By Zachary Grossman, Douglas Katz, Ronald Alberico, Peter Loud
Written through radiologists yet for clinicians, and intended for session within the "heat of conflict" (the busy-sometimes hectic-clinical setting), this unique little publication publications you thru the main affordable and direct imaging path to a prognosis. in contrast to all different books via radiologists, it doesn't try and educate picture interpretation. relatively, protecting sixty five universal scientific difficulties, from GI bleed, to Pulmonary Embolus, to Myocardial Ischemia, to Stroke, The Clinicians's consultant accommodates all to be had technologies-Multi-detector CT, MR, CT angiography, MR angiography, puppy, and mixed PET/CT- to aid clinicians get the solutions they need.Highlights the relative rate with buck symptoms of every imaging attempt or imaging-guided process! (Not on hand in the other text). Explains in transparent, cogent language the step by step common sense in the back of the imaging series for every challenge, but avoids maddening "flow charts". every one problem-oriented bankruptcy stands on my own, for speedy and concise advice in selecting definitely the right try, obviating the necessity to turn backward and forward while there's little time. accommodates the most recent imaging modalities that experience significantly replaced the work-up for plenty of medical stipulations. Covers the main debatable subject matters, like CT screening of the fit inhabitants, the worth of mixed PET/CT scanners, and where of "virtual" colonoscopy.
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Additional resources for Cost Effective Diagnostic Imaging: The Clinician's Guide
When intravenous contrast medium is contraindicated, or when the nature of a lesion remains equivocal after enhanced CT but clinical suspicion of hepatic tumor persists: STEP 2A: MAGNETIC RESONANCE (MR) IMAGING MR technology has largely overcome problems related to motion artifacts from breathing, bowel peristalsis, and vascular pulsations, and the study does not require the iodinated intravenous contrast medium used for CT. A gadolinium-based contrast medium, which is usually safe even in the presence of renal failure or iodinated contrast-medium allergy, is used.
STEP 2: NUCLEAR HEPATOBILIARY IMINODIACETIC ACID (HIDA) SCAN In occasional cases a T-tube cholangiogram is normal, yet signs and symptoms suggest an intermittent leak. Because HIDA is excreted over a period of hours, the “window” during which this study can detect an intermittent leak is longer than that of T-tube cholangiogram. Therefore, when an intermittent leak is suspected, a normal T-tube cholangiogram is often followed by HIDA imaging. Although intraductal lesions and calculi are not well deﬁned by HIDA, the presence of HIDA outside of the normal biliary tree or gut is easily detected.
Normal ﬁndings on CT or US end the workup for pancreatic carcinoma in the jaundiced patient without biliary dilation. 4. If CT reveals a suspicious contour abnormality or if pancreatic cancer is suspected despite a normal ﬁnding on CT in the nonjaundiced patient, MR, ERCP, EUS, or percutaneous imaging-guided biopsy may help to conﬁrm the presence or absence of tumor. ADDITIONAL COMMENTS • Multidetector CT scanners produce extremely thin, high-resolution images during the optimal phase of contrast medium enhancement, without respiratory motion artifact.