Discrepancy Rates of Radiology Resident Interpretations of On-Call Neuroradiology MR Imaging Studies

Radiology ◽  
2008 ◽  
Vol 249 (3) ◽  
pp. 972-979 ◽  
Author(s):  
Christopher G. Filippi ◽  
Brett Schneider ◽  
Heather N. Burbank ◽  
Gary F. Alsofrom ◽  
Grant Linnell ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Imaging Studies ◽  
Radiology Resident

Effectiveness and handling characteristics of a three-layer polymer dura substitute: a prospective multicenter clinical study

2006 ◽  
Vol 105 (6) ◽  
pp. 853-858 ◽  
Author(s):  
A. Martina Messing-Jünger ◽  
Javier Ibáñez ◽  
Fabio Calbucci ◽  
Maurice Choux ◽  
Gabriel Lena ◽  
...  
Keyword(s):  
Clinical Study ◽  
Mr Imaging ◽  
Disease Transmission ◽  
Valsalva Maneuver ◽  
Adhesion Formation ◽  
Type I ◽  
Imaging Studies ◽  
Handling Characteristics ◽  
Csf Leakage ◽  
Multicenter Clinical Study

Object The goal of this study was to assess the effectiveness and handling characteristics of a dura substitute composed of two outer layers of expanded polytetrafluoroethylene (PTFE) and a middle layer consisting of an elastomeric fluoropolymer. Methods In a prospective multicenter study, the dura substitute was implanted using a standard technique in 119 patients undergoing cranial or spinal surgery requiring duraplasty. Intraoperative assessments of the dura patch consisted of testing for cerebrospinal fluid (CSF) leakage employing the Valsalva maneuver and a surgeon’s standard evaluation of the handling characteristics of the device. Postoperative assessments conducted during a mean follow-up time of 15.7 months (range 0.3–45.6 months) consisted of physical examinations, routine computed tomography (CT) or magnetic resonance (MR) imaging studies, and histological studies of any removed dura patches. The mean age of the 119 patients was 40 years (range < 1–81 years). The dura substitute was implanted cranially in 102 patients and spinally in 17. Intraoperative assessment including the Valsalva maneuver led to application of additional sutures in 17 patients. Handling features were rated very good to excellent. Postoperative clinical evaluation resulted in 79 excellent and 18 good results. Imaging studies (MR imaging studies in 69 patients and CT studies in 34 patients) showed no adhesions in 87 patients and minimal adhesions in seven patients (the dura was not visualized in nine patients). Postoperative complications occurred in 12 patients. There were six cases of CSF leakage, three cases of extradural hematoma, one case of arachnoid fibrosis after decompression of a Chiari malformation Type I, and two cases of infection. Eight (7%) of these complications were potentially related to the dura patch. Conclusions In a large, multicenter clinical study of the use of an expanded-PTFE–containing dura substitute, the device was found to be easy to handle and implant. No serious dura patch–related intraoperative adverse events were observed. Postoperatively, there were no major sealing problems or long-term complications. In two cases the patch had to be removed due to fibrosis and infection. The three-layer polymer dura substitute appears to be safe and effective in minimizing CSF leakage and adhesion formation, and its use avoids any risk of prion disease transmission.

scholarly journals Pharmacokinetics of Gd(DO3A-Lys) and MR imaging studies in an orthotopic U87MG glioma tumor model

2015 ◽  
Vol 10 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Prashant Chandrasekharan ◽  
Chang-Tong Yang ◽  
Fatima Ali Nasrallah ◽  
Hui Chien Tay ◽  
Kai-Hsiang Chuang ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tumor Model ◽  
Imaging Studies ◽  
Glioma Tumor

Dural damage due to a loosened hydroxyapatite intraspinous spacer after spinous process–splitting laminoplasty

2007 ◽  
Vol 7 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Atsushi Ono ◽  
Toru Yokoyama ◽  
Takuya Numasawa ◽  
Kanichiro Wada ◽  
Satoshi Toh
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Postoperative Complications ◽  
Mr Imaging ◽  
Nerve Root ◽  
Spinous Process ◽  
Imaging Studies ◽  
Dural Sac ◽  
Neck And Shoulder Pain ◽  
Axial Pain

✓Excellent results from laminoplasty for cervical spinal myelopathy have been reported in many studies. Nevertheless, C-5 nerve root palsy or axial pain such as neck and shoulder pain after laminoplasty are known postoperative complications. To the authors' knowledge, dural damage from dislocation of the hydroxyapatite intraspinous spacer due to absorption of the tip of the spinous process has not been reported. Two cases of dural damage from dislocation of the hydroxyapatite intraspinous spacer after laminoplasty are described. Radiographs, computed tomography myelography, and magnetic resonance (MR) imaging revealed the dislocation of the hydroxyapatite intraspinous spacer, the absorption of the tip of the spinous process, and dural sac compression due to the hydroxyapatite intraspinous spacer. In one patient, the MR imaging studies revealed liquorrhea around the hydroxyapatite intraspinous spacers. Both patients underwent removal of the hydroxyapatite intraspinous spacer and attained good neurological recovery. In patients with dislocation of the hydroxyapatite intraspinous spacer associated with absorption of the tip of the spinous process after spinous process–splitting laminoplasty, each case should be evaluated for aggravating symptoms of myelopathy, dural damage, and liquorrhea around the spacer.

Influence of bolus volume and dose of gadolinium chelate for first-pass myocardial perfusion MR imaging studies

1995 ◽  
Vol 5 (4) ◽  
pp. 411-415 ◽  
Author(s):  
Emmanuelle Canet ◽  
Philippe Douek ◽  
Karim Bendid ◽  
Didier Revel ◽  
Juventino Amaya ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Mr Imaging ◽  
Imaging Studies ◽  
Bolus Volume ◽  
Gadolinium Chelate ◽  
First Pass ◽  
Perfusion Mr ◽  
Perfusion Mr Imaging

Evaluation of intracranial cerebrospinal fluid cytology in staging pediatric medulloblastomas, supratentorial primitive neuroectodermal tumors, and ependymomas

2010 ◽  
Vol 6 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Sergei Terterov ◽  
Mark D. Krieger ◽  
Ira Bowen ◽  
J. Gordon McComb
Keyword(s):  
Cerebrospinal Fluid ◽  
Mr Imaging ◽  
Median Survival ◽  
Kappa Statistic ◽  
Csf Cytology ◽  
Imaging Studies ◽  
Primitive Neuroectodermal Tumors ◽  
Negative Results ◽  
Tumor Dissemination ◽  
Neuroectodermal Tumors

Object The objective of this study was to determine the role of intracranial CSF examination in detecting true cases of early tumor dissemination. Cerebrospinal fluid dissemination is an ominous feature of pediatric brain tumors, occurring in as many as 30% of medulloblastomas, 25% of supratentorial primitive neuroectodermal tumors (PNETs), and 5% of ependymomas at diagnosis. Detecting early dissemination is important for determining both treatment and prognosis. Dissemination can be detected by evaluating imaging of the full neuraxis and by examining CSF cytology. Neuraxis MR imaging and lumbar CSF cytology evaluation are widely accepted methods for determining dissemination. However, the value of examining intracranial CSF cytology in detecting early dissemination is uncertain. Methods Under an institutional review board–approved protocol, medical records, pathology reports, and radiology reports for 150 patients who had undergone resection of brain tumors (88 with medulloblastomas, 21 with supratentorial PNETs, and 41 with ependymomas) and who had been evaluated using neuraxis MR imaging studies in the last 15 years were retrospectively reviewed. Radiology results were compared with the CSF cytology results and long-term disease outcomes. Results Between lumbar and intracranial CSF cytology results, 7 of 40 were discordant: in 2 intracranial CSF was negative and lumbar CSF was positive, and in 5 the reverse was true. The discordance percentage was 18%, with a kappa statistic of 0.36. Between MR imaging and lumbar CSF cytology results, 11 of 65 were discordant: in 9 the lumbar CSF was negative and MR imaging was positive, and in 2 the reverse was true. The discordance percentage is 17%, with a kappa statistic of 0.27. Between MR imaging and intracranial CSF cytology results, 8 of 52 were discordant: in 3 intracranial CSF was negative and MR imaging was positive, and in 5 the reverse was true. The discordance rate was 15%, with a kappa statistic of 0.41. Patients with positive and negative results on perioperative neuraxis MR imaging studies had a median survival of 26.8 and 33.1 months, respectively (p = 0.02). Patients with positive and negative results on perioperative lumbar CSF cytology had a median survival of 20.1 and 31.4 months, respectively (p = 0.11). Patients with positive and negative results on intracranial CSF cytology had a median survival of 31 and 31.4 months, respectively (p = 0.84). Conclusions Discordance exists between the results of neuraxis MR imaging and lumbar and intracranial CSF cytology in perioperative detection of tumor dissemination for pediatric medulloblastoma, supratentorial PNETs, and ependymoma. In 1 case in this series, perioperative dissemination was detected by intracranial CSF cytology, but not by lumbar CSF cytology or neuraxis MR imaging. Isolated intracranial CSF cytology positivity may represent an earlier stage of disseminated disease. Complementary use of perioperative neuraxis MR imaging and lumbar and intracranial CSF cytology can reduce the incidence of missed diagnoses of dissemination. Survival analysis revealed that perioperative neuraxis MR imaging findings are correlated with survival, whereas perioperative lumbar and intracranial CSF cytology findings are not.

Small Hepatocellular Carcinoma

1996 ◽  
Vol 37 (1P1) ◽  
pp. 69-74 ◽  
Author(s):  
C. Bartolozzi ◽  
R. Lencioni ◽  
D. Caramella ◽  
A. Palla ◽  
A. M. Bassi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mr Imaging ◽  
Detection Rate ◽  
Preoperative Evaluation ◽  
Small Hepatocellular Carcinoma ◽  
Imaging Studies ◽  
Detection Rates ◽  
Significant Difference ◽  
Nodular Lesions ◽  
The Difference

Twenty-two patients with 37 small (3 cm or less) nodular lesions of hepatocellular carcinoma (HCC) were examined with ultrasonography (US), CT, MR imaging, digital subtraction angiography (DSA), and CT following intraarterial injection of Lipiodol (Lipiodol-CT). All patients subsequently underwent surgery, and the gold standard was provided by intraoperative US. The detection rate was 70% for US, 65% for CT, 62% for MR imaging, 73% for DSA, and 86% for Lipiodol-CT. A significant difference (p<0.05) was observed between the detection rate of Lipiodol-CT and the detection rates of all the other imaging modalities. The difference was even more manifest (p<0.02) when only lesions smaller than or equal to 1 cm were considered. It is concluded that Lipiodol-CT is the single most sensitive examination to detect small nodules of HCC. It should therefore be considered a mandatory step in the preoperative evaluation of patients with HCC considered to be surgical candidates after noninvasive imaging studies.

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