scholarly journals Update on Pediatric Hip Imaging

2017 ◽  
Vol 21 (05) ◽  
pp. 561-581 ◽  
Author(s):  
Filip Vanhoenacker ◽  
Jacob Jaremko ◽  
Lennart Jans ◽  
Nele Herregods
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Clinical Examination ◽  
Imaging Modality ◽  
Daily Practice ◽  
Resonance Imaging ◽  
Initial Imaging ◽  
Prompt Diagnosis ◽  
Subsequent Selection ◽  
Selection Of

AbstractHip disorders are common in children. Prompt diagnosis and treatment are important because of the potential complications. Symptoms are frequently nonspecific, and clinical examination can be difficult and unreliable, especially in smaller children. Therefore, imaging can be valuable. Radiography and ultrasound remain the initial imaging modalities of choice. Increasingly, magnetic resonance imaging is obtained for assessing the pediatric hip, although the long imaging time and need for sedation may limit its use in daily practice. Because of the exposure to ionizing radiation, the use of computed tomography and bone scintigraphy in children is limited to selected cases. Pediatric hip pathology varies depending on patient age. This article provides an overview of common hip pathologies in children including congenital and developmental pathologies, trauma, infectious processes, inflammatory disease, and neoplasm. The age of the child, history, and clinical examination are essential to narrow down the differential diagnosis and subsequent selection of the appropriate imaging modality.

scholarly journals Agreement of Magnetic Resonance Imaging With Computed Tomography in the Assessment for Acute Skull Fractures in a Canine and Feline Cadaver Model

2021 ◽  
Vol 8 ◽  
Author(s):  
Silke Hecht ◽  
Kimberly M. Anderson ◽  
Aude Castel ◽  
John F. Griffin ◽  
Adrien-Maxence Hespel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Head Trauma ◽  
Imaging Modality ◽  
Small Animal ◽  
Skull Fractures ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Mri Sequences

Computed tomography (CT) is the imaging modality of choice to evaluate patients with acute head trauma. However, magnetic resonance imaging (MRI) may be chosen in select cases. The objectives of this study were to evaluate the agreement of MRI with CT in the assessment for presence or absence of acute skull fractures in a canine and feline cadaver model, compare seven different MRI sequences (T1-W, T2-W, T2-FLAIR, PD-W, T2*-W, “SPACE” and “VIBE”), and determine agreement of four different MRI readers with CT data. Pre- and post-trauma CT and MRI studies were performed on 10 canine and 10 feline cadaver heads. Agreement of MRI with CT as to presence or absence of a fracture was determined for 26 individual osseous structures and four anatomic regions (cranium, face, skull base, temporomandibular joint). Overall, there was 93.5% agreement in assessing a fracture as present or absent between MRI and CT, with a significant difference between the pre and post trauma studies (99.4 vs. 87.6%; p < 0.0001; OR 0.042; 95% CI 0.034–0.052). There was no significant difference between dogs and cats. The agreement for the different MRI sequences with CT ranged from 92.6% (T2*-W) to 94.4% (PD-W). There was higher agreement of MRI with CT in the evaluation for fractures of the face than other anatomic regions. Agreement with CT for individual MRI readers ranged from 92.6 to 94.7%. A PD-W sequence should be added to the MR protocol when evaluating the small animal head trauma patient.

Detection of Wooden Foreign Bodies in Muscle Tissue: Experimental Comparison of Computed Tomography, Magnetic Resonance Imaging, and Ultrasonography

1994 ◽  
Vol 15 (8) ◽  
pp. 437-443 ◽  
Author(s):  
Mark S. Mizel ◽  
Neil D. Steinmetz ◽  
Elly Trepman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Muscle Tissue ◽  
Foreign Bodies ◽  
Imaging Modality ◽  
Experimental Comparison ◽  
Imaging Method ◽  
Resonance Imaging ◽  
Ct And Mri

An experimental study was performed to compare computed tomography (CT), magnetic resonance imaging (MRI), and real-time, high resolution ultrasonography (US) for the detection of wooden foreign bodies in muscle tissue. Wooden splinters were prepared, measured for size, soaked in saline, and placed in porcine muscle distant from and adjacent to bone. The specimens were then examined using roentgenography, CT and MRI in planes parallel and perpendicular to the splinters, and US. The largest wooden foreign bodies (minimum smallest width = 10 mm) were easily detected by CT, MRI, and US. Almost all splinters of various sizes, small and large, soaked in saline for 5 months were easily detected by MRI. Smaller splinters (minimum smallest width = 1–4 mm) soaked for only 3 days and placed distant from bone were most easily detected by US; those soaked for 5 months were most easily detected by either US or MRI. The smaller splinters soaked for only 3 days and placed near bone were not reliably detected by any of the imaging methods; CT and MRI were both more sensitive than US in this situation. MRI scanning was more sensitive perpendicular than parallel to the long axis of the splinters. Therefore, either US or MRI may be the best initial imaging modality for evaluation of a suspected wooden foreign body, depending on availability of imaging method, chronicity of symptoms, and proximity to bone.

scholarly journals Posterior sternoclavicular dislocations: a brief review and technique for closed management of a rare but serious injury

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Matthew E. Deren ◽  
Steve B. Behrens ◽  
Bryan G. Vopat ◽  
Theodore A. Blaine
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Closed Reduction ◽  
Preoperative Planning ◽  
Resonance Imaging ◽  
Effective Technique ◽  
Serious Injury ◽  
Initial Imaging ◽  
Medial Clavicle ◽  
Serious Injuries

Posterior sternoclavicular dislocations are rare but serious injuries. The proximity of the medial clavicle to the vital structures of the mediastinum warrants caution with management of the injury. Radiographs are the initial imaging test, though computed tomography and magnetic resonance imaging are essential for diagnosis and preoperative planning. This paper presents an efficient diagnostic approach and effective technique of closed reduction of posterior sternoclavicular dislocations with a brief review of open and closed reduction procedures.

Computed tomography and/or magnetic resonance imaging for pre-operative planning for inverted nasal papilloma: review of evidence

2009 ◽  
Vol 123 (7) ◽  
pp. 705-709 ◽  
Author(s):  
P D Karkos ◽  
L C Khoo ◽  
S C Leong ◽  
H Lewis-Jones ◽  
A C Swift
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Imaging Modality ◽  
Inverted Papilloma ◽  
Resonance Imaging ◽  
Recurrent Tumour ◽  
Computed Tomography Scanning ◽  
Operative Planning ◽  
Inverted Nasal Papilloma

AbstractBackground:Inverted nasal papilloma is a benign tumour with variable biological behaviour. It is a unique neoplasm and is often difficult to manage, being characterised by a tendency to recur following excision, an association with malignancy and an ability to destroy bone. Radiological diagnosis has traditionally been based on computed tomography, but it is often impossible to differentiate between polyps with entrapped debris and inverted nasal papilloma. Magnetic resonance imaging, especially T2-weighted images, is perhaps a better tool in differentiating inverted nasal papilloma from other nasal lesions, and has recently been advocated as the imaging modality of choice.Aims:To review the evidence on the ideal imaging modality for pre-operative planning of surgery for patients with histologically proven inverted nasal papilloma.Materials and methods:A systematic review of studies was undertaken, focusing on radiological assessment of inverted nasal papilloma (primary and recurrent). All English language articles were potentially included in the review. However, we excluded single case reports, case series, pictorial essays, ‘teaching’ reviews and reviews of inverted nasal papilloma not focusing on pre-operative imaging.Results:Sixteen studies were identified based on our search strategy. Only 10 fulfilled our criteria. Computed tomography scanning was the standard imaging modality of choice for assessing sinus involvement of inverted papilloma and for planning the extent of surgery. T2-weighted magnetic resonance imaging scans were able to distinguish tumour (intermediate signal) from inflammatory tissues (bright signal), but not post-operative scarring from recurrent tumour. No studies were found which compared the specificity and sensitivity of magnetic resonance imaging and computed tomography in the accurate pre-operative identification of the extent of inverted papilloma.Conclusions:There is currently not enough evidence to suggest one sole modality as providing optimum imaging for inverted nasal papilloma. Computed tomography remains the imaging modality of first choice for inverted nasal papilloma, despite certain disadvantages. Magnetic resonance imaging is able to distinguish tumour from inflammation and is advocated as a better tool for recurrent tumour, but bone destruction of sinus walls is less easy to recognise, compared with computed tomography. Evaluation of sinus tumours usually involves both imaging modalities, and inverted nasal papilloma should be included within this pathological group. The cohort of patients is usually small, so cost-effectiveness should not generally be an issue when considering whether to use computed tomography, magnetic resonance imaging or both. A well structured, prospective study is needed to evaluate the efficacy of magnetic resonance imaging versus computed tomography for pre-operative planning of histologically proven inverted nasal papilloma.

scholarly journals Cost Analysis of the Addition of Hyperacute Magnetic Resonance Imaging for Selection of Patients for Endovascular Stroke Therapy

2017 ◽  
Vol 6 (3-4) ◽  
pp. 183-190 ◽  
Author(s):  
Seby John ◽  
Nicolas R. Thompson ◽  
Terry Lesko ◽  
Nancy Papesh ◽  
Nancy Obuchowski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Direct Costs ◽  
Stroke Therapy ◽  
Resonance Imaging ◽  
Mri Protocol ◽  
Selection Of Patients ◽  
Selection Of ◽  
Endovascular Stroke Therapy

Background and Purpose: Patient selection is important to determine the best candidates for endovascular stroke therapy. In application of a hyperacute magnetic resonance imaging (MRI) protocol for patient selection, we have shown decreased utilization with improved outcomes. A cost analysis comparing the pre- and post-MRI protocol time periods was performed to determine if the previous findings translated into cost opportunities. Materials and Methods: We retrospectively identified individuals considered for endovascular stroke therapy from January 2008 to August 2012 who were ≤8 h from stroke symptoms onset. Patients prior to April 30, 2010 were selected based on results of the computed tomography/computed tomography angiography alone (pre-hyperacute), whereas patients after April 30, 2010 were selected based on results of MRI (post-hyperacute MRI). Demographic, outcome, and financial information was collected. Log-transformed average daily direct costs were regressed on time period. The regression model included demographic and clinical covariates as potential confounders. Multiple imputation was used to account for missing data. Results: We identified 267 patients in our database (88 patients in pre-hyperacute MRI period, 179 in hyperacute MRI protocol period). Patient length of stay was not significantly different in the hyperacute MRI protocol period as compared to the pre-hyperacute MRI period (10.6 vs. 9.9 days, p < 0.42). The median of average daily direct costs was reduced by 24.5% (95% confidence interval 14.1-33.7%, p < 0.001). Conclusions: Use of the hyperacute MRI protocol translated into reduced costs, in addition to reduced utilization and better outcomes. MRI selection of patients is an effective strategy, both for patients and hospital systems.

Computed Tomography and Magnetic Resonance Imaging of Cervical Metastasis

1989 ◽  
Vol 101 (4) ◽  
pp. 422-425 ◽  
Author(s):  
Daniel D. Lydiatt ◽  
Rodney S. Markin ◽  
Susan M. Williams ◽  
Leon F. Davis ◽  
Anthony J. Yonkers
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Head And Neck ◽  
Clinical Examination ◽  
Radical Neck Dissection ◽  
Resonance Imaging ◽  
Primary Tumors ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

Thirteen patients with head and neck cancer underwent staging by clinical examination, computed tomography (CT), and magnetic resonance imaging (MRI) in a standardized blinded fashion. All patients subsequently underwent radical neck dissection with subsequent pathologic staging. CT and MRI each predicted 93% of staging results correctly, with clinical examination correct 67% of the time. Staging of primary tumors had an accuracy of 90% by clinical examination, 40% by CT, and 50% by MRI when compared to staging of the pathologic specimen. Understaging was seen in 50% of CT scans and 30% of MRI scans. We believe either CT or MRI should be considered for routine staging of the neck in all head and neck malignancies.

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