Table of Contents
Editorials
Perspectives
Editorial
Review Articles
Level 1 EBM Expedited Publication
- Transforaminal versus Intra-Articular Facet Corticosteroid Injections for the Treatment of Cervical Radiculopathy: A Randomized, Double-Blind, Controlled Study
In this prospective study, patients with cervical radicular pain were assigned to receive CT-guided transforaminal or facet dexamethasone injections and their outcomes were measured at 4 weeks postprocedure and compared with data collected prior to injections. Patients who had facet injections experienced significant pain reduction scores when compared with those who underwent transforaminal injections. Thus, facet injections are an effective treatment of cervical radiculopathy and represent a valid and safer alternative to transforaminal injections.
Patient Safety
Practice Perspectives
- Effect of Direct Neuroradiologist Participation in Physician Marketing on Imaging Volumes in Outpatient Radiology
This study assessed the benefits of using a sales representative and a neuroradiologistas a marketing and sales team for referrals in outpatient imaging. When referring practices were visited by the 2-person team, referral volumes were 2.5 times greater than when they were visited by the sales representative alone. This impact on imaging referral volumes with the use of the neuroradiologist for direct physician-to-physician marketing supports the concept that neuroradiologist visits are important in establishing and maintaining a relationship with the referring clinician's office and maximizing imaging referrals.
- Critical Findings: Timing of Notification in Neuroradiology
These authors attempted to determine the time between identification of a critical finding and verbal communication with the primary caregiver. Ninety-one critical findings identified by trainees and attending physicians were analyzed. The mean time from study acquisition to critical finding discovery was 62 minutes and from then to a telephone call was 3.7 minutes (direct caregiver communication within 15 minutes for 94% of cases). During night or weekend shifts, mean notification times increased and sources of delay were inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers.
Health Care Reform Vignette
Brain
- Calcified Cerebral Emboli, A “Do Not Miss” Imaging Diagnosis: 22 New Cases and Review of the Literature
The prevalence, imaging appearance, presumed source, treatment, and outcome of patients with calcified cerebral emboli on CT were assessed in 22 cases seen by the authors and in 48 from the literature. Most calcified emboli were found in the middle cerebral artery territory and were thought to arise from the heart, aortic arch, or carotid plaques. The overall prevalence of these emboli was 2.7% with 27% initially misdiagnosed and 9% overlooked on the first interpretation.
- Hyperintense Basilar Artery on FLAIR MR Imaging: Diagnostic Accuracy and Clinical Impact in Patients with Acute Brain Stem Stroke
Because FLAIR high signal intensity in occluded arteries occurs elsewhere in the brain, these authors analyzed the signal of the basilar artery in 20 instances of occlusion in a group of patients who also underwent DSA. While the FLAIR hyperintense basilar artery sign showed moderate sensitivity, its specificity and accuracy were high for the detection of occlusions. The extent of the occlusion also predicted survival.
Interventional
Commentary
Pediatrics
Peripheral Nervous System
Spine
- Reliability of the STIR Sequence for Acute Type II Odontoid Fractures
Because STIR images are routinely used for evaluation of the posttraumatic cervical spine, these authors specifically looked at the ability of this sequence to differentiate acute vs. chronic odontoid type II fractures in 75 patients and compared the imaging findings with an equal number of age-matched controls. STIR fared poorly in the detection of fractures in individuals over 57 years of age. Therefore, older patients, particularly those with osteopenia, may have acute odontoid injuries without corresponding STIR hyperintensity.
