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Seminars in Ultrasound, CT, and MR

Tanvir Rizvi, Prem Batchala, Sugoto Mukherjee
Brain death (BD) is an irreversible cessation of functions of the entire brain, including the brainstem. The diagnosis of BD is made on clinical grounds and neurologic examination. In the United States, clinical criteria set by the American Academy of Neurology (AAN) emphasize 3 specific clinical findings to confirm BD, which include coma, absence of brainstem reflexes and apnea. Ancillary tests are needed when neurologic examination or apnea test cannot be performed. AAN recommended ancillary tests include electroencephalogram, which confirms electrical activity loss; catheter cerebral angiogram, which confirms loss of cerebral blood flow; as well as transcranial Doppler and nuclear scintigraphy...
October 2018: Seminars in Ultrasound, CT, and MR
William T O'Brien, Marguerite M Caré, James L Leach
Pediatric head trauma is an important cause of morbidity and mortality in children and may be seen in the setting of accidental or abusive injuries. Although many of the patterns of head injury are similar to adults, the imaging manifestations of head injury in children are more complex due to the developing brain and calvarium. Additionally, there are unique considerations for mechanisms of injury in children, to include abusive head trauma and birth-related injuries. The primary role of the radiologist is to identify and characterize the type and severity of head injury to help guide appropriate patient management...
October 2018: Seminars in Ultrasound, CT, and MR
Marcos Vieira Godinho, Cíntia Elias Pires, Luiz Celso Hygino da Cruz
Our purpose is to describe typical computed tomography and magnetic resonance imaging findings in encephalopathies in the emergency. The focus of this article are the most frequent toxic and acquired metabolic diseases and their preferential sites of involvement, such as hepatic encephalopathy, hypoglicemia, nonketotic hyperglycemia, osmotic demyelination, posterior reversible encephalopathy syndrome, uremia, illegal drug abuse, carbon monoxide poisoning, and hypoxic-ischemic encephalopathy. The radiologist must be able to identify the most usual patterns of lesion in computed tomography and magnetic resonance imaging in these settings...
October 2018: Seminars in Ultrasound, CT, and MR
Courtney Frey, J Michael Hazenfield
Head trauma is a common indication for neuroimaging in the emergency room. CT is the modality of first choice, as it is quick, safe, and effective in evaluating for life-threatening intracranial hemorrhage and mass effect. CT is also best for evaluating for skull fractures, which may alter management and lead to further imaging studies. MRI is reserved for selected patients, particularly when the clinical exam does not match the CT imaging findings, such as in diffuse axonal injury. Emergency room physicians and radiologists, particularly those in training, would benefit from a consistent approach and search pattern for evaluating head trauma...
October 2018: Seminars in Ultrasound, CT, and MR
Humberto Morales
Intracranial hemorrhage (ICH) is one of the most common pathologic findings in the emergent computed tomography (CT) imaging. ICH presents as hyperattenuation in parenchymal, subarachnoid, subdural, or epidural location. However, the initial interpretation of areas of hyperattenuation can be challenging as other pathologic or nonpathologic processes (eg, calcifications, vascular malformations, highly cellular tumors, iodinated contrast, or beam-hardening artifacts) can have similar appearance. ICH can also present as isoattenuation on CT, being difficult to distinguish from the brain parenchyma...
October 2018: Seminars in Ultrasound, CT, and MR
Amin F Saad, Ruchir Chaudhari, Nancy J Fischbein, Max Wintermark
Intracranial hemorrhage is a medical event frequently encountered in the clinical practice of radiology that has significant potential for patient morbidity and mortality. The expedient and accurate identification of intracranial hemorrhage as well as elucidation of the underlying cause can assist in optimizing the care of these patients. In this review, we attempt to familiarize the reader with the imaging appearance of multiple types of intracranial hemorrhage, both intra-axial and extra-axial and utilizing both computed tomography and magnetic resonance imaging, as well as to provide a framework for assessment of the underlying cause of the hemorrhage...
October 2018: Seminars in Ultrasound, CT, and MR
Humberto Morales, Marshall Kong
Stroke is caused by occlusion of a medium- or large-sized vessel in the brain. The treatment with either intravenous or intra-arterial thrombolysis is based on an accurate and time-sensitive diagnosis. On clinical and imaging grounds a number of entities-seizures, toxic-metabolic, infectious, or demyelinating diseases-can mimic stroke. Identifying them is paramount as the treatment differs significantly. Prior imaging reviews have focused on the nonterritorial distribution of these mimics. However, some important questions arise here...
October 2018: Seminars in Ultrasound, CT, and MR
Andrew A Pavlina, Rupa Radhakrishnan, Achala S Vagal
Rapid multimodal imaging is essential in the workup and management of acute ischemic stroke. Early parenchymal findings on noncontrast computed tomography or standard magnetic resonance imaging are used to triage patients for intravenous thrombolysis and to provide insight on prognosis. In the wake of recent endovascular stroke trials, advanced techniques including perfusion imaging and noninvasive vascular imaging are becoming important tools to guide potential endovascular treatment or expand therapy windows...
October 2018: Seminars in Ultrasound, CT, and MR
Humberto Morales
No abstract text is available yet for this article.
October 2018: Seminars in Ultrasound, CT, and MR
Juliann Giese, Christopher Cerniglia
Soft tissue digital injury of the hand is a common presenting complaint in the emergency setting. Although initial work-up requires physical examination and radiographs, many of these entities may be radiographically occult and solely appreciated on ultrasound (US) or magnetic resonance imaging (MRI). If undiagnosed, these conditions may lead to sequela of untreated disease including early osteoarthritis, pain, permanent deformity, and immobility. Soft tissue finger injuries that may not be readily apparent without the use of MRI or US are discussed...
August 2018: Seminars in Ultrasound, CT, and MR
Helen Hr Kim, Jean-Marc Gauguet
Elbow trauma in children is one of the most commonly encountered musculoskeletal injuries in pediatric radiology. However, elbow injuries in children can be misdiagnosed due to secondary ossification centers unique to pediatric patients. Familiarity of the normal elbow anatomy in children is crucial for an accurate diagnosis. This article seeks to improve diagnostic accuracy of these elbow injuries by reviewing the secondary ossification centers in the elbow in the pediatric population, followed by a discussion of commonly encountered acute and chronic fractures, dislocations or other injuries...
August 2018: Seminars in Ultrasound, CT, and MR
Timothy Gleeson, David Blehar
The use of point-of-care ultrasound in trauma is widespread. Focused Assessment with Sonography for Trauma examination is a prototypical bedside examination used by the treating provider to quickly determine need for intervention and appropriate patient disposition. The role of bedside ultrasound in trauma, however, has expanded beyond the Focused Assessment with Sonography for Trauma examination. Advancements in diagnostics include contrast-enhanced ultrasound, thoracic, and musculoskeletal applications. Ultrasound is also an important tool for trauma providers for procedural guidance including vascular access and regional anesthesia...
August 2018: Seminars in Ultrasound, CT, and MR
Andrew E Bennett, Robin B Levenson, Jon D Dorfman
In contemporary practice, multidetector computed tomography plays a critical role in the diagnostic evaluation of patients with suspected acute mesenteric and bowel trauma. Although less common than solid organ injuries, it may be seen in up to 5% of blunt trauma patients. Evaluation with CT remains challenging even with improvements in technology. The major imaging signs of mesenteric and bowel trauma and what is known about their applicability in clinical practice are reviewed here. Examples illustrate both the subtlety and variable significance of many of the key signs as well as how these are typically integrated into clinical practice...
August 2018: Seminars in Ultrasound, CT, and MR
Staci Gagne, Bryan O Sullivan-Murphy, Hao S Lo, Lacey J McIntosh
Pancreaticobiliary injury is an uncommon entity which more often occurs in the setting of blunt than penetrating trauma. We present cases of pancreaticobiliary traumatic injuries from our Level 1 trauma center to illustrate an imaging update on the spectrum of injuries and correlation with current grading systems.
August 2018: Seminars in Ultrasound, CT, and MR
Alex Newbury, Jon D Dorfman, Hao S Lo
Thoracic injury results from penetrating and blunt trauma and is a major contributor to overall trauma morbidity and mortality in the United States. Modern imaging algorithms utilize ultrasound, chest radiograph, and computed tomography with intravenous contrast to accurately diagnose and effectively treat patients with acute thoracic trauma. This review focuses on the etiologies, signs and symptoms, imaging, and management of several life-threatening thoracic injuries including tracheobronchial rupture, pulmonary parenchymal injury, hemothorax, pneumothorax, diaphragmatic rupture, and axial skeleton injury...
August 2018: Seminars in Ultrasound, CT, and MR
David J Choi, Evelyn S Guerra, Sathish Dundadamappa
Trauma involving the vessels of the head and neck portends risk of hemorrhage, cerebral infarction, and death. Imaging is essential for the timely diagnosis of these injuries. This article will review diagnostic imaging findings and pitfalls as well as related pathophysiology, screening risk factors, management, and follow-up recommendations.
August 2018: Seminars in Ultrasound, CT, and MR
Gabriela Santos-Nunez, Hao S Lo, Hemang Kotecha, Joe Jose, Aly Abayazeed
Spinal cord injury often times is a catastrophic result of trauma. Delay in diagnosis may result in increased morbidity and mortality. Cross-sectional imaging is now increasingly used as a first-line diagnostic modality in the setting of trauma for recognition of spine fractures and ligamentous injuries that might be missed on routine radiographs. The learning objectives of this article are to review the anatomy of the spine and understand the mechanisms of injury in the cervical, thoracic, and lumbosacral column by applying easy and reproducible classification systems to guide clinical management...
August 2018: Seminars in Ultrasound, CT, and MR
Hao S Lo
No abstract text is available yet for this article.
August 2018: Seminars in Ultrasound, CT, and MR
Brett W Carter
Lung cancer is the leading cause of cancer-related mortality and accounts for more deaths than breast, prostate, and colon cancers combined. Traditionally, treatment options have included surgery, chemotherapy, and radiation therapy. Continual advances in the characterization of lung cancer have resulted in the development of effective immunotherapies. These agents help the immune system recognize tumors as foreign, stimulate the immune system, and relieve the inhibition that allows the growth and spread of cancer...
June 2018: Seminars in Ultrasound, CT, and MR
Girish S Shroff, Marcelo F Benveniste, Patricia M de Groot, Brett W Carter, Carol C Wu, Chitra Viswanathan, Mylene T Truong
The identification of genetic mutations known as oncogenic driver mutations that lead to the growth and survival of cancer cells has been an important advance in the field of oncology. Treatment in advanced non-small-cell lung cancer (NSCLC) has transitioned from a more general approach to a more personalized approach based on genetic mutations of the cancer itself. Common mutations detected in patients with advanced NSCLC include mutations of epidermal growth factor receptor and anaplastic lymphoma kinase (ALK)...
June 2018: Seminars in Ultrasound, CT, and MR
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