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Do osseous geodes enhance following IV Gadolinium? [posted
7/2001] |
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Dr. Joseph Gagliardi
responds |
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What is the state of the art protocol for MRCP? [posted
7/2001] |
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Dr. Peter Buetow
responds |
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What is the protocol for patient prep when performing contrast
studies while taking Glucophage and Glucovance? [posted
7/2001] |
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Dr. Steven
Sireci responds |
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What evidence is there, if any, for the usefulness of CT
(rather than MRI) in the diagnosis of spinal osteomyelitis? What do you
see? [posted 7/2001] |
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F.L. Chan, M.D.
responds |
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Is it better to add normal saline or water when diluting
contrast media for injection with respect to patient safety, i.e. load on
kidneys, ionicity, and potential for reaction? [posted 7/2001] |
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Dr. Steven
Sireci responds |
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What's the best imaging-diagnosis for suspected femur necrosis?
Can I use PET or SPECT? [posted 5/2001] |
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Dr. Tatiana Kain
responds |
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Package insert says that there is essentially no contraindication
for Bracco's Isovue® when used in pregnant females if the
study is clinically indicated. Do you have information about fetal uptake
of the contrast agent? [posted 5/2001] |
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Dr. Steven Sireci
responds |
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A 65-year-old woman with a two year history of lower backache.
No radiculopathy and normal bloods (ESR, WBC, and CRP). No fever. Her MRI
(1.5 T) shows disc space narrowing and spondilolisthesis at L4/5. There
are Modic I changes at this level and the fat-sat T2 sagital showed focal
increased signal (fluid) in the disc space region. There was contrast enhancement
(linear) in the posterior aspect of the disc space, adjacent to the end
plate (I believe that the enhancement is within the disc space and not end
plate enhancement). I reported that the features were consistent with discitis
and the patient was treated for a four week period. Her repeat MRI, obtained
six weeks following the initial scan, showed no change, and her symptoms
have not resolved. The neurosurgeon has asked me to review the diagnosis
in view of this. I am aware that one can get end plate enhancement in Modic
I changes but have not seen enhancement within the disc space before. Could
these changes all be attributed to end plate and discogenic degeneration?
[posted 5/2001] |
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Dr. F.L.
Chan responds |
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How can one distinguish between pseudarthrosis and an infectious
process? [posted 4/2001] |
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Dr.
F.L. Chan responds |
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Can you steer me to a non-proprietary scoring system for
evaluation of myocardial perfusion scans with probability of CAD based upon
the score? Cedar Sinai uses such a system and has kept data over the years
correlating cath outcomes and likelihood of future cardiac event based upon
a "score" derived from regional analyses of SPECT images, but
I am told their data is not available to the imaging community at large.
[posted 4/2001] |
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Dr.
Tatiana Kain responds |
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Which diagnostic and/or interventional procedures are "Wholey"
wires used for? What percentage of time are the wires used as a primary
wire? A secondary wire? [posted 4/2001]
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Dr.
Herb Lustberg responds |
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What is the role of TRUS in ischiorectal fossa abscess? [posted
4/2001] |
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Dr.
Jeffrey H. Newhouse responds |
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A 28 year-old female patient presented with a small, soft but firm mass
on the dorsum of the foot. It had been present for the last two years
and had remained asymptomatic. Recently it had become painful and had
registered a slight increase in size. On physical examination there was
a 1.5 X 1.5 cm soft but firm mass overlying the body of the Talus. It
was dome-shaped. It was non-mobile and slightly tender.
Plain X-rays of the foot were done with frontal and oblique projections.
They showed an elongated lytic lesion in the dorsal cortex of the body
of the Talus with cortical thinning (with a thin rim of bone covering
it), slight expansion, and a well-defined margin in the bone. The lesion
was oriented along the cortical surface in its long axis. No sclerotic
margin or calcification was seen. On a subsequent 'profile' view, a small
dome-shaped projection was seen from the cortex with soft tissue density.
What could be the possible differential diagnosis and how could I proceed
with it? [posted 4/2001]
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Dr.
Joseph Gagliardi responds |
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Over the last few years (see Radiology 4/98and AJR
10/99) research has been published suggesting that screening ultrasound
is useful as an adjunct to screening mammography in patients with dense
breasts, even in patients with no specific mammographic findings. Weighing
the increased time and expense needed against the increased yield of non-palpable,
mammographically occult cancers found, is this a reasonable approach?
Has it become the standard of care or will it soon become the standardof
care? [posted 3/2001]
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Dr.
Ellen Shaw de Paredes responds |
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What are criteria for ordering emergency CT exam of the head by emergency
room M.D.? [posted 3/2001]
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Dr.
James Abraham responds |
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How frequently, in terms of percent, is US abnormal in palpable
invasive breast cancer? [posted 3/2001] |
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Dr.Ellen Shaw de Paredes responds
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When diagnosing acute diverticulitis (for example of sigma)
there is often concern over whether the correct diagnosis is acute diverticulitis
or whether there might be a colonic tumor. (Diverticula are quite common
and therefore as a single criteria are not specific for either diagnosis).
What diagnostic criteria do you use to recommend colonoscopy? There was
a report that stated that if the length of the lesion is more than 8 cm,
a safe diagnosis of acute diverticulitis can be made. Is that your experience,
too? [posted 2/2001] |
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Dr. Peter Buetow
responds |
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Is there any significance attached to asymmetry of the lateral
ventricles in a patient whose brain parenchyma is otherwise normal? [posted
2/2001] |
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Dr. James Abraham
responds |
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If sclerosis is seen as hypointensity, why is mesial temporal
sclerosis hyperintense in signal? [posted 2/2001]
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Dr. James Abrahams
responds |
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Does encephalitis ever present as small (1 cm) lesions on
CT? How can it be differentiated from "micro insults?" [posted
2/2001] |
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Dr. James Abrahams
responds |
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Are there any criteria to help differentiate between patterns
of edema in infarction and tumor in the CNS? [posted 10/2000] |
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Dr. James Abrahams responds |
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What are causes of symmetric enhancement to the optic nerve
sheaths? [posted 10/2000] |
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Dr. James Smirniotopoulos
responds |
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What is the current recommendation for the evaluation of
patients suspected of having pulmonary embolism? [posted
1/2000] |
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Dr. Peter Buetow responds |
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How do you perform MR arthrography of the hip? [posted
12/1999] |
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Dr. Joseph Gagliardi
responds |
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In evaluating trauma patients with abdominal trauma, do you
perform an ER bedside ultrasound assessment or evaluate the patient in the
CT or US department? [posted 12/1999] |
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Dr. Neil Specht responds |
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