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Imaging the fetal spine using in utero MR: diagnostic accuracy and impact on management. In Pediatr Radiol 2006 Jul 18; [Epub ahead of print] By Griffiths PD et al.
"In-utero MR imaging (iuMR) has entered the clinical arena during the last decade. It is used mainly for imaging fetal brain abnormalities. Authors report their experience of imaging the fetal spine and spinal cord in fetuses with known or suspected abnormalities diagnosed on US imaging. In 40 (80%) of 50 fetuses, iuMR and US imaging were in complete agreement. In the other 10 fetuses (20%), iuMR provided additional information or changed the diagnosis, including 8 fetuses where the iuMR could find no abnormality and was found to be correct by later follow-up.
Authors conclude-The clinical impact of iuMR may be numerically less than with brain abnormalities, but is still sufficient to warrant its use, especially if there is any uncertainty about the US imaging, and particularly as a relatively high proportion of diagnoses on US imaging are false-positives."
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July 2006
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Reference-Diagnostic Accuracy of Transesophageal Echocardiography, Helical Computed Tomography, and Magnetic Resonance Imaging for Suspected Thoracic Aortic Dissection: Systematic Review and Meta-analysis. By Shiga T et al in Arch Intern Med 2006 Jul 10;166(13):1350-6.
"Patients with suspected thoracic aortic dissection require early and accurate diagnosis. Aortography has been replaced by less invasive imaging techniques including transesophageal echocardiography (TEE), helical computed tomography (CT), and magnetic resonance imaging (MRI); however, accuracies have varied from trial to trial, and which imaging technique should be applied to which risk population remains unclear.
In their study authors found Pooled sensitivity and specificity were comparable between imaging techniques. The pooled positive likelihood ratio appeared to be higher for MRI than for TEE or helical CT. All 3 imaging techniques, ie, TEE, helical CT, and MRI, yield clinically equally reliable diagnostic values for confirming or ruling out thoracic aortic dissection."
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July 2006
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Dear Friends as you all know Second edition of the monthly summary of the Radiology Blogosphere is coming up on the last Sunday of this month, 30th July. So Hurry Up!! rush in your Radiology Related posts to me at-
sumerdoc-AT-yahoo-DOT-com
Please Note you need not be a Radiologist to post, I am looking forward to posts from all technicians, students, Physicians, nurse etc...
Details about future schedule and guidelines-
Radiology Grand Rounds
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July 2006
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I was not able to access my blog for last few days thought it was some problem with blogger, till i saw the following news item... Highly objectionable act by the Goverment.. straight violation of the right to freedom of speech...
Indian Government Blocks Web Access
Action Mirrors That of China (Source-Washington Post)
"India's Internet regulators have started blocking several Web sites, following the lead of China, where government censors heavily restrict the flow of online information. India's department of telecommunications sent an order late last week to Internet service providers to block several Web sites, according to a department spokesman. The spokesman, Rajesh Malhotra, declined to disclose the contents of the letter or discuss the order, saying it was a "confidential exchange of information between the department and the operators." Several telecom operators confirmed that they were directed to block more than 15 Web sites. Close to a third of those are home to blogs, or personalized Web logs, such as Blogger.com and Geocities.com."
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Posted in
July 2006
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MR of cerebral malaria. In AJNR Am J Neuroradiol 1998 May;19(5):871-4. By Cordoliani YS et al.
"In three cases of cerebral malaria, MR imaging disclosed either cortical infarcts (one case) or hyperintense areas of white matter (two cases) on T2-weighted and fluid-attenuated inversion-recovery sequences. These white matter abnormalities were, in one case, sharply limited, symmetrical, hyperintense, and unenhanced; in the other case, they were diffuse, hyperintense, and had a more limited focus. The diffuse hyperintensity was probably due to edema, whereas focal lesions were probably associated with gliosis."
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Posted in
July 2006
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In an Article entitiled "Impact of the availability of sonography in the acute gynecology unit." in Ultrasound Obstet Gynecol 2006 Jun 29; [Epub ahead of print] by Haider Z et al, the authors investigated the impact of the availability of transvaginal sonography at the time of initial assessment of the emergency gynecology patient. The initial assessment of acute gynecology patients is usually based on history and clinical examination and does not involve ultrasound. Authors found that Following the ultrasound examination there was a change in clinical management for 38.1% of non-pregnant women and a reduction in admissions (from 37.1% to 19.4%) and outpatient follow-up examinations (from 25.7% to 18.1%). It appears that the availability of transvaginal sonography at the time of initial assessment of emergency gynecology patients improves diagnostic accuracy and reduces unnecessary admissions and follow-up examinations.
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July 2006
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+ = increase, - = decrease, O = no change
Interesting post in Desert Imaging in which he talks about a Real Tough Radiography examination he appeared.
He goes like-
"It was one of those tests with questions like:"If you increase focal spot size how does it affect image detail?", "If kVP is increased by 15% what will happen to image density?", "When you increase OID what happens to radiographic contrast?" yada, yada, yada, blah, blah, blah, etc., etc., etc......."
And then follows up with a very useful Table for all Radiographers as well as Radiology Residents...
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Posted in
July 2006
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Overdiagnosis and Overtreatment of Breast Cancer: Is Overdiagnosis an Issue for Radiologists?
Reference-Breast Cancer Res. 2006;8(2)
Complete article here at Medscape
"Overdiagnosis is diagnosis of cancers that would not present within the life of the patient and is one of the downsides of screening. This applies to low-grade ductal carcinoma in situ and some small grade 1 invasive cancers. Radiologists are responsible for cancer diagnosis, but at the time of diagnosis they cannot determine whether a particular low-grade diagnosis is one to which the definition of overdiagnosis applies. Overdiagnosis is likely to be driven by technological developments, including digital mammography, computer-aided detection and improved biopsy techniques. It is also driven by the patient's fear that cancer will be missed and the doctor's fear of litigation. It is therefore an issue of importance for radiologists, presenting them with difficult fine-tuned decisions in every assessment clinic that are ultimately counted later by those who evaluate their screening."
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Posted in
July 2006
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