Outpatient treatment of osteomyelitis with telavancin.

Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres.

Multidetector CT of pancreas: effects of contrast material flow rate and individualized scan delay on enhancement of pancreas and tumor contrast.

Purpose: To prospectively assess whether high contrast material flow rate (8 mL/sec) and individualized scan delay improve enhancement of normal pancreas with multidetector computed tomography (CT) and, as a result, tumor-to-pancreas contrast of pancreatic adenocarcinoma.

Materials And Methods: Informed consent was obtained in 40 patients (21 women, 19 men; mean age, 67.1 years); the institutional review board approved this protocol.

[Pancreas. Part II: Tumors].

Adenocarcinoma is the most common malignant pancreatic tumor, affecting the head in 60-70% of cases. By the time of diagnosis, approximately 80% of tumors are unresectable. Helical CT is very effective in detection and staging of adenocarcinoma, with a sensitivity of 76-92% for detection and an accuracy of 80-90% for staging, but it has limitations in the detection of small cancers (< or =2 cm).

Computed tomography colonography: feasibility of computer-aided polyp detection in a "first reader" paradigm.

Objective: : To determine the feasibility of a computer-aided detection (CAD) algorithm as the "first reader" in computed tomography colonography (CTC).

Methods: : In phase 1 of a 2-part blind trial, we measured the performance of 3 radiologists reading 41 CTC studies without CAD. In phase 2, readers interpreted the same cases using a CAD list of 30 potential polyps.

Effect of contrast dose and field strength in the magnetic resonance detection of brain metastases.

Purpose: To compare the diagnostic efficacy of a standard and cumulative triple dose of magnetic resonance (MR) imaging contrast agent in the evaluation of brain metastases using a high-field 3.0 T MR unit versus a standard field 1.5 T MR unit.

Multidetector CT of pancreatic adenocarcinoma: diagnostic advances and therapeutic relevance.

Detection and staging of pancreatic malignancies remains a challenge for radiologists. Considering the poor prognosis of pancreatic adenocarcinoma, accurate preoperative staging is the key to a possibly curative surgical treatment. Contrast-enhanced helical CT has been the most commonly used for evaluation of pancreatic cancer in many institutions, although it suffers from many limitations.

[Pancreatic carcinoma: state of the art imaging].

In view of the bad prognosis of pancreatic carcinoma the exact pre-surgical staging is essential for curative therapy. The rapid development of multi-detector computed tomography with the clinical implementation of 16 row scanners allow for almost isotropic pixel size and high-resolution multiplanar reconstruction. Sensitivity and specificity of magnetic resonance imaging are similar to those of computed tomography with lower values in the detection of vessel wall infiltration.

Line scan diffusion imaging of the spine.

Background And Purpose: Recent findings suggest that diffusion-weighted imaging might be an important adjunct to the diagnostic workup of disease processes in the spine, but physiological motion and the challenging magnetic environment make it difficult to perform reliable quantitative diffusion measurements. Multi-section line scan diffusion imaging of the spine was implemented and evaluated to provide quantitative diffusion measurements of vertebral bodies and intervertebral disks.

Methods: Line scan diffusion imaging of 12 healthy study participants and three patients with benign vertebral compression fractures was performed to assess the potential of line scan diffusion imaging of the spinal column.

Local staging of pancreatic carcinoma with multi-detector row CT: use of curved planar reformations initial experience.

Purpose: To evaluate the utility of curved planar reformations compared with standard transverse images in the assessment of pancreatic tumors.

Materials And Methods: Forty-three patients suspected of having pancreatic tumors underwent contrast material-enhanced biphasic multi-detector row computed tomography (CT). Curved planar reformations were generated along the pancreatic duct, common bile duct, and major mesenteric vessels.

Isoattenuating pancreatic adenocarcinoma at multi-detector row CT: secondary signs.

Purpose: To assess the frequency of isoattenuating pancreatic adenocarcinoma with multi-detector row computed tomography (CT) and determine whether there are specific secondary signs that aid in detection.

Materials And Methods: Fifty-three patients with pancreatic adenocarcinoma underwent contrast material-enhanced biphasic multi-detector row CT with curved planar reformation. Tumors were initially deemed isoattenuating or hypoattenuating to normal pancreatic parenchyma on the basis of visual inspection, and the degree of attenuation was confirmed by calculating the mean attenuation differences between normal pancreatic parenchyma and tumor (tumor-pancreas contrast) during the pancreatic phase.

Diffusion tensor imaging using single-shot SENSE-EPI.

SENSitivity Encoding (SENSE) greatly enhances the quality of diffusion-weighted echo-planar imaging (EPI) by reducing blurring and off-resonance artifacts. Such improvement would also be desirable for diffusion tensor imaging (DTI), but measures derived from the diffusion tensor can be extremely sensitive to any kind of image distortion. Whether DTI is feasible in combination with SENSE has not yet been explored, and is the focus of this study.

Predictive geometric factors in a standardized model of femoral neck fracture. Experimental study of cadaveric human femurs.

An experimental study was performed on 20 cadaveric human proximal femurs to investigate both the reproducibility of their mechanical behavior under uniaxial compression and the correlation of mechanical properties with geometric dimensions and bone density. These variables were assessed by radiography, physical measurement, and dual-energy X-ray absorptiometry (DEXA). The specimens were immobilized, loaded to the point of fracture, and analyzed with the help of a materials testing machine.

Diffusion-weighted imaging of the spinal cord: interleaved echo-planar imaging is superior to fast spin-echo.

Purpose: To compare and evaluate two novel diffusion-weighted sequences, based either on fast spin-echo (FSE) or interleaved echo-planar imaging (EPI) methods, as potential tools for investing spinal cord abnormalities.

Materials And Methods: Following recent improvements, both interleaved EPI (IEPI) and FSE techniques could be alternative approaches for rapid diffusion-weighted imaging (DWI). Therefore, a navigated diffusion-weighted multishot FSE sequence and a fat-suppressed navigated diffusion-weighted IEPI sequence with local shimming capabilities were tested.

Accuracy of multiphasic helical computed tomography and intraoperative sonography in patients undergoing orthotopic liver transplantation for hepatoma: what is the truth?

Objective: To determine the real value of liver imaging in cirrhosis by macro- and histomorphologic examination of the entire organ after orthotopic liver transplantation for hepatocellular carcinoma (HCC).

Summary Background Data: In comparative studies, a virtual sensitivity of up to 94% is described for helical computed tomography in HCC staging. The tumor detection rate of intraoperative ultrasonography (IOUS) is reported to be almost 100%.

CT angiography of the subclavian artery: utility of curved planar reformations.

Despite advances in the diagnosis and treatment of peripheral vascular occlusive disease, an ever-aging population continues to provide scores of new cases requiring medical care. While traditional angiography has been the mainstay of diagnosis for many years, newer, less invasive techniques such as CT angiography with three-dimensional reformation are rapidly establishing themselves as first-line diagnostic modalities. We present a case of severe left subclavian artery stenosis that demonstrates the utility of curved planar reformation in providing a concise visual summary of the pertinent anatomy and abnormalities.

Adrenal hemorrhage after orthotopic liver transplantation: MR appearance.

The purpose of this paper is to describe the MR imaging findings of right adrenal hemorrhage after orthotopic liver transplantation. Twenty-seven orthotopic liver transplantation patients underwent MR studies of the liver and/or biliary system. Patients were referred to MR examination because of suspected biliary complications ( n=22) or for evaluation of mass lesions ( n=5).

Femoral neck fracture after removal of the standard gamma interlocking nail: a cadaveric study to determine factors influencing the biomechanical properties of the proximal femur.

We retrospectively analyzed 1334 patients who were implanted standard gamma interlocking nails (SGN) to stabilize trochanteric femoral fractures over the years 1992-1998. Reoperation to remove the nails was performed in 37 patients, in 9 of them purely because of pain. Three out of these 9 patients with removed SGN suffered femoral neck fractures in the early postoperative course after having been mobilized to full weight-bearing capacity.

MRI in the diagnosis of a peritoneal leak in continuous ambulatory peritoneal dialysis.

Mechanical problems in continuous ambulatory peritoneal dialysis (CAPD) can result in ultrafiltration failure and disruption of CAPD therapy. The recently described tool of CT peritoneography with water-soluble contrast medium has the disadvantage of radiation and instillation of nephrotoxic substances. We report a child with a peritoneal leak diagnosed by MRI after instillation of a gadodiamide-dialysate mixture.

Displacement of coils into the lung during embolotherapy: clinical importance and follow-up with helical CT.

Rationale And Objectives: The authors performed this study to evaluate the clinical importance and computed tomographic (CT) appearance of coils displaced into the lung during embolotherapy.

Materials And Methods: The authors retrospectively studied clinical charts and serial chest images from 25 consecutive patients after coil embolization. Chest radiography was performed in all patients, whereas helical chest CT was performed only in patients in whom dislocated coils were visible on chest radiographs.

Inadvertent transpericardial insertion of a central venous line with cardiac tamponade failure of preventive practices.

A 56-year-old man who had undergone cardiac surgery suffered from cardiac tamponade after administration of contrast-medium through a central venous catheter. Pericardiotomy showed the catheter transversing the pericardial sac just beneath an unusual high reflection and then reentering the superior vena cava. Preventive practices including chest radiography, confirming free venous blood return and manometry may fail to detect catheter malposition in rare cases.

Measurement of hepatic perfusion with dynamic computed tomography: assessment of normal values and comparison of two methods to compensate for motion artifacts.

Rationale And Objectives: To assess normal values of hepatic perfusion by dynamic, single-section computed tomography, to compare two methods of data processing (a smoothing with a fitting procedure), and to evaluate the influence of motion artifacts.

Methods: Twenty-five volunteers with no history or suspicion of liver disease were examined (age range, 32.8-81.

Timing of the hepatic arterial phase during contrast-enhanced computed tomography of the liver: assessment of normal values in 25 volunteers.

Objectives: To define normal values of the beginning and duration of the hepatic arterial phase (HAP) during contrast-enhanced computed tomography (CT).

Methods: Twenty-five volunteers (16 men, 9 women; mean age, 60.0 years) without history or suspicion of liver disease were examined with dynamic single-section CT.

Preoperative fast MRI of brain tumors using three-dimensional segmented echo planar imaging compared to three-dimensional gradient echo technique.

The purpose of this study was to compare the diagnostic efficacy of a newly developed T(1)-weighted three-dimensional segmented echo planar imaging (3D EPI) sequence versus a conventional T(1)-weighted three dimensional spoiled gradient echo (3D GRE) sequence in the evaluation of brain tumors. Forty-four patients with cerebral tumors and infections were examined on a 1.0 T MR unit with 23 mT/m gradient strength.