computerized tomography (CT) scans who received care from anesthesia providers was compared with the increase in the total number of MRI and CT procedures performed in children. Anesthesia providers included anesthesiologists, residents, Certified Registered Nurse Anesthetists, and student Certified Registered Nurse Anesthetists. Toward the end of the study, a team of sedation nurses was employed by the hospital to administer moderate sedation. They provided an alternative to anesthesia providers from the anesthesia department, who usually administered general anesthesia. Use of sedation nurses versus anesthesia providers, and the relationship to scan duration and patient age, were studied over a 6-mo period.RESULTS: The number of children receiving care from anesthesia providers for MRI and CT scans grew at the same 8%-9% annual rate as the number of scans performed. The percentage of children receiving anesthesia care did not change over the 12 yr. Creation of a nurse sedation team that provided moderate sedation did not alter the number of children receiving care from anesthesia providers but did increase the total number of children receiving hypnotics. Anesthesia was rarely used for scans shorter than 30 min in duration. Increases in scan duration were associated with increased utilization of anesthesia providers for both MRI and CT after stratifying by age. An age of 3-5 yr was associated with the highest rates of anesthesia care.CONCLUSIONS: Future workload for anesthesia providers administering general anesthesia and/or sedation for pediatric diagnostic imaging will depend on trends in the total number of scans performed. Workload may also be sensitive to factors that increase scan duration or alter the percentage of patients in the 3-5 yr age group. It may additionally depend on reimbursements from insurance companies.
Gadhinglajkar, Shrinivas ; Sreedhar, Rupa
Surgery for Anomalous Origin of Left Coronary Artery From Pulmonary Artery: The Utility of Intraoperative Transesophageal Echocardiography.
Anesthesia & Analgesia. 108(5):1470-1472, May 2009.
Garwood, Susan MB, ChB
Measuring Renal Blood Flow with the Intraoperative Transesophageal Echocardiography Probe.[Editorial]
Anesthesia & Analgesia. 108(5):1371-1376, May 2009.
Yang, Ping-Liang ; Wong, David T. ; Dai, Shuang-Bo ; Song, Hai-Bo et al
The Feasibility of Measuring Renal Blood Flow Using Transesophageal Echocardiography in Patients Undergoing Cardiac Surgery.
Anesthesia & Analgesia. 108(5):1418-1424, May 2009.
Abstract
BACKGROUND: There is no reliable method to monitor renal blood flow intraoperatively. In this study, we evaluated the feasibility and reproducibility of left renal blood flow measurements using transesophageal echocardiography during cardiac surgery.METHODS: In this prospective noninterventional study, left renal blood flow was measured with transesophageal echocardiography during three time points (pre-, intra-, and postcardiopulmonary bypass) in 60 patients undergoing cardiac surgery. Sonograms from 6 subjects were interpreted by 2 blinded independent assessors at the time of acquisition and 6 mo later. Interobserver and intraobserver reproducibility were quantified by calculating variability and intraclass correlation coefficients.RESULTS: Patients with Doppler angles of >30[degrees] (20 of 60 subjects) were eliminated from renal blood flow measurements. Left renal blood flow was successfully measured and analyzed in 36 of 60 (60%) subjects. Both interobserver and intraobserver variability were <10%.>
Monday 8 June 2009
Articles from BJOG
Link to journal online
Song, Y a; Yang, J a; Liu, Z b; Shen, K a;
Preoperative evaluation of endometrial carcinoma by contrast-enhanced ultrasonography.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):294-299, January 2009.
Abstract
Objective: To investigate the potential usefulness of contrast-enhanced ultrasonography in the preoperative evaluation of endometrial carcinoma and observe its enhancement pattern and time-intensity curve.Design: A prospective study.Setting: Gynaecological department of a college hospital.Population: A total of 35 women diagnosed with endometrial carcinoma.Methods: The patients were evaluated with real-time grey-scale contrast-enhanced ultrasonography. In 21 women, the parameters of time-intensity curve were compared between the endometrial lesion and normal myometrium. Findings about the depth of myometrial invasion on sonograms were compared with histological findings.Main outcome measures: Enhancement pattern, parameters of time-intensity curve, depth of myometrial invasion detected on sonograms.Results: In visual evaluation, the brightness of the power Doppler signal and the amount of recognisable vascular areas increased in each tumour after contrast agent administration. Feeding vessels of the tumour were shown in 77.1% (27/35) of women. The other 22.9% (8/35) of women revealed that the signals were first visualised in the central portion of the tumour. The arrival time and peak time of endometrial lesion tended to be shorter than normal myometrium. The tumours started to enhance earlier than or at the same time as myometrium in 90.5% (19/21) of women. The peak intensity, enhancement intensity, and rising rate were higher in endometrial lesion than normal myometrium. There was no myometrial invasion in eight women, inner half myometrial invasion in 19 women and the outer half myometrial invasion in eight women. The corresponding values for ultrasound were 9, 17, and 9. The sensitivity of contrast-enhanced ultrasonography in detecting deep invasion was 75.0%, while the specificity was 88.9%, and the accuracy was 85.7%. The overall accuracy of assessment of myometrial invasion was 68.6%.Conclusion: There is some benefit in contrast-enhanced ultrasonography of endometrial carcinoma. It may provide better information in tumour imaging. Large studies are needed to determine the appropriate use and benefit of this new procedure.
Rousian, M ; Verwoerd-Dikkeboom, C M ; Koning, A HJ ; Hop, W C et al
Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):278-285, January 2009.
Abstract
Objective: To investigate accuracy and reliability of four different ultrasound-related volume-measuring methods.Design: Observational study.Setting: Both in vitro and in vivo.Population or Sample: Ten phantoms for in vitro measurements and 28 pregnancies with gestational ages ranging from 6 to 11 weeks for in vivo measurements were included.Methods: Three-dimensional (3D) ultrasound images of phantoms (with known variable contents) and yolk sacs were used to calculate volumes using four different methods: Virtual Organ Computed-Aided AnaLysis (VOCAL), inversion mode, Sono Automatic Volume Calculation (SonoAVC) and V-Scope. V-Scope is a newly developed 3D volume visualisation application using a Barco I-Space virtual reality system. Intra- and interobserver agreement was established by calculating intraclass correlation coefficients (ICC).Main outcome measure: Evaluation of accuracy and reliability by comparing the different techniques with true volumes (in vitro) and with each other (in vitro and in vivo).Results: In the in vitro study, volume measurements by VOCAL, inversion mode and V-Scope proved to be accurate. SonoAVC measurements resulted in a substantial systematic underestimation. Correlation coefficients of measured versus true volumes were excellent in all four techniques. For all techniques, an intra- and interobserver agreement of at least 0.91 was found. Yolk sac measurements by the different techniques proved to be highly correlated (ICCs > 0.91).Conclusions: We demonstrated that VOCAL, inversion mode and V-Scope can all be used to measure volumes of hypoechoic structures. The newly introduced V-Scope application proved to be accurate and reliable.
Vincent, K ; Moore, J ; Kennedy, S ; Tracey, I
Blood oxygenation level dependent functional magnetic resonance imaging: current and potential uses in obstetrics and gynaecology.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):240-246, January 2009.
Abstract
Blood-oxygenation-level-dependent functional magnetic resonance imaging is a noninvasive technique that has become increasingly popular in the neurosciences. It measures the proportion of oxygenated haemoglobin in specific areas of the brain, mirroring blood flow and therefore function. Here we review how the findings from functional studies impact on areas of gynaecological practice as diverse as chronic pain, continence, and premenstrual dysphoric disorder. Finally we review some of the more novel applications of the technique, such as imaging of pelvic floor function and the effects of hypoxia on the fetus.
Louwers, J A ; Kocken, M ; Harmsel, W Ater ; Verheijen, R HM e
Digital colposcopy: ready for use? An overview of literature.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):220-229, January 2009.
Abstract
The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.
Song, Y a; Yang, J a; Liu, Z b; Shen, K a;
Preoperative evaluation of endometrial carcinoma by contrast-enhanced ultrasonography.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):294-299, January 2009.
Abstract
Objective: To investigate the potential usefulness of contrast-enhanced ultrasonography in the preoperative evaluation of endometrial carcinoma and observe its enhancement pattern and time-intensity curve.Design: A prospective study.Setting: Gynaecological department of a college hospital.Population: A total of 35 women diagnosed with endometrial carcinoma.Methods: The patients were evaluated with real-time grey-scale contrast-enhanced ultrasonography. In 21 women, the parameters of time-intensity curve were compared between the endometrial lesion and normal myometrium. Findings about the depth of myometrial invasion on sonograms were compared with histological findings.Main outcome measures: Enhancement pattern, parameters of time-intensity curve, depth of myometrial invasion detected on sonograms.Results: In visual evaluation, the brightness of the power Doppler signal and the amount of recognisable vascular areas increased in each tumour after contrast agent administration. Feeding vessels of the tumour were shown in 77.1% (27/35) of women. The other 22.9% (8/35) of women revealed that the signals were first visualised in the central portion of the tumour. The arrival time and peak time of endometrial lesion tended to be shorter than normal myometrium. The tumours started to enhance earlier than or at the same time as myometrium in 90.5% (19/21) of women. The peak intensity, enhancement intensity, and rising rate were higher in endometrial lesion than normal myometrium. There was no myometrial invasion in eight women, inner half myometrial invasion in 19 women and the outer half myometrial invasion in eight women. The corresponding values for ultrasound were 9, 17, and 9. The sensitivity of contrast-enhanced ultrasonography in detecting deep invasion was 75.0%, while the specificity was 88.9%, and the accuracy was 85.7%. The overall accuracy of assessment of myometrial invasion was 68.6%.Conclusion: There is some benefit in contrast-enhanced ultrasonography of endometrial carcinoma. It may provide better information in tumour imaging. Large studies are needed to determine the appropriate use and benefit of this new procedure.
Rousian, M ; Verwoerd-Dikkeboom, C M ; Koning, A HJ ; Hop, W C et al
Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):278-285, January 2009.
Abstract
Objective: To investigate accuracy and reliability of four different ultrasound-related volume-measuring methods.Design: Observational study.Setting: Both in vitro and in vivo.Population or Sample: Ten phantoms for in vitro measurements and 28 pregnancies with gestational ages ranging from 6 to 11 weeks for in vivo measurements were included.Methods: Three-dimensional (3D) ultrasound images of phantoms (with known variable contents) and yolk sacs were used to calculate volumes using four different methods: Virtual Organ Computed-Aided AnaLysis (VOCAL), inversion mode, Sono Automatic Volume Calculation (SonoAVC) and V-Scope. V-Scope is a newly developed 3D volume visualisation application using a Barco I-Space virtual reality system. Intra- and interobserver agreement was established by calculating intraclass correlation coefficients (ICC).Main outcome measure: Evaluation of accuracy and reliability by comparing the different techniques with true volumes (in vitro) and with each other (in vitro and in vivo).Results: In the in vitro study, volume measurements by VOCAL, inversion mode and V-Scope proved to be accurate. SonoAVC measurements resulted in a substantial systematic underestimation. Correlation coefficients of measured versus true volumes were excellent in all four techniques. For all techniques, an intra- and interobserver agreement of at least 0.91 was found. Yolk sac measurements by the different techniques proved to be highly correlated (ICCs > 0.91).Conclusions: We demonstrated that VOCAL, inversion mode and V-Scope can all be used to measure volumes of hypoechoic structures. The newly introduced V-Scope application proved to be accurate and reliable.
Vincent, K ; Moore, J ; Kennedy, S ; Tracey, I
Blood oxygenation level dependent functional magnetic resonance imaging: current and potential uses in obstetrics and gynaecology.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):240-246, January 2009.
Abstract
Blood-oxygenation-level-dependent functional magnetic resonance imaging is a noninvasive technique that has become increasingly popular in the neurosciences. It measures the proportion of oxygenated haemoglobin in specific areas of the brain, mirroring blood flow and therefore function. Here we review how the findings from functional studies impact on areas of gynaecological practice as diverse as chronic pain, continence, and premenstrual dysphoric disorder. Finally we review some of the more novel applications of the technique, such as imaging of pelvic floor function and the effects of hypoxia on the fetus.
Louwers, J A ; Kocken, M ; Harmsel, W Ater ; Verheijen, R HM e
Digital colposcopy: ready for use? An overview of literature.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):220-229, January 2009.
Abstract
The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.
Articles from Neurology
Link to journal online
Copenhaver, B R. ; Shin, J ; Warach, S ; Butman, J A. ; Saver, J L. ; Kidwell, C S.
Gradient echo MRI: Implementation of a training tutorial for intracranial hemorrhage diagnosis.
Neurology. 72(18):1576-1581, May 5, 2009.
Abstract
Background: Recent studies have demonstrated that gradient echo (GRE) MRI sequences are as accurate as CT for the detection of intracerebral hemorrhage (ICH) in the context of acute stroke. However, many physicians who currently read acute stroke imaging studies may be unfamiliar with interpretation of GRE images.Methods: An NIH Web-based training program was developed including a pretest, tutorial, and posttest. Physicians involved in the care of acute stroke patients were encouraged to participate. The tutorial covered acute, chronic, and mimic hemorrhages as they appear on CT, diffusion-weighted imaging, and GRE sequences. Ability of users to identify ICH presence, type, and age on GRE was compared from the pretest to posttest timepoint.Results: A total of 104 users completed the tutorial. Specialties represented included general radiology (42%), general neurology (16%), neuroradiology (15%), stroke neurology (14%), emergency medicine (1%), and other (12%). Median overall score improved pretest to posttest from 66.7% to 83.3%, p < p =" 0.787.">
Rovaris, M MD; Barkhof, F MD; Calabrese, M MD; De Stefano, N MD; Fazekas, F et al
MRI features of benign multiple sclerosis: Toward a new definition of this disease phenotype.[Review]
Neurology. 72(19):1693-1701, May 12, 2009.
Abstract
It is well known that the current classification of patients with benign multiple sclerosis (BMS), i.e., those with absent or minimal locomotor disability several years after disease onset, suffers from not having any prognostic value for the subsequent evolution of multiple sclerosis (MS). The identification of markers predictive of the longer-term course of MS will help define BMS more reliably and would allow better counseling of patients, particularly when advising on the initiation of a disease-modifying treatment. MRI-based evidence suggests that there are three potential, but not mutually exclusive, explanations for the scarce clinical impact of BMS: 1) the paucity of tissue damage within and outside MS lesions; 2) the relative sparing of clinically eloquent regions; and 3) the presence of effective compensatory mechanisms. In addition, the results of correlative MRI/neuropsychology studies underpin the need for a new definition of BMS, which should consider the maintenance of a normal cognitive profile as an additional criterion.
Copenhaver, B R. ; Shin, J ; Warach, S ; Butman, J A. ; Saver, J L. ; Kidwell, C S.
Gradient echo MRI: Implementation of a training tutorial for intracranial hemorrhage diagnosis.
Neurology. 72(18):1576-1581, May 5, 2009.
Abstract
Background: Recent studies have demonstrated that gradient echo (GRE) MRI sequences are as accurate as CT for the detection of intracerebral hemorrhage (ICH) in the context of acute stroke. However, many physicians who currently read acute stroke imaging studies may be unfamiliar with interpretation of GRE images.Methods: An NIH Web-based training program was developed including a pretest, tutorial, and posttest. Physicians involved in the care of acute stroke patients were encouraged to participate. The tutorial covered acute, chronic, and mimic hemorrhages as they appear on CT, diffusion-weighted imaging, and GRE sequences. Ability of users to identify ICH presence, type, and age on GRE was compared from the pretest to posttest timepoint.Results: A total of 104 users completed the tutorial. Specialties represented included general radiology (42%), general neurology (16%), neuroradiology (15%), stroke neurology (14%), emergency medicine (1%), and other (12%). Median overall score improved pretest to posttest from 66.7% to 83.3%, p < p =" 0.787.">
Rovaris, M MD; Barkhof, F MD; Calabrese, M MD; De Stefano, N MD; Fazekas, F et al
MRI features of benign multiple sclerosis: Toward a new definition of this disease phenotype.[Review]
Neurology. 72(19):1693-1701, May 12, 2009.
Abstract
It is well known that the current classification of patients with benign multiple sclerosis (BMS), i.e., those with absent or minimal locomotor disability several years after disease onset, suffers from not having any prognostic value for the subsequent evolution of multiple sclerosis (MS). The identification of markers predictive of the longer-term course of MS will help define BMS more reliably and would allow better counseling of patients, particularly when advising on the initiation of a disease-modifying treatment. MRI-based evidence suggests that there are three potential, but not mutually exclusive, explanations for the scarce clinical impact of BMS: 1) the paucity of tissue damage within and outside MS lesions; 2) the relative sparing of clinically eloquent regions; and 3) the presence of effective compensatory mechanisms. In addition, the results of correlative MRI/neuropsychology studies underpin the need for a new definition of BMS, which should consider the maintenance of a normal cognitive profile as an additional criterion.
Articles from Anesthesiology
Link to journal online
Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging: A Report by the American Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging
Source
Anesthesiology. 110(3):459-479, March 2009.
Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging: A Report by the American Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging
Source
Anesthesiology. 110(3):459-479, March 2009.
Articles from Stroke
Link to journal online
Earnshaw, Stephanie R. PhD; Jackson, Dan MSc; Farkouh, Ray PhD; Schwamm, Lee MD;
Cost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis.
Stroke. 40(5):1710-1720, May 2009.
Abstract
Background and Purpose-: Better selection of patients for intravenous recombinant tissue plasminogen activator (IV tPA) treatment may improve clinical outcomes. We examined the cost-effectiveness of adding penumbral-based MRI to usual computed tomography (CT)-based methods to identify patients for IV tPA treatment.Methods-: A decision-analytic model estimated the lifetime costs and outcomes associated with penumbral-based MRI selection in a patient population similar to that enrolled in the IV tPA clinical trials. Inputs were obtained from published literature, clinical trial data, claims databases, and expert opinion. Outcomes included cost per life-year saved and cost per quality-adjusted life-year (QALY) gained. Costs and outcomes were discounted at 3% annually. Sensitivity analyses were conducted.Results-: The addition of penumbral-based MRI selection increased total cost by $103 over the patient's remaining lifetime. Penumbral-based MRI selection resulted in favorable outcomes (modified Rankin Scale <=1) more often than CT-based selection (36.66% versus 35.06%) with an incremental cost per life year of $1840 and an incremental cost per QALY of $1004. Multivariate sensitivity analysis predicted cost-effectiveness (<=$50 000 per QALY) in 99.7% of simulation runs.Conclusions-: Selecting ischemic stroke patients for IV tPA treatment using penumbral-based MRI after routine CT may increase overall acute care costs, but the benefit is large enough to make this highly cost-effective. This economic analysis lends further support to the consideration of a paradigm shift in acute stroke evaluation
Kidwell, Chelsea S. MD; Lees, Kennedy R. MD; Muir, Keith W. MD; Chen, Christopher et al
Results of the MRI Substudy of the Intravenous Magnesium Efficacy in Stroke Trial.
Stroke. 40(5):1704-1709, May 2009.
Abstract
Background and Purpose-: Although magnesium is neuroprotective in animal stroke models, no clinical benefit was confirmed in the Intravenous Magnesium Efficacy in Stroke (IMAGES) trial of acute stroke patients. The Magnetic Resonance in IMAGES (MR IMAGES) substudy investigated the effects of magnesium on the imaging surrogate outcome of infarct growth.Methods-: IMAGES trial patients in participating centers were randomized to receive either intravenous magnesium or placebo within 12 hours of stroke onset. Infarct growth was defined as volume difference between baseline diffusion-weighted imaging and day 90 fluid-attenuated inversion recovery image lesions. Patients who died were imputed the largest infarct growth observed.Results-: Among the 90 patients included in the primary analysis, there was no difference in infarct growth (median absolute growth, P=0.639; median percentage growth, P=0.616; proportion with any growth, P=0.212) between the 46 treated with magnesium and 44 with placebo. Infarct growth correlated with NIHSS score change from baseline to day 90. There was a trend showing baseline serum glucose correlated with infarct growth with magnesium treatment, but not in the placebo group. The mismatch frequency was reduced from 73% to 47% by increasing the mismatch threshold from >20% to >100% of core volume.Conclusions-: Infarct growth, confirmed here as a surrogate for clinical progression, was similar between magnesium and placebo treatment, paralleling the main IMAGES trial clinical outcomes. Glucose was a covariate for infarct growth with magnesium treatment. A more stringent mismatch threshold to define penumbra more appropriately would have excluded half of the patients in this 12-hour time window stroke study.
Heiss, Wolf-Dieter MD; Sorensen, A Gregory MD;
Advances in Imaging
Source
Stroke. 40(5):e313-e314, May 2009.
Earnshaw, Stephanie R. PhD; Jackson, Dan MSc; Farkouh, Ray PhD; Schwamm, Lee MD;
Cost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis.
Stroke. 40(5):1710-1720, May 2009.
Abstract
Background and Purpose-: Better selection of patients for intravenous recombinant tissue plasminogen activator (IV tPA) treatment may improve clinical outcomes. We examined the cost-effectiveness of adding penumbral-based MRI to usual computed tomography (CT)-based methods to identify patients for IV tPA treatment.Methods-: A decision-analytic model estimated the lifetime costs and outcomes associated with penumbral-based MRI selection in a patient population similar to that enrolled in the IV tPA clinical trials. Inputs were obtained from published literature, clinical trial data, claims databases, and expert opinion. Outcomes included cost per life-year saved and cost per quality-adjusted life-year (QALY) gained. Costs and outcomes were discounted at 3% annually. Sensitivity analyses were conducted.Results-: The addition of penumbral-based MRI selection increased total cost by $103 over the patient's remaining lifetime. Penumbral-based MRI selection resulted in favorable outcomes (modified Rankin Scale <=1) more often than CT-based selection (36.66% versus 35.06%) with an incremental cost per life year of $1840 and an incremental cost per QALY of $1004. Multivariate sensitivity analysis predicted cost-effectiveness (<=$50 000 per QALY) in 99.7% of simulation runs.Conclusions-: Selecting ischemic stroke patients for IV tPA treatment using penumbral-based MRI after routine CT may increase overall acute care costs, but the benefit is large enough to make this highly cost-effective. This economic analysis lends further support to the consideration of a paradigm shift in acute stroke evaluation
Kidwell, Chelsea S. MD; Lees, Kennedy R. MD; Muir, Keith W. MD; Chen, Christopher et al
Results of the MRI Substudy of the Intravenous Magnesium Efficacy in Stroke Trial.
Stroke. 40(5):1704-1709, May 2009.
Abstract
Background and Purpose-: Although magnesium is neuroprotective in animal stroke models, no clinical benefit was confirmed in the Intravenous Magnesium Efficacy in Stroke (IMAGES) trial of acute stroke patients. The Magnetic Resonance in IMAGES (MR IMAGES) substudy investigated the effects of magnesium on the imaging surrogate outcome of infarct growth.Methods-: IMAGES trial patients in participating centers were randomized to receive either intravenous magnesium or placebo within 12 hours of stroke onset. Infarct growth was defined as volume difference between baseline diffusion-weighted imaging and day 90 fluid-attenuated inversion recovery image lesions. Patients who died were imputed the largest infarct growth observed.Results-: Among the 90 patients included in the primary analysis, there was no difference in infarct growth (median absolute growth, P=0.639; median percentage growth, P=0.616; proportion with any growth, P=0.212) between the 46 treated with magnesium and 44 with placebo. Infarct growth correlated with NIHSS score change from baseline to day 90. There was a trend showing baseline serum glucose correlated with infarct growth with magnesium treatment, but not in the placebo group. The mismatch frequency was reduced from 73% to 47% by increasing the mismatch threshold from >20% to >100% of core volume.Conclusions-: Infarct growth, confirmed here as a surrogate for clinical progression, was similar between magnesium and placebo treatment, paralleling the main IMAGES trial clinical outcomes. Glucose was a covariate for infarct growth with magnesium treatment. A more stringent mismatch threshold to define penumbra more appropriately would have excluded half of the patients in this 12-hour time window stroke study.
Heiss, Wolf-Dieter MD; Sorensen, A Gregory MD;
Advances in Imaging
Source
Stroke. 40(5):e313-e314, May 2009.
Articles from Spine
Link to journal online
Cheung, Kenneth M. C. ; Karppinen, Jaro; Chan, Danny; Ho, Daniel W. H. et al
Prevalence and Pattern of Lumbar Magnetic Resonance Imaging Changes in a Population Study of One Thousand Forty-Three Individuals.
Spine. 34(9):934-940, April 20, 2009.
Abstract
Study Design. A cross-sectional population study of magnetic resonance imaging (MRI) changes.Objective. To examine the pattern and prevalence of lumbar spine MRI changes within a southern Chinese population and their relationship with back pain.Summary of Background Data. Previous studies on MRI changes and back pain have used populations of asymptomatic individuals or patients presenting with back pain and sciatica. Thus, the prevalence and pattern of intervertebral disc degeneration within the population is not known.Methods. Lumbar spine MRIs were obtained in 1043 volunteers between 18 to 55 years of age. MRI changes including disc degeneration, herniation, anular tears (HIZ), and Schmorl's nodes were noted by 2 independent observers. Differences were settled by consensus. Disc degeneration was graded using Schneiderman's classification, and a total score (DDD score) was calculated by the summation of the Schneiderman's score for each lumbar level. A K-mean clustering program was used to group individuals into different patterns of degeneration.Results. Forty percent of individuals under 30 years of age had lumbar intervertebral disc degeneration (LDD), the prevalence of LDD increasing progressively to over 90% by 50 to 55 years of age. There was a positive correlation between the DDD score and low back pain. L5-S1 and L4-L5 were the most commonly affected levels. Apart from the usual patterns of degeneration, some uncommon patternsof degeneration were identified, comprising of subjects with skip level lesions (intervening normal levels) and isolated upper or mid lumbar degeneration.Conclusion. LDD is common, and its incidence increases with age. In a population setting, there is a significant association of LDD on MRI with back pain
Morphological Analysis in Patients With Sciatica: A Magnetic Resonance Imaging Study Using Three-Dimensional High-Resolution Diffusion-Weighted Magnetic Resonance Neurography Techniques.
Spine. 34(7):E245-E250, April 1, 2009.
Abstract
Study Design. A prospective observational study of patients with sciatica.Objective. We investigated the effectiveness of 3-dimensional high-spatial resolution diffusion-weighted MR neurography based on steady state free precession (3-dimensional diffusion-weighted steady-state free precession [DW-SSFP]) in the diagnosis of sciatica.Summary of Background Data. Patients with sciatica challenge a physician who desires a precise diagnosis for the etiology of the pain. Direct imaging of the sciatic nerve with high resolution and high contrast may contribute to accurate localization and help to find the causes of sciatica and provide reliable information to clinicians in treatment choice. Thus, we supposed that 3-dimensional DW-SSFP method have the ability to confirm the etiologies of sciatica.Methods. The 3-dimensional DW-SSFP sequence was performed on 137 patients with sciatica and 32 patients in control group. The postprocessing techniques were used to generate images of lumbosacral plexus and sciatic nerve, and the images acquired were assessed based on the presence or absence of nerve abnormality. The certainty of identifying the lumbosacral plexus and main branches from all cases was determined in each of the reconstruction planes for each case individually and assessed by using a 3-score scale.Results. All subjects were successfully performed. The sciatic nerve and its main branches were differentiated and a clear picture was obtained in all subjects. Compared with the control group, the presence of nerve root compression or increased T2 signal intensity changes can be observed in all patients. The mean score of certainty of identifying the sciatic nerve and main branches was 1.76 +/- 0.4, which indicate that the sciatic nerve and main branches can be identified with certainty.Conclusion. The 3-dimensional DW-SSFP MRI with high spatial and sufficient contrast is an excellent technique to define the nature of sciatica and assists in prognostication and possibly in management.
Okada, Eijiro MD ; Matsumoto, Morio MD ; Ichihara, Daisuke MD ; Chiba, Kazuhiro MD et al
Aging of the Cervical Spine in Healthy Volunteers: A 10-Year Longitudinal Magnetic Resonance Imaging Study
Spine. 34(7):706-712, April 1, 2009.
Abstract
Study Design. Prospective longitudinal study, mean follow-up period; 11.7 +/- 0.8 years was conducted from 1995 to 2007.Objective. To clarify normal aging process of cervical spine and correlation between progression of disc degeneration and development of clinical symptoms.Summary of Background Data. Aging of the cervical spine can inevitably occur in anyone. Long-term longitudinal studies following the same individuals are necessary to elucidate the accurate aging processes of the cervical spine.Methods. Two hundred twenty-three subjects of 497 original cohorts (123 men, 100 women, mean age: 39.0 +/- 15.0, follow-up rate: 44.9%). Subjects, who underwent MRI 10 years ago, underwent another MRI, neurologic examination, and questionnaire survey regarding symptoms related to cervical spine and life style. Following 5 MR findings representing intervertebral disc degeneration were evaluated: (1) decrease in signal intensity of disc, (2) anterior compression of dura and spinal cord, (3) posterior disc protrusion (PDP), (4) disc space narrowing (DSN), and (5) foraminal stenosis (FS).Results. Progression of degenerative findings was observed in 189 subjects (81.1%). Progression of decrease in signal intensity of disc was observed in 59.6%, anterior compression of dura and spinal cord in 61.4%, PDP in 70.0%, DSN in 26.9%, and FS in 9.0%. Logistic regression analysis revealed that incidence of progression of PDP, DSN, FS was higher in elderly subjects. There were no correlations between any degenerative MR findings and sex, smoking, alcohol, sport, or body mass index. Neck pain, shoulder stiffness, and numbness in upper extremities were recognized in 9.9%, 30.0%, and 4.0% of subjects, and 1 or more clinical symptoms have developed in 34.1% during 10 years.Conclusion. Progression of degeneration of cervical spine on MRI was frequently observed during 10-year period, with development of symptoms in 34% of subjects. No factor related to progression of degeneration of cervical spine was identified except for age.
Lurie, Jon D. ; Doman, David M. ; Spratt, Kevin F. PhD; Tosteson, Anna N. A. ; Weinstein, James N. et al
Magnetic Resonance Imaging Interpretation in Patients With Symptomatic Lumbar Spine Disc Herniations: Comparison of Clinician and Radiologist Readings.
Spine. 34(7):701-705, April 1, 2009.
Abstract
Study Design. Retrospective review of imaging data from a clinical trial.Objective. To compare the interpretation of lumbar spine magnetic resonance imaging (MRIs) by clinical spine specialists and radiologists in patients with lumbar disc herniation.Summary of Background Data. MRI is the imaging modality of choice for evaluation of the lumbar spine in patients with suspected lumbar disc herniation. Guidelines provide standardization of terms to more consistently describe disc herniation. The extent to which these guidelines are being followed in clinical practice is unknown.Methods. We abstracted data from radiology reports from patients with lumbar intervertebral disc herniation enrolled in the Spine Patient Outcomes Research Trial. We evaluated the frequency with which morphology (e.g., protrusions, extrusions, or sequestrations) was reported as per guidelines and when present we compared the morphology ratings to those of clinicians who completed a structured data form as part of the trial. We assessed agreement using percent agreement and the [kappa] statistic.Results. There were 396 patients with sufficient data to analyze. Excellent agreement was observed between clinician and radiologist on the presence and level of herniation (93.4%), with 3.3% showing disagreement regarding level, of which a third could be explained by the presence of a transitional vertebra. In 3.3% of the cases in which the clinician reported a herniation (protrusion, extrusion, or sequestration), the radiologist reported no herniation on the MRI.The radiology reports did not clearly describe morphology in 42.2% of cases. In the 214 cases with clear morphologic descriptions, agreement was fair ([kappa] = 0.24) and the disagreement was asymmetric (Bowker's test of symmetry P <>
Uchida, Kenzo ; Nakajima, Hideaki ; Yayama, Takafumi ; Kobayashi, Shigeru et al
High-Resolution Magnetic Resonance Imaging and 18FDG-PET Findings of the Cervical Spinal Cord Before and After Decompressive Surgery in Patients With Compressive Myelopathy.
Status
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 30 April 2009
Abstract
Study Design. Evaluation of cervical spinal cord (CSC) of patients with compressive myelopathy by magnetic resonance imaging (MRI) and high-resolution (18F)fluoro-deoxyglucose (18FDG) positron emission tomography (PET).Objective. To determine changes in morphology, intramedullary signal intensity, and glucose metabolic rate in CSC after decompression, and to assess the utility of 18FDG-PET in evaluation of patients with cervical myelopathy.Summary of Background Data. The significance of CSC enlargement after decompression and signal intensity changes within the cord remain elusive. No data are available on metabolic activity of the compressed CSC. Only a few studies have examined correlation between high-resolution MRI and 18FDG-PET neuroimaging in cervical myelopathy.Methods. We studied 24 patients who underwent cervical decompressive surgery in terms of postoperative neurologic improvement and changes in MRI and 18FDG-PET. Neurologic status was assessed by the Japanese Orthopedic Association scoring system (17-point scale). Signal intensity change in the cord was qualitatively assessed on both T1- and T2-weighted images. The transverse area of the CSC on MRIs and glucose metabolic rate (standardized uptake value [SUV]) from 18FDG-PET were measured digitally.Results. Neurologic improvement correlated with preoperative CSC transverse area at maximal compression (P <>
Cheung, Kenneth M. C. ; Karppinen, Jaro; Chan, Danny; Ho, Daniel W. H. et al
Prevalence and Pattern of Lumbar Magnetic Resonance Imaging Changes in a Population Study of One Thousand Forty-Three Individuals.
Spine. 34(9):934-940, April 20, 2009.
Abstract
Study Design. A cross-sectional population study of magnetic resonance imaging (MRI) changes.Objective. To examine the pattern and prevalence of lumbar spine MRI changes within a southern Chinese population and their relationship with back pain.Summary of Background Data. Previous studies on MRI changes and back pain have used populations of asymptomatic individuals or patients presenting with back pain and sciatica. Thus, the prevalence and pattern of intervertebral disc degeneration within the population is not known.Methods. Lumbar spine MRIs were obtained in 1043 volunteers between 18 to 55 years of age. MRI changes including disc degeneration, herniation, anular tears (HIZ), and Schmorl's nodes were noted by 2 independent observers. Differences were settled by consensus. Disc degeneration was graded using Schneiderman's classification, and a total score (DDD score) was calculated by the summation of the Schneiderman's score for each lumbar level. A K-mean clustering program was used to group individuals into different patterns of degeneration.Results. Forty percent of individuals under 30 years of age had lumbar intervertebral disc degeneration (LDD), the prevalence of LDD increasing progressively to over 90% by 50 to 55 years of age. There was a positive correlation between the DDD score and low back pain. L5-S1 and L4-L5 were the most commonly affected levels. Apart from the usual patterns of degeneration, some uncommon patternsof degeneration were identified, comprising of subjects with skip level lesions (intervening normal levels) and isolated upper or mid lumbar degeneration.Conclusion. LDD is common, and its incidence increases with age. In a population setting, there is a significant association of LDD on MRI with back pain
Morphological Analysis in Patients With Sciatica: A Magnetic Resonance Imaging Study Using Three-Dimensional High-Resolution Diffusion-Weighted Magnetic Resonance Neurography Techniques.
Spine. 34(7):E245-E250, April 1, 2009.
Abstract
Study Design. A prospective observational study of patients with sciatica.Objective. We investigated the effectiveness of 3-dimensional high-spatial resolution diffusion-weighted MR neurography based on steady state free precession (3-dimensional diffusion-weighted steady-state free precession [DW-SSFP]) in the diagnosis of sciatica.Summary of Background Data. Patients with sciatica challenge a physician who desires a precise diagnosis for the etiology of the pain. Direct imaging of the sciatic nerve with high resolution and high contrast may contribute to accurate localization and help to find the causes of sciatica and provide reliable information to clinicians in treatment choice. Thus, we supposed that 3-dimensional DW-SSFP method have the ability to confirm the etiologies of sciatica.Methods. The 3-dimensional DW-SSFP sequence was performed on 137 patients with sciatica and 32 patients in control group. The postprocessing techniques were used to generate images of lumbosacral plexus and sciatic nerve, and the images acquired were assessed based on the presence or absence of nerve abnormality. The certainty of identifying the lumbosacral plexus and main branches from all cases was determined in each of the reconstruction planes for each case individually and assessed by using a 3-score scale.Results. All subjects were successfully performed. The sciatic nerve and its main branches were differentiated and a clear picture was obtained in all subjects. Compared with the control group, the presence of nerve root compression or increased T2 signal intensity changes can be observed in all patients. The mean score of certainty of identifying the sciatic nerve and main branches was 1.76 +/- 0.4, which indicate that the sciatic nerve and main branches can be identified with certainty.Conclusion. The 3-dimensional DW-SSFP MRI with high spatial and sufficient contrast is an excellent technique to define the nature of sciatica and assists in prognostication and possibly in management.
Okada, Eijiro MD ; Matsumoto, Morio MD ; Ichihara, Daisuke MD ; Chiba, Kazuhiro MD et al
Aging of the Cervical Spine in Healthy Volunteers: A 10-Year Longitudinal Magnetic Resonance Imaging Study
Spine. 34(7):706-712, April 1, 2009.
Abstract
Study Design. Prospective longitudinal study, mean follow-up period; 11.7 +/- 0.8 years was conducted from 1995 to 2007.Objective. To clarify normal aging process of cervical spine and correlation between progression of disc degeneration and development of clinical symptoms.Summary of Background Data. Aging of the cervical spine can inevitably occur in anyone. Long-term longitudinal studies following the same individuals are necessary to elucidate the accurate aging processes of the cervical spine.Methods. Two hundred twenty-three subjects of 497 original cohorts (123 men, 100 women, mean age: 39.0 +/- 15.0, follow-up rate: 44.9%). Subjects, who underwent MRI 10 years ago, underwent another MRI, neurologic examination, and questionnaire survey regarding symptoms related to cervical spine and life style. Following 5 MR findings representing intervertebral disc degeneration were evaluated: (1) decrease in signal intensity of disc, (2) anterior compression of dura and spinal cord, (3) posterior disc protrusion (PDP), (4) disc space narrowing (DSN), and (5) foraminal stenosis (FS).Results. Progression of degenerative findings was observed in 189 subjects (81.1%). Progression of decrease in signal intensity of disc was observed in 59.6%, anterior compression of dura and spinal cord in 61.4%, PDP in 70.0%, DSN in 26.9%, and FS in 9.0%. Logistic regression analysis revealed that incidence of progression of PDP, DSN, FS was higher in elderly subjects. There were no correlations between any degenerative MR findings and sex, smoking, alcohol, sport, or body mass index. Neck pain, shoulder stiffness, and numbness in upper extremities were recognized in 9.9%, 30.0%, and 4.0% of subjects, and 1 or more clinical symptoms have developed in 34.1% during 10 years.Conclusion. Progression of degeneration of cervical spine on MRI was frequently observed during 10-year period, with development of symptoms in 34% of subjects. No factor related to progression of degeneration of cervical spine was identified except for age.
Lurie, Jon D. ; Doman, David M. ; Spratt, Kevin F. PhD; Tosteson, Anna N. A. ; Weinstein, James N. et al
Magnetic Resonance Imaging Interpretation in Patients With Symptomatic Lumbar Spine Disc Herniations: Comparison of Clinician and Radiologist Readings.
Spine. 34(7):701-705, April 1, 2009.
Abstract
Study Design. Retrospective review of imaging data from a clinical trial.Objective. To compare the interpretation of lumbar spine magnetic resonance imaging (MRIs) by clinical spine specialists and radiologists in patients with lumbar disc herniation.Summary of Background Data. MRI is the imaging modality of choice for evaluation of the lumbar spine in patients with suspected lumbar disc herniation. Guidelines provide standardization of terms to more consistently describe disc herniation. The extent to which these guidelines are being followed in clinical practice is unknown.Methods. We abstracted data from radiology reports from patients with lumbar intervertebral disc herniation enrolled in the Spine Patient Outcomes Research Trial. We evaluated the frequency with which morphology (e.g., protrusions, extrusions, or sequestrations) was reported as per guidelines and when present we compared the morphology ratings to those of clinicians who completed a structured data form as part of the trial. We assessed agreement using percent agreement and the [kappa] statistic.Results. There were 396 patients with sufficient data to analyze. Excellent agreement was observed between clinician and radiologist on the presence and level of herniation (93.4%), with 3.3% showing disagreement regarding level, of which a third could be explained by the presence of a transitional vertebra. In 3.3% of the cases in which the clinician reported a herniation (protrusion, extrusion, or sequestration), the radiologist reported no herniation on the MRI.The radiology reports did not clearly describe morphology in 42.2% of cases. In the 214 cases with clear morphologic descriptions, agreement was fair ([kappa] = 0.24) and the disagreement was asymmetric (Bowker's test of symmetry P <>
Uchida, Kenzo ; Nakajima, Hideaki ; Yayama, Takafumi ; Kobayashi, Shigeru et al
High-Resolution Magnetic Resonance Imaging and 18FDG-PET Findings of the Cervical Spinal Cord Before and After Decompressive Surgery in Patients With Compressive Myelopathy.
Status
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 30 April 2009
Abstract
Study Design. Evaluation of cervical spinal cord (CSC) of patients with compressive myelopathy by magnetic resonance imaging (MRI) and high-resolution (18F)fluoro-deoxyglucose (18FDG) positron emission tomography (PET).Objective. To determine changes in morphology, intramedullary signal intensity, and glucose metabolic rate in CSC after decompression, and to assess the utility of 18FDG-PET in evaluation of patients with cervical myelopathy.Summary of Background Data. The significance of CSC enlargement after decompression and signal intensity changes within the cord remain elusive. No data are available on metabolic activity of the compressed CSC. Only a few studies have examined correlation between high-resolution MRI and 18FDG-PET neuroimaging in cervical myelopathy.Methods. We studied 24 patients who underwent cervical decompressive surgery in terms of postoperative neurologic improvement and changes in MRI and 18FDG-PET. Neurologic status was assessed by the Japanese Orthopedic Association scoring system (17-point scale). Signal intensity change in the cord was qualitatively assessed on both T1- and T2-weighted images. The transverse area of the CSC on MRIs and glucose metabolic rate (standardized uptake value [SUV]) from 18FDG-PET were measured digitally.Results. Neurologic improvement correlated with preoperative CSC transverse area at maximal compression (P <>
BJR VOL 82; NUMB 977; 2009
pp. 353-362
21st L H Gray Conference: the radiobiology/radiation protection interface.
West, C.M.L.; Martin, C.J.; Sutton, D.G.; Wright, E.G.
pp. 363-370
The use of gonad shielding in paediatric hip and pelvis radiographs.
Fawcett, S.L.; Barter, S.J.
pp. 371-373
Incidence of semicircular canal dehiscence in Singapore.
Loke, S.C.; Goh, J.P.N.
pp. 374-379
MRI of intermittent meniscal dislocation in the knee.
Lyle, N.J.; Sampson, M.A.; Barrett, D.S.
pp. 380-385
Cisplatin-conjugated degradable gelatin microspheres: fundamental study in vitro.
Ohta, S.; Nitta, N.; Sonoda, A.; Seko, A.; Tanaka, T.; Takahashi, M.; Kimura, Y.; Tabata, Y.; Murata, K.
pp. 386-391
Quantification of left-to-right shunting in adult congenital heart disease: phase-contrast cine MRI compared with invasive oximetry.
Debl, K.; Djavidani, B.; Buchner, S.; Heinicke, N.; Poschenrieder, F.; Feuerbach, S.; Riegger, G.; Luchner, A.
pp. 392-400
Evaluation of the potential of hexamethylenetetramine, compared with tirapazamine, as a combined agent with gamma -irradiation and cisplatin treatment in vivo.
Masunaga, S.; Tano, K.; Watanabe, M.; Kashino, G.; Suzuki, M.; Kinashi, Y.; Ono, K.; Nakamura, J.
pp. 401-411
Three-dimensional simulation of lung nodules for paediatric multidetector array CT.
Li, X.; Samei, E.; Delong, D.M.; Jones, R.P.; Gaca, A.M.; Hollingsworth, C.L. et al
pp. 412-420
The use of time to maximum enhancement to indicate areas of ablation following the treatment of liver tumours with high-intensity focused ultrasound.
Noterdaeme, O.; Leslie, T.A.; Kennedy, J.E.; Phillips, R.R.; Brady, M.
pp. 421-425
Non-small-cell lung cancer dimensions: CT-pathological correlation and interobserver variation.
Macpherson, R.E.; Higgins, G.S.; Murchison, J.T.; Wallace, W.A.H. et al
pp. 426-434
Differential diagnosis of hyperintense cerebrospinal fluid on fluid-attenuated inversion recovery images of the brain. Part I: pathological conditions.
Tha, K.K.; Terae, S.; Kudo, K.; Miyasaka, K.
pp. 435-437
A curious mass of the anterior compartment in the knee.
Demir, M.K.; Unlu, E.; Usta, U.
pp. 438-439
Interference of gadolinium-based contrast agents with the measurement of serum creatinine by the Jaffe reaction.
Haylor, J.; Vickers, M.E.; Morcos, S.K.
21st L H Gray Conference: the radiobiology/radiation protection interface.
West, C.M.L.; Martin, C.J.; Sutton, D.G.; Wright, E.G.
pp. 363-370
The use of gonad shielding in paediatric hip and pelvis radiographs.
Fawcett, S.L.; Barter, S.J.
pp. 371-373
Incidence of semicircular canal dehiscence in Singapore.
Loke, S.C.; Goh, J.P.N.
pp. 374-379
MRI of intermittent meniscal dislocation in the knee.
Lyle, N.J.; Sampson, M.A.; Barrett, D.S.
pp. 380-385
Cisplatin-conjugated degradable gelatin microspheres: fundamental study in vitro.
Ohta, S.; Nitta, N.; Sonoda, A.; Seko, A.; Tanaka, T.; Takahashi, M.; Kimura, Y.; Tabata, Y.; Murata, K.
pp. 386-391
Quantification of left-to-right shunting in adult congenital heart disease: phase-contrast cine MRI compared with invasive oximetry.
Debl, K.; Djavidani, B.; Buchner, S.; Heinicke, N.; Poschenrieder, F.; Feuerbach, S.; Riegger, G.; Luchner, A.
pp. 392-400
Evaluation of the potential of hexamethylenetetramine, compared with tirapazamine, as a combined agent with gamma -irradiation and cisplatin treatment in vivo.
Masunaga, S.; Tano, K.; Watanabe, M.; Kashino, G.; Suzuki, M.; Kinashi, Y.; Ono, K.; Nakamura, J.
pp. 401-411
Three-dimensional simulation of lung nodules for paediatric multidetector array CT.
Li, X.; Samei, E.; Delong, D.M.; Jones, R.P.; Gaca, A.M.; Hollingsworth, C.L. et al
pp. 412-420
The use of time to maximum enhancement to indicate areas of ablation following the treatment of liver tumours with high-intensity focused ultrasound.
Noterdaeme, O.; Leslie, T.A.; Kennedy, J.E.; Phillips, R.R.; Brady, M.
pp. 421-425
Non-small-cell lung cancer dimensions: CT-pathological correlation and interobserver variation.
Macpherson, R.E.; Higgins, G.S.; Murchison, J.T.; Wallace, W.A.H. et al
pp. 426-434
Differential diagnosis of hyperintense cerebrospinal fluid on fluid-attenuated inversion recovery images of the brain. Part I: pathological conditions.
Tha, K.K.; Terae, S.; Kudo, K.; Miyasaka, K.
pp. 435-437
A curious mass of the anterior compartment in the knee.
Demir, M.K.; Unlu, E.; Usta, U.
pp. 438-439
Interference of gadolinium-based contrast agents with the measurement of serum creatinine by the Jaffe reaction.
Haylor, J.; Vickers, M.E.; Morcos, S.K.
AJR 1 June 2009 Vol. 192 No. 6 Supplement
URL: http://www.ajronline.org/content/vol192/6_Supplement/
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1.5 CME 1.0 SAM
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Complications of Nonvascular Interventions and Their Management: Case-Based
Review
Hector Ferral, Andres Eugenio Garza-Berlanga, and Nilesh H. Patel
AJR 2009;192:63-77
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S63
Complications of Nonvascular Interventions and Their Management:
Self-Assessment Module
Hector Ferral, Andres Eugenio Garza-Berlanga, and Nilesh H. Patel
AJR 2009;192:78-82
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S78
Utility of the FIESTA Pulse Sequence in Body Oncologic Imaging: Review
Priya Bhosale, Jingfei Ma, and Haesun Choi
AJR 2009;192:83-93
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S83
Utility of the FIESTA Pulse Sequence in Body Oncologic Imaging:
Self-Assessment Module
Priya Bhosale, Jingfei Ma, Aparna Balachandran, Janio Szklaruk, and
Haesun Choi
AJR 2009;192:94-97
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S94
Imaging of Male Infertility: Pictorial Review
William L. Simpson, Jr. and Dana R. Rausch
AJR 2009;192:98-107
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S98
Imaging of Male Infertility: Self-Assessment Module
William L. Simpson, Jr. and Dana R. Rausch
AJR 2009;192:108-111
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S108
Radiology of the Retroperitoneum: Case-Based Review
Rupan Sanyal and Erick M. Remer
AJR 2009;192:112-117
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S112
Radiology of the Retroperitoneum: Self-Assessment Module
Rupan Sanyal and Erick M. Remer
AJR 2009;192:118-121
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S118
AJR Teaching File: Fat-Containing Retroperitoneal Mass Presenting With
Acute Flank Pain
Justin R. Routhier, Courtney A. Woodfield, and William W. Mayo-Smith
AJR 2009;192:122-124
http://www.ajronline.org/cgi/content/full/192/6_Supplement/S122
AJR Teaching File: Enlarging Adrenal Mass Previously Characterized as an
Adenoma
Rafel Tappouni and Lucas DeJohn
AJR 2009;192:125-127
http://www.ajronline.org/cgi/content/full/192/6_Supplement/S125
-----------------------------------------------------------------
1.5 CME 1.0 SAM
-----------------------------------------------------------------
Complications of Nonvascular Interventions and Their Management: Case-Based
Review
Hector Ferral, Andres Eugenio Garza-Berlanga, and Nilesh H. Patel
AJR 2009;192:63-77
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S63
Complications of Nonvascular Interventions and Their Management:
Self-Assessment Module
Hector Ferral, Andres Eugenio Garza-Berlanga, and Nilesh H. Patel
AJR 2009;192:78-82
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S78
Utility of the FIESTA Pulse Sequence in Body Oncologic Imaging: Review
Priya Bhosale, Jingfei Ma, and Haesun Choi
AJR 2009;192:83-93
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S83
Utility of the FIESTA Pulse Sequence in Body Oncologic Imaging:
Self-Assessment Module
Priya Bhosale, Jingfei Ma, Aparna Balachandran, Janio Szklaruk, and
Haesun Choi
AJR 2009;192:94-97
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S94
Imaging of Male Infertility: Pictorial Review
William L. Simpson, Jr. and Dana R. Rausch
AJR 2009;192:98-107
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S98
Imaging of Male Infertility: Self-Assessment Module
William L. Simpson, Jr. and Dana R. Rausch
AJR 2009;192:108-111
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S108
Radiology of the Retroperitoneum: Case-Based Review
Rupan Sanyal and Erick M. Remer
AJR 2009;192:112-117
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S112
Radiology of the Retroperitoneum: Self-Assessment Module
Rupan Sanyal and Erick M. Remer
AJR 2009;192:118-121
http://www.ajronline.org/cgi/content/abstract/192/6_Supplement/S118
AJR Teaching File: Fat-Containing Retroperitoneal Mass Presenting With
Acute Flank Pain
Justin R. Routhier, Courtney A. Woodfield, and William W. Mayo-Smith
AJR 2009;192:122-124
http://www.ajronline.org/cgi/content/full/192/6_Supplement/S122
AJR Teaching File: Enlarging Adrenal Mass Previously Characterized as an
Adenoma
Rafel Tappouni and Lucas DeJohn
AJR 2009;192:125-127
http://www.ajronline.org/cgi/content/full/192/6_Supplement/S125
AJR 1 June 2009; Vol. 192, No. 6
URL: http://www.ajronline.org/content/vol192/issue6/
Editor's Notebook
The AJR Education Mission: How Are We Doing?
Thomas H. Berquist
AJR 2009;192:1453
http://www.ajronline.org/cgi/content/full/192/6/1453
The Practice of Radiology
Vision and Quality in the Digital Imaging Environment: How Much Does the Visual Acuity of Radiologists Vary at an Intermediate Distance?
Nabile M. Safdar, Khan M. Siddiqui, Farah Qureshi et al
AJR 2009;192:335-340
http://www.ajronline.org/cgi/content/abstract/192/6/W335
Cardiopulmonary Imaging
Free-Breathing MRI for the Assessment of Myocardial Infarction: Clinical
Validation
Harrie C. M. van den Bosch, Jos J. M. Westenberg, Johannes C. Post et al
AJR 2009;192:277-281
http://www.ajronline.org/cgi/content/abstract/192/6/W277
Assessment of Myocardial Viability with 3D MRI at 3 T
Kerstin U. Bauner, Olaf Muehling, Daniel Theisen, Carmel Hayes et al
AJR 2009;192:1645-1650
http://www.ajronline.org/cgi/content/abstract/192/6/1645
Vascular Enhancement and Image Quality of MDCT Pulmonary Angiography in 400 Cases: Comparison of Standard and Low Kilovoltage Settings
Shin Matsuoka, Andetta R. Hunsaker, Ritu R. Gill, Isabel B. Oliva et al
AJR 2009;192:1651-1656
http://www.ajronline.org/cgi/content/abstract/192/6/1651
In Vivo Repeatability of Automated Volume Calculations of Small Pulmonary
Nodules With CT
Cristiano Rampinelli, Elvio De Fiori, Sara Raimondi, Giulia Veronesi,
and Massimo Bellomi
AJR 2009;192:1657-1661
http://www.ajronline.org/cgi/content/abstract/192/6/1657
Whole-Chest 64-MDCT of Emergency Department Patients with Nonspecific Chest
Pain: Radiation Dose and Coronary Artery Image Quality with Prospective ECG
Triggering Versus Retrospective ECG Gating
William P. Shuman, Kelley R. Branch, Janet M. May, Lee M. Mitsumori et al
AJR 2009;192:1662-1667
http://www.ajronline.org/cgi/content/abstract/192/6/1662
Differences in Aortic Valve Area Measured with CT Planimetry and
Echocardiography (Continuity Equation) Are Related to Divergent Estimates
of Left Ventricular Outflow Tract Area
Ethan J. Halpern, Raghuram Mallya, Matthew Sewell, Matisyahu Shulman,
and Donna R. Zwas
AJR 2009;192:1668-1673
http://www.ajronline.org/cgi/content/abstract/192/6/1668
Gastrointestinal Imaging
Gadoxetic Acid-Enhanced MRI Versus Triple-Phase MDCT for the Preoperative
Detection of Hepatocellular Carcinoma
Seong Hyun Kim, Seung Hoon Kim, Jongmee Lee, Min Ju Kim et al
AJR 2009;192:1675-1681
http://www.ajronline.org/cgi/content/abstract/192/6/1675
Influence of Computer-Aided Detection False-Positives on Reader Performance
and Diagnostic Confidence for CT Colonography
Stuart A. Taylor, John Brittenden, James Lenton, Hannah Lambie et al
AJR 2009;192:1682-1689
http://www.ajronline.org/cgi/content/abstract/192/6/1682
Genitourinary Imaging
Detection of Urinary Stones at Reduced Radiation Exposure: A Phantom Study
Comparing Computed Radiography and a Low-Dose Digital Radiography Linear
Slit Scanning System
Zsolt Szucs-Farkas, Dev P. Chakraborty, Harriet C. Thoeny et al
AJR 2009;192:271-274
http://www.ajronline.org/cgi/content/abstract/192/6/W271
Renal Angiomyolipoma With Nontraumatic Pulmonary Fat Embolus
Claire K. Sandstrom, Jeffrey Pugsley, and Lee M. Mitsumori
AJR 2009;192:275-276
http://www.ajronline.org/cgi/content/full/192/6/W275
Challenges in Clinical Prostate Cancer: Role of Imaging
Gary J. Kelloff, Peter Choyke, Donald S. Coffey for The Prostate
Cancer Imaging Working Group
AJR 2009;192:1455-1470
http://www.ajronline.org/cgi/content/abstract/192/6/1455
Imaging Localized Prostate Cancer: Current Approaches and New Developments
Baris Turkbey, Paul S. Albert, Karen Kurdziel, and Peter L. Choyke
AJR 2009;192:1471-1480
http://www.ajronline.org/cgi/content/abstract/192/6/1471
Imaging and Staging of Transitional Cell Carcinoma: Part 1, Lower Urinary
Tract
Raghunandan Vikram, Carl M. Sandler, and Chaan S. Ng
AJR 2009;192:1481-1487
http://www.ajronline.org/cgi/content/abstract/192/6/1481
Imaging and Staging of Transitional Cell Carcinoma: Part 2, Upper Urinary
Tract
Raghunandan Vikram, Carl M. Sandler, and Chaan S. Ng
AJR 2009;192:1488-1493
http://www.ajronline.org/cgi/content/abstract/192/6/1488
Imaging Appearance of Granulomatous Disease After Intravesical Bacille
Calmette-Guerin (BCG) Treatment of Bladder Carcinoma
Weining Ma, Stella K. Kang, Hedvig Hricak, Scott R. Gerst, and Jingbo
Zhang
AJR 2009;192:1494-1500
http://www.ajronline.org/cgi/content/abstract/192/6/1494
MDCT Urography: Exploring a New Paradigm for Imaging of Bladder Cancer
Richard H. Cohan, Elaine M. Caoili, Nigel C. Cowan et al
AJR 2009;192:1501-1508
http://www.ajronline.org/cgi/content/abstract/192/6/1501
Assessment of Urinary Tract Calculi With 64-MDCT: The Axial Versus Coronal
Plane
Ur Metser, Sangeet Ghai, Yang Yi Ong, Gina Lockwood, and Sidney B.
Radomski
AJR 2009;192:1509-1513
http://www.ajronline.org/cgi/content/abstract/192/6/1509
Imaging of Genitourinary Trauma
Parvati Ramchandani and Philip Michael Buckler
AJR 2009;192:1514-1523
http://www.ajronline.org/cgi/content/abstract/192/6/1514
Renal Cell Carcinoma: T1 and T2 Signal Intensity Characteristics of
Papillary and Clear Cell Types Correlated with Pathology
M. Raquel Oliva, Jonathan N. Glickman, Kelly H. Zou, Sze Y. Teo et al
AJR 2009;192:1524-1530
http://www.ajronline.org/cgi/content/abstract/192/6/1524
Free-Breathing Accelerated Gadolinium-Enhanced MR Angiography in the
Diagnosis of Renovascular Disease
Alain Nchimi, Denis Brisbois, Roland Materne, Thomas K. Y. Broussaud et al
AJR 2009;192:1531-1537
http://www.ajronline.org/cgi/content/abstract/192/6/1531
High-Dose Gadodiamide for Catheter Angiography and CT in Patients With
Varying Degrees of Renal Insufficiency: Prevalence of Subsequent
Nephrogenic Systemic Fibrosis and Decline in Renal Function
Mellena D. Bridges, Brandon S. St. Amant, Rebecca B. McNeil et al
AJR 2009;192:1538-1543
http://www.ajronline.org/cgi/content/abstract/192/6/1538
Reducing the Risk of Contrast-Induced Nephropathy: A Perspective on the
Controversies
James H. Ellis and Richard H. Cohan
AJR 2009;192:1544-1549
http://www.ajronline.org/cgi/content/abstract/192/6/1544
Renal Functional MRI: Are We Ready for Clinical Application?
Hersh Chandarana and Vivian S. Lee
AJR 2009;192:1550-1557
http://www.ajronline.org/cgi/content/abstract/192/6/1550
Imaging-Guided Percutaneous Ablation of Renal Cell Carcinoma: A Primer of
How We Do It
Raul N. Uppot, Stuart G. Silverman, Ronald J. Zagoria, Kemal Tuncali et al
AJR 2009;192:1558-1570
http://www.ajronline.org/cgi/content/abstract/192/6/1558
MRI and CT Characteristics of Successfully Ablated Renal Masses: Imaging
Surveillance After Radiofrequency Ablation
Matthew S. Davenport, Elaine M. Caoili, Richard H. Cohan et al
AJR 2009;192:1571-1578
http://www.ajronline.org/cgi/content/abstract/192/6/1571
Women's Imaging
Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A
Series of 15 Pregnancies
Kavous Firouznia, Hossein Ghanaati, Mina Sanaati, Amir H. Jalali, and
Madjid Shakiba
AJR 2009;192:1588-1592
http://www.ajronline.org/cgi/content/abstract/192/6/1588
History of Uterine Artery Occlusion and Subsequent Pregnancy
Fred Burbank
AJR 2009;192:1593-1600
http://www.ajronline.org/cgi/content/abstract/192/6/1593
Uterine Artery Embolization Along With the Administration of Methotrexate
for Cervical Ectopic Pregnancy: Technical and Clinical Outcomes
Masakazu Hirakawa, Tsuyoshi Tajima, Kengo Yoshimitsu, Hiroyuki Irie et al
AJR 2009;192:1601-1607
http://www.ajronline.org/cgi/content/abstract/192/6/1601
In Vivo Proton MR Spectroscopy of the Breast Using the Total Choline Peak
Integral as a Marker of Malignancy
Francesco Sardanelli, Alfonso Fausto, Giovanni Di Leo, Robin de Nijs et al
AJR 2009;192:1608-1617
http://www.ajronline.org/cgi/content/abstract/192/6/1608
Endometriosis of the Posterior Cul-De-Sac: Clinical Presentation and
Findings at Transvaginal Ultrasound
Jan-Hein J. Hensen and Julien B. C. M. Puylaert
AJR 2009;192:1618-1624
http://www.ajronline.org/cgi/content/abstract/192/6/1618
Anatomic Distribution of Posterior Deeply Infiltrating Endometriosis on MRI
After Vaginal and Rectal Gel Opacification
Pierre Loubeyre, Patrick Petignat, Sandrine Jacob, Jean-Francois
Egger et al
AJR 2009;192:1625-1631
http://www.ajronline.org/cgi/content/abstract/192/6/1625
Unusual Imaging Appearances of Endometriosis
Shaile Choudhary, Najla Fasih, Demetri Papadatos, and Venkateswar R.
Surabhi
AJR 2009;192:1632-1644
http://www.ajronline.org/cgi/content/abstract/192/6/1632
Musculoskeletal Imaging
Diffusion Tensor Imaging and Fiber Tractography of Skeletal Muscle:
Optimization of b Value for Imaging at 1.5 T
Nadja Saupe, Lawrence M. White, Jeffrey Stainsby, George Tomlinson,
and Marshall S. Sussman
AJR 2009;192:282-290
http://www.ajronline.org/cgi/content/abstract/192/6/W282
Angioleiomyoma in Soft Tissue of Extremities: MRI Findings
Hye Jin Yoo, Jung-Ah Choi, Jin-Haeng Chung, Joo Han Oh, Gyung-Kyu Lee et al
AJR 2009;192:291-294
http://www.ajronline.org/cgi/content/abstract/192/6/W291
Functional Joint Imaging Using 256-MDCT: Technical Feasibility
Vivek Kalia, Rick W. Obray, Ross Filice, Laura M. Fayad et al
AJR 2009;192:295-299
http://www.ajronline.org/cgi/content/abstract/192/6/W295
Assessment of Capsular Laxity in Patients With Recurrent Anterior Shoulder
Dislocation Using MRI
Alex Wing Hung Ng, C. M. Chu, W. N. Lo, Y. M. Lai, and C. K. Kam
AJR 2009;192:1690-1695
http://www.ajronline.org/cgi/content/abstract/192/6/1690
Hoffa's Fat Pad: Evaluation on Unenhanced MR Images as a Measure of
Patellofemoral Synovitis in Osteoarthritis
Frank W. Roemer, Ali Guermazi, Yuqing Zhang, Mei Yang, David J.
Hunter et al
AJR 2009;192:1696-1700
http://www.ajronline.org/cgi/content/abstract/192/6/1696
Accuracy of MRI, MR Arthrography, and Ultrasound in the Diagnosis of
Rotator Cuff Tears: A Meta-Analysis
Joseph O. de Jesus, Laurence Parker, Andrea J. Frangos, and Levon N.
Nazarian
AJR 2009;192:1701-1707
http://www.ajronline.org/cgi/content/abstract/192/6/1701
MRI Findings in Inflammatory Muscle Diseases and Their Noninflammatory
Mimics
Maximilian Schulze, Ina Kotter, Ulrike Ernemann, Michael Fenchel et al
AJR 2009;192:1708-1716
http://www.ajronline.org/cgi/content/abstract/192/6/1708
Pediatric Imaging
CT in Children With Suspected Residual Foreign Body in Airway After
Bronchoscopy
Su-Mi Shin, Woo Sun Kim, Jung-Eun Cheon, Ah Young Jung, Byung Jae
Youn et al
AJR 2009;192:1744-1751
http://www.ajronline.org/cgi/content/abstract/192/6/1744
Vascular and Interventional Radiology
Adrenal Metastasis From Hepatocellular Carcinoma: Radiofrequency Ablation
Combined With Adrenal Arterial Chemoembolization in Six Patients
Koichiro Yamakado, Hiroshi Anai, Haruyuki Takaki, Hiroshi Sakaguchi et al
AJR 2009;192:300-305
http://www.ajronline.org/cgi/content/abstract/192/6/W300
Vascular Regeneration by Repeated Infusions of Basic Fibroblast Growth
Factor in a Rabbit Model of Hind-Limb Ischemia
Ayumi Seko, Norihisa Nitta, Akinaga Sonoda, Shinichi Ohta et al
AJR 2009;192:306-310
http://www.ajronline.org/cgi/content/abstract/192/6/W306
Direct CT Venography for Evaluation of the Lower Extremity Venous Anomalies
of Klippel-Trenaunay Syndrome
Ertugrul Mavili, Mehmet Ozturk, Yigit Akcali, Halil Donmez, Ali
Yikilmaz et al
AJR 2009;192:311-316
http://www.ajronline.org/cgi/content/abstract/192/6/W311
MRI of TIPS with Covered Stent-Grafts: In Vitro Analysis Using a Flow
Phantom and Initial Clinical Experience
Maxim Itkin, Aalpen Patel, Scott O. Trerotola, and Harold I. Litt
AJR 2009;192:317-320
http://www.ajronline.org/cgi/content/abstract/192/6/W317
Freehand Versus Guided Breast Biopsy: Comparison of Accuracy, Needle
Motion, and Biopsy Time in a Tissue Model
Nathan Bluvol, Anat Kornecki, Allison Shaikh, David Del Rey Fernandez et al
AJR 2009;192:1720-1725
http://www.ajronline.org/cgi/content/abstract/192/6/1720
Kerma Area Product Method for Effective Dose Estimation During Lumbar
Epidural Steroid Injection Procedures: Phantom Study
Sangroh Kim, Greta Toncheva, Colin Anderson-Evans, Billy K. Huh et al
AJR 2009;192:1726-1730
http://www.ajronline.org/cgi/content/abstract/192/6/1726
Time-Resolved MR Angiography in the Evaluation of Central Thoracic Venous
Occlusive Disease
Kambiz Nael, Mayil Krishnam, Stefan G. Ruehm, Henrik J. Michaely et al
AJR 2009;192:1731-1738
http://www.ajronline.org/cgi/content/abstract/192/6/1731
Medical Physics and Informatics
Free and Open Source Software for the Manipulation of Digital Images
Robert W. Solomon
AJR 2009;192:330-334
http://www.ajronline.org/cgi/content/abstract/192/6/W330
Health Care Policy and Quality
Do Clinicians Use the American College of Radiology Appropriateness
Criteria in the Management of Their Patients?
Andre B. Bautista, Anthony Burgos, Barbara J. Nickel, John J. Yoon et al
AJR 2009;192:1581-1585
http://www.ajronline.org/cgi/content/abstract/192/6/1581
Letters
Dual-Energy CT Pulmonary Angiography: A New Horizon in the Imaging of Acute
Pulmonary Thromboembolism
Edward T. D. Hoey, Deepa Gopalan, and Nicholas J. Screaton
AJR 2009;192:341-342
http://www.ajronline.org/cgi/content/full/192/6/W341
Reply
Sudhakar N. J. Pipavath and J. David Godwin
AJR 2009;192:343
http://www.ajronline.org/cgi/content/full/192/6/W343
Superior Vena Cava Syndrome Resulting in Osseous Venous Congestion
Simulating Sclerotic Bone Lesions
Robert A. Jesinger, Bang Huynh, and David Gover
AJR 2009;192:344-345
http://www.ajronline.org/cgi/content/full/192/6/W344
Setting the Record Straight Concerning the ABR's Future Core and Certifying
Examinations in Diagnostic Radiology
Gary J. Becker, N. Reed Dunnick, Jennifer Bosma, and Anthony M.
Gerdeman
AJR 2009;192:346-347
http://www.ajronline.org/cgi/content/full/192/6/W346
Reply
Jonathan H. Sunshine, Rebecca S. Lewis, and Mythreyi Bhargavan
AJR 2009;192:348
http://www.ajronline.org/cgi/content/full/192/6/W348
Metastatic Intramammary Lymph Node as a Synchronous Benign-Appearing Breast
Nodule Detected in a Patient with Breast Cancer
Silma Solorzano, Michael Seidler, and Benoit Mesurolle
AJR 2009;192:349
http://www.ajronline.org/cgi/content/full/192/6/W349
MR Hysterosalpingography Compared With Conventional Hysterosalpingography
James E. Silberzweig
AJR 2009;192:350
http://www.ajronline.org/cgi/content/full/192/6/W350
Intrascrotal Arteriovenous Malformation Simulating Varicocele
Cengiz Yilmaz, Muhammed Arslan, and Murat Arslan
AJR 2009;192:351
http://www.ajronline.org/cgi/content/full/192/6/W351
Book Reviews
Breast Cancer Imaging: A Multidisciplinary, Multimodality Approach.
Michelle D. McDonough
AJR 2009;192:352
http://www.ajronline.org/cgi/content/full/192/6/W352
Growth of the Pediatric Skeleton: A Primer for Radiologists.
Edem F. Chen
AJR 2009;192:353
http://www.ajronline.org/cgi/content/full/192/6/W353
Neuroradiology/Head and Neck Imaging
Feasibility of Superficial Temporal Artery as the Input Artery for Cerebral
Perfusion CT
Kiran Sheikh, Matthew J. Schipper, and Ellen G. Hoeffner
AJR 2009;192:321-329
http://www.ajronline.org/cgi/content/abstract/192/6/W321
Other Content
Correction for Volume 191, p. 1436
Fergus Coakley
AJR 2009;192:1454
http://www.ajronline.org/cgi/content/full/192/6/1454
Correction for Volume 192, p. 1407
Bethany U. Casagranda
AJR 2009;192:1454
http://www.ajronline.org/cgi/content/full/192/6/1454-a
Edward Vincent Staab
C. Douglas Maynard
AJR 2009;192:1754-1755
http://www.ajronline.org/cgi/content/full/192/6/1754
Editor's Notebook
The AJR Education Mission: How Are We Doing?
Thomas H. Berquist
AJR 2009;192:1453
http://www.ajronline.org/cgi/content/full/192/6/1453
The Practice of Radiology
Vision and Quality in the Digital Imaging Environment: How Much Does the Visual Acuity of Radiologists Vary at an Intermediate Distance?
Nabile M. Safdar, Khan M. Siddiqui, Farah Qureshi et al
AJR 2009;192:335-340
http://www.ajronline.org/cgi/content/abstract/192/6/W335
Cardiopulmonary Imaging
Free-Breathing MRI for the Assessment of Myocardial Infarction: Clinical
Validation
Harrie C. M. van den Bosch, Jos J. M. Westenberg, Johannes C. Post et al
AJR 2009;192:277-281
http://www.ajronline.org/cgi/content/abstract/192/6/W277
Assessment of Myocardial Viability with 3D MRI at 3 T
Kerstin U. Bauner, Olaf Muehling, Daniel Theisen, Carmel Hayes et al
AJR 2009;192:1645-1650
http://www.ajronline.org/cgi/content/abstract/192/6/1645
Vascular Enhancement and Image Quality of MDCT Pulmonary Angiography in 400 Cases: Comparison of Standard and Low Kilovoltage Settings
Shin Matsuoka, Andetta R. Hunsaker, Ritu R. Gill, Isabel B. Oliva et al
AJR 2009;192:1651-1656
http://www.ajronline.org/cgi/content/abstract/192/6/1651
In Vivo Repeatability of Automated Volume Calculations of Small Pulmonary
Nodules With CT
Cristiano Rampinelli, Elvio De Fiori, Sara Raimondi, Giulia Veronesi,
and Massimo Bellomi
AJR 2009;192:1657-1661
http://www.ajronline.org/cgi/content/abstract/192/6/1657
Whole-Chest 64-MDCT of Emergency Department Patients with Nonspecific Chest
Pain: Radiation Dose and Coronary Artery Image Quality with Prospective ECG
Triggering Versus Retrospective ECG Gating
William P. Shuman, Kelley R. Branch, Janet M. May, Lee M. Mitsumori et al
AJR 2009;192:1662-1667
http://www.ajronline.org/cgi/content/abstract/192/6/1662
Differences in Aortic Valve Area Measured with CT Planimetry and
Echocardiography (Continuity Equation) Are Related to Divergent Estimates
of Left Ventricular Outflow Tract Area
Ethan J. Halpern, Raghuram Mallya, Matthew Sewell, Matisyahu Shulman,
and Donna R. Zwas
AJR 2009;192:1668-1673
http://www.ajronline.org/cgi/content/abstract/192/6/1668
Gastrointestinal Imaging
Gadoxetic Acid-Enhanced MRI Versus Triple-Phase MDCT for the Preoperative
Detection of Hepatocellular Carcinoma
Seong Hyun Kim, Seung Hoon Kim, Jongmee Lee, Min Ju Kim et al
AJR 2009;192:1675-1681
http://www.ajronline.org/cgi/content/abstract/192/6/1675
Influence of Computer-Aided Detection False-Positives on Reader Performance
and Diagnostic Confidence for CT Colonography
Stuart A. Taylor, John Brittenden, James Lenton, Hannah Lambie et al
AJR 2009;192:1682-1689
http://www.ajronline.org/cgi/content/abstract/192/6/1682
Genitourinary Imaging
Detection of Urinary Stones at Reduced Radiation Exposure: A Phantom Study
Comparing Computed Radiography and a Low-Dose Digital Radiography Linear
Slit Scanning System
Zsolt Szucs-Farkas, Dev P. Chakraborty, Harriet C. Thoeny et al
AJR 2009;192:271-274
http://www.ajronline.org/cgi/content/abstract/192/6/W271
Renal Angiomyolipoma With Nontraumatic Pulmonary Fat Embolus
Claire K. Sandstrom, Jeffrey Pugsley, and Lee M. Mitsumori
AJR 2009;192:275-276
http://www.ajronline.org/cgi/content/full/192/6/W275
Challenges in Clinical Prostate Cancer: Role of Imaging
Gary J. Kelloff, Peter Choyke, Donald S. Coffey for The Prostate
Cancer Imaging Working Group
AJR 2009;192:1455-1470
http://www.ajronline.org/cgi/content/abstract/192/6/1455
Imaging Localized Prostate Cancer: Current Approaches and New Developments
Baris Turkbey, Paul S. Albert, Karen Kurdziel, and Peter L. Choyke
AJR 2009;192:1471-1480
http://www.ajronline.org/cgi/content/abstract/192/6/1471
Imaging and Staging of Transitional Cell Carcinoma: Part 1, Lower Urinary
Tract
Raghunandan Vikram, Carl M. Sandler, and Chaan S. Ng
AJR 2009;192:1481-1487
http://www.ajronline.org/cgi/content/abstract/192/6/1481
Imaging and Staging of Transitional Cell Carcinoma: Part 2, Upper Urinary
Tract
Raghunandan Vikram, Carl M. Sandler, and Chaan S. Ng
AJR 2009;192:1488-1493
http://www.ajronline.org/cgi/content/abstract/192/6/1488
Imaging Appearance of Granulomatous Disease After Intravesical Bacille
Calmette-Guerin (BCG) Treatment of Bladder Carcinoma
Weining Ma, Stella K. Kang, Hedvig Hricak, Scott R. Gerst, and Jingbo
Zhang
AJR 2009;192:1494-1500
http://www.ajronline.org/cgi/content/abstract/192/6/1494
MDCT Urography: Exploring a New Paradigm for Imaging of Bladder Cancer
Richard H. Cohan, Elaine M. Caoili, Nigel C. Cowan et al
AJR 2009;192:1501-1508
http://www.ajronline.org/cgi/content/abstract/192/6/1501
Assessment of Urinary Tract Calculi With 64-MDCT: The Axial Versus Coronal
Plane
Ur Metser, Sangeet Ghai, Yang Yi Ong, Gina Lockwood, and Sidney B.
Radomski
AJR 2009;192:1509-1513
http://www.ajronline.org/cgi/content/abstract/192/6/1509
Imaging of Genitourinary Trauma
Parvati Ramchandani and Philip Michael Buckler
AJR 2009;192:1514-1523
http://www.ajronline.org/cgi/content/abstract/192/6/1514
Renal Cell Carcinoma: T1 and T2 Signal Intensity Characteristics of
Papillary and Clear Cell Types Correlated with Pathology
M. Raquel Oliva, Jonathan N. Glickman, Kelly H. Zou, Sze Y. Teo et al
AJR 2009;192:1524-1530
http://www.ajronline.org/cgi/content/abstract/192/6/1524
Free-Breathing Accelerated Gadolinium-Enhanced MR Angiography in the
Diagnosis of Renovascular Disease
Alain Nchimi, Denis Brisbois, Roland Materne, Thomas K. Y. Broussaud et al
AJR 2009;192:1531-1537
http://www.ajronline.org/cgi/content/abstract/192/6/1531
High-Dose Gadodiamide for Catheter Angiography and CT in Patients With
Varying Degrees of Renal Insufficiency: Prevalence of Subsequent
Nephrogenic Systemic Fibrosis and Decline in Renal Function
Mellena D. Bridges, Brandon S. St. Amant, Rebecca B. McNeil et al
AJR 2009;192:1538-1543
http://www.ajronline.org/cgi/content/abstract/192/6/1538
Reducing the Risk of Contrast-Induced Nephropathy: A Perspective on the
Controversies
James H. Ellis and Richard H. Cohan
AJR 2009;192:1544-1549
http://www.ajronline.org/cgi/content/abstract/192/6/1544
Renal Functional MRI: Are We Ready for Clinical Application?
Hersh Chandarana and Vivian S. Lee
AJR 2009;192:1550-1557
http://www.ajronline.org/cgi/content/abstract/192/6/1550
Imaging-Guided Percutaneous Ablation of Renal Cell Carcinoma: A Primer of
How We Do It
Raul N. Uppot, Stuart G. Silverman, Ronald J. Zagoria, Kemal Tuncali et al
AJR 2009;192:1558-1570
http://www.ajronline.org/cgi/content/abstract/192/6/1558
MRI and CT Characteristics of Successfully Ablated Renal Masses: Imaging
Surveillance After Radiofrequency Ablation
Matthew S. Davenport, Elaine M. Caoili, Richard H. Cohan et al
AJR 2009;192:1571-1578
http://www.ajronline.org/cgi/content/abstract/192/6/1571
Women's Imaging
Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A
Series of 15 Pregnancies
Kavous Firouznia, Hossein Ghanaati, Mina Sanaati, Amir H. Jalali, and
Madjid Shakiba
AJR 2009;192:1588-1592
http://www.ajronline.org/cgi/content/abstract/192/6/1588
History of Uterine Artery Occlusion and Subsequent Pregnancy
Fred Burbank
AJR 2009;192:1593-1600
http://www.ajronline.org/cgi/content/abstract/192/6/1593
Uterine Artery Embolization Along With the Administration of Methotrexate
for Cervical Ectopic Pregnancy: Technical and Clinical Outcomes
Masakazu Hirakawa, Tsuyoshi Tajima, Kengo Yoshimitsu, Hiroyuki Irie et al
AJR 2009;192:1601-1607
http://www.ajronline.org/cgi/content/abstract/192/6/1601
In Vivo Proton MR Spectroscopy of the Breast Using the Total Choline Peak
Integral as a Marker of Malignancy
Francesco Sardanelli, Alfonso Fausto, Giovanni Di Leo, Robin de Nijs et al
AJR 2009;192:1608-1617
http://www.ajronline.org/cgi/content/abstract/192/6/1608
Endometriosis of the Posterior Cul-De-Sac: Clinical Presentation and
Findings at Transvaginal Ultrasound
Jan-Hein J. Hensen and Julien B. C. M. Puylaert
AJR 2009;192:1618-1624
http://www.ajronline.org/cgi/content/abstract/192/6/1618
Anatomic Distribution of Posterior Deeply Infiltrating Endometriosis on MRI
After Vaginal and Rectal Gel Opacification
Pierre Loubeyre, Patrick Petignat, Sandrine Jacob, Jean-Francois
Egger et al
AJR 2009;192:1625-1631
http://www.ajronline.org/cgi/content/abstract/192/6/1625
Unusual Imaging Appearances of Endometriosis
Shaile Choudhary, Najla Fasih, Demetri Papadatos, and Venkateswar R.
Surabhi
AJR 2009;192:1632-1644
http://www.ajronline.org/cgi/content/abstract/192/6/1632
Musculoskeletal Imaging
Diffusion Tensor Imaging and Fiber Tractography of Skeletal Muscle:
Optimization of b Value for Imaging at 1.5 T
Nadja Saupe, Lawrence M. White, Jeffrey Stainsby, George Tomlinson,
and Marshall S. Sussman
AJR 2009;192:282-290
http://www.ajronline.org/cgi/content/abstract/192/6/W282
Angioleiomyoma in Soft Tissue of Extremities: MRI Findings
Hye Jin Yoo, Jung-Ah Choi, Jin-Haeng Chung, Joo Han Oh, Gyung-Kyu Lee et al
AJR 2009;192:291-294
http://www.ajronline.org/cgi/content/abstract/192/6/W291
Functional Joint Imaging Using 256-MDCT: Technical Feasibility
Vivek Kalia, Rick W. Obray, Ross Filice, Laura M. Fayad et al
AJR 2009;192:295-299
http://www.ajronline.org/cgi/content/abstract/192/6/W295
Assessment of Capsular Laxity in Patients With Recurrent Anterior Shoulder
Dislocation Using MRI
Alex Wing Hung Ng, C. M. Chu, W. N. Lo, Y. M. Lai, and C. K. Kam
AJR 2009;192:1690-1695
http://www.ajronline.org/cgi/content/abstract/192/6/1690
Hoffa's Fat Pad: Evaluation on Unenhanced MR Images as a Measure of
Patellofemoral Synovitis in Osteoarthritis
Frank W. Roemer, Ali Guermazi, Yuqing Zhang, Mei Yang, David J.
Hunter et al
AJR 2009;192:1696-1700
http://www.ajronline.org/cgi/content/abstract/192/6/1696
Accuracy of MRI, MR Arthrography, and Ultrasound in the Diagnosis of
Rotator Cuff Tears: A Meta-Analysis
Joseph O. de Jesus, Laurence Parker, Andrea J. Frangos, and Levon N.
Nazarian
AJR 2009;192:1701-1707
http://www.ajronline.org/cgi/content/abstract/192/6/1701
MRI Findings in Inflammatory Muscle Diseases and Their Noninflammatory
Mimics
Maximilian Schulze, Ina Kotter, Ulrike Ernemann, Michael Fenchel et al
AJR 2009;192:1708-1716
http://www.ajronline.org/cgi/content/abstract/192/6/1708
Pediatric Imaging
CT in Children With Suspected Residual Foreign Body in Airway After
Bronchoscopy
Su-Mi Shin, Woo Sun Kim, Jung-Eun Cheon, Ah Young Jung, Byung Jae
Youn et al
AJR 2009;192:1744-1751
http://www.ajronline.org/cgi/content/abstract/192/6/1744
Vascular and Interventional Radiology
Adrenal Metastasis From Hepatocellular Carcinoma: Radiofrequency Ablation
Combined With Adrenal Arterial Chemoembolization in Six Patients
Koichiro Yamakado, Hiroshi Anai, Haruyuki Takaki, Hiroshi Sakaguchi et al
AJR 2009;192:300-305
http://www.ajronline.org/cgi/content/abstract/192/6/W300
Vascular Regeneration by Repeated Infusions of Basic Fibroblast Growth
Factor in a Rabbit Model of Hind-Limb Ischemia
Ayumi Seko, Norihisa Nitta, Akinaga Sonoda, Shinichi Ohta et al
AJR 2009;192:306-310
http://www.ajronline.org/cgi/content/abstract/192/6/W306
Direct CT Venography for Evaluation of the Lower Extremity Venous Anomalies
of Klippel-Trenaunay Syndrome
Ertugrul Mavili, Mehmet Ozturk, Yigit Akcali, Halil Donmez, Ali
Yikilmaz et al
AJR 2009;192:311-316
http://www.ajronline.org/cgi/content/abstract/192/6/W311
MRI of TIPS with Covered Stent-Grafts: In Vitro Analysis Using a Flow
Phantom and Initial Clinical Experience
Maxim Itkin, Aalpen Patel, Scott O. Trerotola, and Harold I. Litt
AJR 2009;192:317-320
http://www.ajronline.org/cgi/content/abstract/192/6/W317
Freehand Versus Guided Breast Biopsy: Comparison of Accuracy, Needle
Motion, and Biopsy Time in a Tissue Model
Nathan Bluvol, Anat Kornecki, Allison Shaikh, David Del Rey Fernandez et al
AJR 2009;192:1720-1725
http://www.ajronline.org/cgi/content/abstract/192/6/1720
Kerma Area Product Method for Effective Dose Estimation During Lumbar
Epidural Steroid Injection Procedures: Phantom Study
Sangroh Kim, Greta Toncheva, Colin Anderson-Evans, Billy K. Huh et al
AJR 2009;192:1726-1730
http://www.ajronline.org/cgi/content/abstract/192/6/1726
Time-Resolved MR Angiography in the Evaluation of Central Thoracic Venous
Occlusive Disease
Kambiz Nael, Mayil Krishnam, Stefan G. Ruehm, Henrik J. Michaely et al
AJR 2009;192:1731-1738
http://www.ajronline.org/cgi/content/abstract/192/6/1731
Medical Physics and Informatics
Free and Open Source Software for the Manipulation of Digital Images
Robert W. Solomon
AJR 2009;192:330-334
http://www.ajronline.org/cgi/content/abstract/192/6/W330
Health Care Policy and Quality
Do Clinicians Use the American College of Radiology Appropriateness
Criteria in the Management of Their Patients?
Andre B. Bautista, Anthony Burgos, Barbara J. Nickel, John J. Yoon et al
AJR 2009;192:1581-1585
http://www.ajronline.org/cgi/content/abstract/192/6/1581
Letters
Dual-Energy CT Pulmonary Angiography: A New Horizon in the Imaging of Acute
Pulmonary Thromboembolism
Edward T. D. Hoey, Deepa Gopalan, and Nicholas J. Screaton
AJR 2009;192:341-342
http://www.ajronline.org/cgi/content/full/192/6/W341
Reply
Sudhakar N. J. Pipavath and J. David Godwin
AJR 2009;192:343
http://www.ajronline.org/cgi/content/full/192/6/W343
Superior Vena Cava Syndrome Resulting in Osseous Venous Congestion
Simulating Sclerotic Bone Lesions
Robert A. Jesinger, Bang Huynh, and David Gover
AJR 2009;192:344-345
http://www.ajronline.org/cgi/content/full/192/6/W344
Setting the Record Straight Concerning the ABR's Future Core and Certifying
Examinations in Diagnostic Radiology
Gary J. Becker, N. Reed Dunnick, Jennifer Bosma, and Anthony M.
Gerdeman
AJR 2009;192:346-347
http://www.ajronline.org/cgi/content/full/192/6/W346
Reply
Jonathan H. Sunshine, Rebecca S. Lewis, and Mythreyi Bhargavan
AJR 2009;192:348
http://www.ajronline.org/cgi/content/full/192/6/W348
Metastatic Intramammary Lymph Node as a Synchronous Benign-Appearing Breast
Nodule Detected in a Patient with Breast Cancer
Silma Solorzano, Michael Seidler, and Benoit Mesurolle
AJR 2009;192:349
http://www.ajronline.org/cgi/content/full/192/6/W349
MR Hysterosalpingography Compared With Conventional Hysterosalpingography
James E. Silberzweig
AJR 2009;192:350
http://www.ajronline.org/cgi/content/full/192/6/W350
Intrascrotal Arteriovenous Malformation Simulating Varicocele
Cengiz Yilmaz, Muhammed Arslan, and Murat Arslan
AJR 2009;192:351
http://www.ajronline.org/cgi/content/full/192/6/W351
Book Reviews
Breast Cancer Imaging: A Multidisciplinary, Multimodality Approach.
Michelle D. McDonough
AJR 2009;192:352
http://www.ajronline.org/cgi/content/full/192/6/W352
Growth of the Pediatric Skeleton: A Primer for Radiologists.
Edem F. Chen
AJR 2009;192:353
http://www.ajronline.org/cgi/content/full/192/6/W353
Neuroradiology/Head and Neck Imaging
Feasibility of Superficial Temporal Artery as the Input Artery for Cerebral
Perfusion CT
Kiran Sheikh, Matthew J. Schipper, and Ellen G. Hoeffner
AJR 2009;192:321-329
http://www.ajronline.org/cgi/content/abstract/192/6/W321
Other Content
Correction for Volume 191, p. 1436
Fergus Coakley
AJR 2009;192:1454
http://www.ajronline.org/cgi/content/full/192/6/1454
Correction for Volume 192, p. 1407
Bethany U. Casagranda
AJR 2009;192:1454
http://www.ajronline.org/cgi/content/full/192/6/1454-a
Edward Vincent Staab
C. Douglas Maynard
AJR 2009;192:1754-1755
http://www.ajronline.org/cgi/content/full/192/6/1754
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