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3.
Acad Radiol ; 30(11): 2761-2768, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37208259

RESUMO

The Alliance of Leaders in Academic Affairs in Radiology (ALAAR) advocates for a Universal Curriculum Vitae for all medical institutions and to that end, we have developed a template that can be downloaded on the AUR website (ALAAR CV template) that includes all of the elements required by many academic institutions. Members of ALAAR represent multiple academic institutions and have spent many hours reviewing and providing input on radiologists' curricula vitae. The purpose of this review is to help academic radiologists accurately maintain and optimize their CVs with minimal effort and to clarify common questions that arise at many different institutions in the process of constructing a CV.

7.
Neurohospitalist ; 8(3): 141-145, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29977445

RESUMO

Strokes involving the artery of Percheron (AOP), an anatomic variant of thalamic vascular supply, are rare. Little is known about the inpatient hospital course for these patients. We retrospectively identified consecutive patients with AOP in their medical charts from a university-based tertiary care hospital from January 1, 2000, to August 15, 2017. A chart review identified demographics, transfer status, in-hospital versus community onset of stroke, emergency medical services (EMS) use, presenting signs/symptoms, time to radiologic diagnosis (from time of presentation to tertiary care hospital or from time of initial symptom onset in an already hospitalized patient), tissue plasminogen activator (tPA) use, intensive care unit (ICU) stays, intubation, length of stay (LOS), and discharge location. After radiologic inclusion/exclusion criteria were applied, 12 patients were included in the study. There were 7 men and 5 women, and the mean age (SD) was 68 (15). Seven were transfers, and 4 had an in-hospital stroke. Of the 8 community-onset strokes, 7 utilized EMS. Mental status changes occurred in 11 of 12 and ocular disturbances in all patients. Time to radiologic diagnosis averaged 1.9 (median = 1.1) days. One patient received tPA. Eight received care in the ICU. Four were intubated. Average LOS was 8.3 days. Four were discharged home, 3 entered inpatient rehabilitation facilities, and 5 entered skilled nursing facilities. In-hospital stroke status further complicates the already challenging diagnosis of AOP infarct, and clinicians must maintain a high suspicion for this rare stroke in order to quickly diagnose and intervene.

8.
J Ultrasound Med ; 32(12): 2191-7, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24277903

RESUMO

Our aim with this study was to develop a user-friendly method for pediatric sonographically guided lumbar punctures so that we can visualize intrathecal anatomy, confirm intrathecal injection at the time of injection, and, most importantly, avoid ionizing radiation to a child's already radiosensitive pelvis. Sonographically guided lumbar puncture was prospectively performed in children aged 7 weeks to 16 years. All attempts (n = 9) were successful. We were able to identify relevant anatomy (including the conus in children 10 years and younger), confirm intrathecal injection, visualize intrathecal hematoma, and avoid radiation. Sonography is a promising modality for image-guided lumbar punctures without radiation in children.


Assuntos
Líquido Cefalorraquidiano/citologia , Líquido Cefalorraquidiano/diagnóstico por imagem , Biópsia Guiada por Imagem/métodos , Punção Espinal/métodos , Ultrassonografia de Intervenção/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
9.
J Comput Assist Tomogr ; 37(5): 666-72, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24045238

RESUMO

PURPOSE: The objective of this study was to evaluate spectral Hounsfield unit (HU) curves and effective Z (atomic number) generated on dual-energy gemstone spectral imaging computed tomography (CT) in the differentiation of benign and malignant neck pathologic findings. METHODS: This was a retrospective review of 38 patients who underwent neck CT on a gemstone spectral imaging dual-energy CT (Lightspeed CT750 HD 64-slice CT scanner; GE Medical Systems, Milwaukee, Wis) from November 2009 to June 2012 with identifiable masses. One board-certified radiologist placed regions of interest within the mass (19 benign, 19 malignant) and in paraspinal muscles (PSMs) to create 2 spectral HU curves in each patient. The curve parameters compared between the benign and malignant groups included range (conceptually, the difference between the highest and lowest HU), asymptote, decay, and the differences and ratios (of lesion to PSM) of each of these 3 parameters. A logistic regression model was built with these parameters and effective Z. RESULTS: The difference in ranges (between lesion and PSM) was the best predictor of malignancy, with a threshold of 75 or greater demonstrating 95% sensitivity, 89% specificity, and 91.8% area under the curve (AUC). Adding other spectral HU parameters and effective Z to the model did not substantially increase the AUC (93.3%, difference between the 2 models not statistically significant, P > 0.25). The effective Z showed a 79.9% AUC with 68% sensitivity and 68% specificity at an 8.80 cutoff. CONCLUSIONS: The spectral HU curve is promising for differentiating benign and malignant neck pathologic findings, with the difference in range between the lesion and PSM showing the best predictive value.


Assuntos
Algoritmos , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Intensificação de Imagem Radiográfica/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/classificação , Neoplasias de Cabeça e Pescoço/congênito , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
10.
AJR Am J Roentgenol ; 201(4): 878-83, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24059379

RESUMO

OBJECTIVE: Our aim was to evaluate the utility of dual-energy CT (DECT) virtual kilo-electron volt (keV) monochromatic images for the visualization of the transpedicular screw-bone interface after spinal fusion. MATERIALS AND METHODS: This retrospective study included postfusion spine CT studies performed from October 2011 through April 2012 on a dual-energy 64-MDCT unit (Discovery CT750 HD). Studies were postprocessed on an Advantage Windows workstation (version 4.4) by two neuroradiologists with creation of monochromatic images from 40 to 140 keV. Each reader graded the screw-bone interfaces on the 70-keV images (used for clinical interpretation) and on the monochromatic series using a 5-point scale (1 [uninterpretable] to 5 [excellent]). The grades of the interfaces were compared using the Wilcoxon signed rank test to detect differences between the 70-keV image and the monochromatic series. RESULTS: Ninety-two transpedicular screws in 10 patients were studied. Significant improvement in the visibility of the hardware-bone interface was seen on the monochromatic series compared with the 70-keV images: The median grade for the monochromatic series was 4 (range, 2-5) for both readers, whereas the median grade for the 70-keV images was 3 (range, 2-4) for reader 1 and 2 (range, 2-3) for reader 2 (both, p < 0.001). The interobserver agreement using weighted kappa was 0.51 for grading screw-bone interface visualization. The volume CT dose index was 29.5 mGy in all patients and the mean dose-length product was 805.2 mGy × cm. CONCLUSION: Monochromatic images generated on gemstone spectral DECT are beneficial in the reduction of metallic streak artifact and enable better visualization of the hardware-bone interface than the 70-keV series in patients treated with spinal transpedicular screw fixation.


Assuntos
Parafusos Ósseos , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/cirurgia , Fusão Vertebral/instrumentação , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do Tratamento
12.
Otolaryngol Clin North Am ; 45(6): 1405-22, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23153755

RESUMO

The normal appearance of the posttherapy neck after common surgical procedures and chemoradiation therapy is presented, with specific details for each surgical procedure. Subsequently, the authors emphasize the recognition of complications and disease recurrence with illustrated examples.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Atrofia , Terapia Combinada , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Tecido Linfoide/patologia , Espectroscopia de Ressonância Magnética , Pescoço/diagnóstico por imagem , Esvaziamento Cervical/métodos , Tomografia por Emissão de Pósitrons , Período Pós-Operatório , Intensificação de Imagem Radiográfica
13.
Neuroimaging Clin N Am ; 22(4): 557-83, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23122257

RESUMO

Central nervous system infections account for 1% of primary hospital admissions and 2% of nosocomial infections and when encountered require prompt diagnosis and initiation of specific treatment. Imaging findings are mostly nonspecific with respect to the causative pathogen. This article describes the anatomy of cranial meninges and extra-axial spaces of the brain. Characteristic findings and recent advances in neuroimaging of meningitis and its complications and ventriculitis are summarized, and certain noninfectious causes of meningitis and meningitis mimics are described.


Assuntos
Ventriculite Cerebral/diagnóstico , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Meningite/diagnóstico , Doença Aguda , Adulto , Encéfalo/patologia , Abscesso Encefálico/diagnóstico , Doenças dos Nervos Cranianos/diagnóstico , Infecção Hospitalar/diagnóstico , Diagnóstico Diferencial , Encefalocele/diagnóstico , Humanos , Lactente , Meninges/patologia , Meningite/etiologia , Valores de Referência , Punção Espinal , Vasculite do Sistema Nervoso Central/diagnóstico
14.
Neuroimaging Clin N Am ; 22(4): 585-607, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23122258

RESUMO

Imaging plays an important role in the diagnosis and treatment of brain abscess, pyogenic infection, and encephalitis. The role of CT and MRI in the diagnosis and management of pyogenic brain abscess and its complications is reviewed. The imaging appearances of several common and select uncommon infectious encephalitides are reviewed. Common causes of encephalitis in immunocompromised patients, and their imaging appearances, are also discussed. When combined with CSF, serologic studies and patient history, imaging findings can suggest the cause of encephalitis.


Assuntos
Abscesso Encefálico/diagnóstico , Imagem de Difusão por Ressonância Magnética , Encefalite/diagnóstico , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Meningite/diagnóstico , Tomografia Computadorizada por Raios X , Encéfalo/patologia , Abscesso Encefálico/etiologia , Diagnóstico Diferencial , Encefalite/etiologia , Humanos , Espectroscopia de Ressonância Magnética , Meningite/etiologia , Prognóstico , Sensibilidade e Especificidade , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologia
15.
Neuroimaging Clin N Am ; 22(4): 677-705, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23122262

RESUMO

With the onset of the human immunodeficiency virus pandemic, the incidence of tuberculosis, including central nervous system (CNS) tuberculosis, has increased in developed countries. It is no longer a disease confined to underdeveloped and developing countries. The imaging appearance has become more complex with the onset of multidrug-resistant tuberculosis. Imaging plays an important role in the early diagnosis of CNS tuberculosis and may prevent unnecessary morbidity and mortality. This article presents an extensive review of typical and atypical imaging appearances of intracranial tuberculosis, and discusses pathogenesis, patterns of involvement, and advances in imaging of intracranial tuberculosis.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/fisiopatologia , Angiografia Cerebral , Imagem de Difusão por Ressonância Magnética , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Tuberculose do Sistema Nervoso Central/diagnóstico , Tuberculose do Sistema Nervoso Central/fisiopatologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Encéfalo/patologia , Estudos Transversais , Diagnóstico Diferencial , Humanos , Incidência , Meninges/patologia , Prognóstico , Sensibilidade e Especificidade , Medula Espinal/patologia , Coluna Vertebral/patologia , Tuberculose do Sistema Nervoso Central/epidemiologia
16.
Neuroimaging Clin N Am ; 22(4): 727-54, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23122264

RESUMO

Infections of the head and neck vary in their clinical course and outcome because of the diversity of organs and anatomic compartments involved. Imaging plays a central role in delineating the anatomic extent of the disease process, identifying the infection source, and detecting complications. The utility of imaging to differentiate between a solid phlegmonous mass and an abscess cannot be overemphasized. This review briefly describes and pictorially illustrates the typical imaging findings of some important head and neck infections, such as malignant otitis externa, otomastoiditis bacterial and fungal sinusitis, orbital cellulitis, sialadenitis, cervical lymphadenitis, and deep neck space infections.


Assuntos
Infecções Bacterianas/diagnóstico , Aumento da Imagem , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Micoses/diagnóstico , Otorrinolaringopatias/diagnóstico , Tomografia Computadorizada por Raios X , Ultrassonografia , Viroses/diagnóstico , Abscesso/diagnóstico , Infecções Bacterianas/patologia , Celulite (Flegmão)/diagnóstico , Colesteatoma da Orelha Média/diagnóstico , Colesteatoma da Orelha Média/patologia , Meios de Contraste/administração & dosagem , Humanos , Meningite/diagnóstico , Meningite/patologia , Micoses/patologia , Otorrinolaringopatias/patologia , Prognóstico , Sensibilidade e Especificidade , Viroses/patologia
18.
Neurosurg Focus ; 31(6): E11, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22133167

RESUMO

OBJECT: The aim of this article was to report on the nature and prevalence of incidental imaging findings in a consecutive series of patients older than 90 years of age who underwent intracranial imaging for any reason. METHODS: The authors retrospectively reviewed the electronic medical and imaging records of consecutive patients who underwent brain MR imaging at a single institution over a 153-month interval and were at least 90 but less than 100 years of age at the time of the imaging study. The prevalence of lesions by type in this consecutive series of MR imaging evaluations was calculated for all patients. The authors reviewed the medical record to evaluate whether a change in management was recommended based on MR imaging findings. They evaluated patient age at the time of death and the time interval between MR imaging and death. RESULTS: The authors identified 177 patients who met the study criteria. The group included 119 women (67%) and 58 (33%) men. Their mean age was 92.3 ± 1.8 years. Evidence of acute ischemic changes or cerebrovascular accident (CVA) was found in 36 patients (20%). Fifteen patients (8%) had an intracranial tumor. Intracranial aneurysms were incidentally identified in 6 patients (3%). Chronic subdural hematomas were found in 3 patients (2%). Overall, 25 patients (14%) had some change in medical management as a result of the MR imaging findings. The most common MR imaging finding that resulted in a change in medical management was an acute CVA (p < 0.0001). The mean time to death from date of MR imaging was 2.5 ± 2.3 years. CONCLUSIONS: Intracranial imaging is rarely performed in patients older than 90 years. In cases of suspected stroke, MR imaging findings may influence treatment decisions. Brain MR imaging studies ordered for other indications in this age group rarely influence treatment decisions. Incidentally discovered lesions in this age group are generally not treated.


Assuntos
Neoplasias Encefálicas/diagnóstico , Hematoma Subdural Intracraniano/diagnóstico , Achados Incidentais , Aneurisma Intracraniano/diagnóstico , Imageamento por Ressonância Magnética , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/terapia , Feminino , Hematoma Subdural Intracraniano/terapia , Humanos , Aneurisma Intracraniano/terapia , Imageamento por Ressonância Magnética/métodos , Masculino , Estudos Retrospectivos
19.
J Spinal Disord Tech ; 22(2): 86-90, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19342928

RESUMO

STUDY DESIGN: Retrospective clinical series. OBJECTIVE: To evaluate the management and outcomes of patients with unilateral, asymptomatic vertebral artery occlusion (VAO) undergoing surgery for cervical fractures associated with subluxation. SUMMARY OF BACKGROUND DATA: The management of VAO is controversial with several treatment options available, including observation alone, antiplatelet therapy, or anticoagulation therapy. METHODS: A chart review inclusive of the years 2004 to 2006 was performed to include patients who presented after nonpenetrating trauma with cervical fracture associated with subluxation requiring surgery. An associated asymptomatic VAO was also required for inclusion. Eight patients were identified. RESULTS: Seven patients were male and the mean age was 26.8 years. Six patients suffered an associated spinal cord injury. Three patients underwent closed reduction before surgical stabilization. Five patients underwent open reduction with stabilization. No patient received treatment for VAO before reduction. Postoperative treatment for VAO was variable, with 5 of 8 patients undergoing observation alone. The remaining 3 patients were treated with aspirin therapy, although 1 patient received heparin intravenously for 1 day. None of the patients experienced an ischemic complication. CONCLUSIONS: Reduction of a fracture, whether closed or open, without treatment of an associated asymptomatic VAO seems safe. Postoperative management of VAO consisting of either observation alone or aspirin therapy also seems to be a safe option.


Assuntos
Traumatismo Cerebrovascular/cirurgia , Vértebras Cervicais/lesões , Vértebras Cervicais/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Artéria Vertebral/lesões , Artéria Vertebral/cirurgia , Adolescente , Adulto , Traumatismo Cerebrovascular/etiologia , Traumatismo Cerebrovascular/fisiopatologia , Vértebras Cervicais/patologia , Estudos de Coortes , Feminino , Humanos , Fixadores Internos , Luxações Articulares/complicações , Luxações Articulares/patologia , Luxações Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/uso terapêutico , Cuidados Pós-Operatórios , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/fisiopatologia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/patologia , Fusão Vertebral/instrumentação , Fusão Vertebral/métodos , Resultado do Tratamento , Artéria Vertebral/patologia , Dissecação da Artéria Vertebral/etiologia , Dissecação da Artéria Vertebral/fisiopatologia , Dissecação da Artéria Vertebral/cirurgia , Adulto Jovem
20.
J Surg Oncol ; 97(8): 644-8, 2008 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-18493943

RESUMO

Computerized tomography (CT) and magnetic resonance imaging (MRI), positron emission tomography (PET) and the hybrid modality of PET/CT are sensitive and reliable tools for detection and staging of head and neck cancers. This article describes the role of PET/CT in initial staging of head and neck squamous cell carcinoma, the utility of CT/MR perfusion imaging in qualitative analysis of tumor tissue, and the usefulness of diffusion weighted MR and dynamic contrast-enhanced MR imaging in head and neck oncological imaging.


Assuntos
Diagnóstico por Imagem/métodos , Neoplasias de Cabeça e Pescoço/diagnóstico , Meios de Contraste/administração & dosagem , Diagnóstico por Imagem/tendências , Fluordesoxiglucose F18 , Neoplasias de Cabeça e Pescoço/irrigação sanguínea , Humanos , Compostos Radiofarmacêuticos
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