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In Vivo 18 F-Fluorodeoxyglucose Positron Emission Tomography Imaging Provides a Noninvasive Measure of Carotid Plaque Inflammation in Patients
J Am Coll Cardiol, 2006; 48:1818-1824
By Dr. Ahmed Tawakol et al
"Given the importance of inflammation in atherosclerosis, authors sought to determine if atherosclerotic plaque inflammation could be measured noninvasively in humans using positron emission tomography (PET). Seventeen patients with severe carotid stenoses underwent FDG-PET imaging 3 h after FDG administration (13 to 25 mCi), after which carotid plaque FDG uptake was determined as the ratio of plaque to blood activity (target to background ratio, TBR). Less than 1 month after imaging, subjects underwent CEA, after which carotid specimens were processed to identify macrophages (staining with anti-CD68 antibodies). There was a significant correlation between the PET signal from the carotid plaques and the macrophage staining from the corresponding histologic sections. Authors established that FDG-PET imaging can be used to assess the severity of inflammation in carotid plaques in patients."
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Posted in
November 2006
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Found this very interesting article on FilmJacket.com. Read the full article its very accurate."What is an under-the-table imaging request? Most radiologists encounter it at some point in their career, be it a foot radiograph for a nurse whose big toe was crushed by a stretcher wheel, a chest radiograph for a coughing ER physician or a gallbladder ultrasound for a healthy-looking resident with right upper quadrant pain. Instead of going through proper channels, the above patients may approach a radiologist or even a radiologic technologist directly and ask for what they think is an appropriate imaging study. There are multiple reasons why such unofficial imaging should be categorically denied and all patients should be directed to seek proper medical attention."
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Posted in
November 2006
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Excellent case with images here- ARRS Case Of the Day
"PRES presents with nonspecific signs and symptoms including headaches, confusion, visual disturbances, elevated blood pressure and seizures. Clinical findings are not sufficiently specific to establish the diagnosis, however, magnetic resonance imaging (MRI) pattern is often characteristic and represents an essential component of the diagnosis of PRES. PRES is an acute episode of vasogenic edema in the cerebral white matter, with a predilection for the posterior temporal, parietal and occipital regions. The vasogenic edema is likely due to autoregulatory dysfunction and endothelial dysfunction. The explanation for predilection for the posterior circulation is uncertain. Non enhanced CT shows patchy bilateral white matter nonconfluent hypodensity, and contrast enhanced CT images show variable mild patchy punctuate enhancement. The findings in the subcortical white-matter are hyperintense on T2-weighted images, hypointense or isointense on diffusion-weighted images, and hyperintense on apparent diffusion coefficient (ADC) images. PRES has been described with a number of medical conditions including hypertensive encephalopathy, eclampsia, and cytotoxic and immunosuppressive drugs (i.e. cisplatin, cyclosporin, tacrolimus, antiretroviral therapy, and erythropoietin). The reversibility of the clinical and radiologic abnormalities is dependent on prompt control of blood pressure and/or discontinuing the offending drug. If unrecognized, conversion to irreversible cytotoxic edema may occur. Rapidly developing, fluctuating or intermittent hypertension is a particular risk. "
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Posted in
November 2006
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From Auntminnie.com
"Our field faces a multitude of threats: reduced reimbursement, self-referral, radiation safety issues, and a heightened awareness by all payors that we are an important component of healthcare costs. But in the face of our recent growth in demand, our supply is woefully inadequate, leaving us quite vulnerable. While some individuals may appreciate the relative shortage because it results in short-term higher salaries and wages, it may be the proverbial battle success in a lost war. We will have failed as a specialty if we allow a shortage of our own making to lead to our diminution. As it takes at least six years from "match day" to train a radiologist, action must happen soon."
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Posted in
November 2006
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Dear Readers
Sixth Radiology Grand Rounds is coming up on the last sunday of this month, on 26-11-2006. If you have anything from the world of Radiology send it over fast so that it can be included in this issue.
Send submissions to-
sumerdoc-AT-yahoo-DOT-com
Scheduled host- Spot Diagnosis
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Posted in
November 2006
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Source and Full article -Medscape
"If a diagnostic procedure increases cancer risk, should patients be informed of that risk? Apparently not, at least for one procedure performed more than 150,000 times a day in the United States. CT scans use multiple x-rays to create three-dimensional images that are diagnostically useful but expose people to far more radiation than conventional x-rays. In fact, one CT scan exposes a patient to the lower range of radiation received by some Nagasaki bombing survivors. Up to one in a thousand patients will develop cancer from this exposure.Sixty million CT scans a year will thus cause cancer in thousands of people. Yet most consent forms are silent about this."
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Posted in
November 2006
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"Europeans find more gadolinium-related adverse reactions
Problems with gadolinium-containing contrast agents administered to patients with renal impairment are more common than originally estimated. The lack of awareness among radiologists about the potential dangers for those at high risk is striking, according to researchers. In June 2006, the FDA advised against giving gadolinium-containing contrast agents during MRI exams to patients with renal impairment. The warning came after the Danish Medicines Agency reported that 25 patients with kidney failure developed a life-threatening condition known as nephrogenic systemic fibrosis (NSF, previously known as nephrogenic fibrosing dermopathy). "
Reference- Diagnostic Imaging Online
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Posted in
November 2006
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"THE practice of "Googling" for a diagnosis could help doctors and patients accurately identify their ailments, research suggests. A study has found that putting symptoms into the Google internet search engine produced the right diagnosis in the majority of cases. But experts warned that relying on the internet could be dangerous to patients and the web should be used with caution. It is thought that doctors carry two million facts in their heads to help them diagnose illnesses, but with medical knowledge expanding rapidly, even this may not be enough. "
From Scotsman News
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Posted in
November 2006
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 Just Discovered this new site-Radiology Picture of the Day which features a new medical image daily, with a brief description.
Discovered some very characterstic CT scan finding of this interesting case on this site-
"Epiploic appendagitis is an inflammatory / ischaemic process involving
an appendix epiploica of the colon. The characteristic CT appearance is
shown: a fat-density ovoid structure adjacent to colon, with a thin
high-density rim; surrounding inflammatory fat stranding. The diagnosis
can be confidently made with CT, and exploratory surgery avoided. The
condition can be expected to resolve in around 7 days."
Full case with high resolution image and many more such cases here-
Archives For Radiology Picture of the Day
A Site by Dr Dr Laughlin Dawes |
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Posted in
November 2006
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