Radiologic Clinics of North America RSS feed: Current Issue. Radiologic Clinics of North America brings you comprehensive, clinical information that can be applied directly to your practice. Each bimonthly issue covers one current topic in radiology under the guidance of a guest editor specializing in the field. You'll find detailed articles written by leading experts, along with high-quality reproductions of radiographs, MR images, CT scans and sonograms. In addition, you can earn valuable CME credits - up to 90 per year - with your subscription. http://www.radiologic.theclinics.com/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. Radiologic Clinics of North America0033-8389501January 2012 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.radiologic.theclinics.com/article/PIIS0033838911002235/abstract?rss=yesContributors10.1016/S0033-8389(11)00223-5Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6iiiivhttp://www.radiologic.theclinics.com/article/PIIS0033838911002247/abstract?rss=yesContents10.1016/S0033-8389(11)00224-7Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6vviihttp://www.radiologic.theclinics.com/article/PIIS0033838911002429/abstract?rss=yesCME Accreditation Page and Author Disclosure10.1016/j.rcl.2011.11.001Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6viiiviiihttp://www.radiologic.theclinics.com/article/PIIS0033838911002260/abstract?rss=yesForthcoming Issues10.1016/S0033-8389(11)00226-0Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6ixixhttp://www.radiologic.theclinics.com/article/PIIS0033838911002181/abstract?rss=yesIt is no secret that technological advances in medical imaging have modified substantially the way that health care is provided to acutely ill patients. In many instances, findings on imaging tests performed as emergency procedures provide the decisive information that directly determines the best management options. In other cases, appropriate triaging of patients initially admitted through the emergency room is performed almost exclusively on the basis of results of imaging examinations. Not surprisingly, the last decade has seen an almost exponential increase in the number and complexity of emergency imaging tests, especially CT. The practice of Emergency Radiology has undergone the same rapid change: as imaging procedures are increasingly performed within short periods of time after the arrival of patients to the emergency room, the expectation for near real-time interpretations (often by subspecialists) has gained popularity. Larger emergency centers provide 24-hour onsite coverage by well-trained radiologists, while others rely on the services of equally well-trained radiologists located off-site, taking advantage of modern universal interconnectivity. Either way, radiologists’ input is increasingly affecting the immediate outcome of patients presenting with acute symptoms.Emergency RadiologyJorge A. Soto10.1016/j.rcl.2011.10.002Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6xixiihttp://www.radiologic.theclinics.com/article/PIIS0033838911001540/abstract?rss=yesMany tools and strategies exist to enable the reduction of radiation exposure from computed tomography (CT). The common CT metrics of x-ray output, CTDIvol and DLP, are explained and serve as the basis for monitoring radiation exposure from CT scans. Many strategies to dose optimize CT protocols are explored that, in combination with available hardware and software tools, allow robust diagnostic quality CT scans to be performed with a radiation exposure appropriate for the clinical scenario and the size of the patients. Specific emergency department example protocols are used to demonstrate these techniques.Strategies for Reducing Radiation Exposure in Multi-Detector Row CTAaron Sodickson10.1016/j.rcl.2011.08.006Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6114http://www.radiologic.theclinics.com/article/PIIS0033838911001588/abstract?rss=yesComputed tomography (CT) and magnetic resonance (MR) play important roles in the evaluation of traumatic brain injury. Modern CT scanners allow for rapid and accurate diagnosis of intracranial hemorrhage and mass effect and allow the efficient implementation of emergent CT angiography. Newer sequences, such as gradient recalled echo, susceptibility-weighted imaging, and diffusion-weighted imaging, can provide greater sensitivity for specific types of diffuse posttraumatic brain injury. MR spectroscopy can provide additional chemical information, and diffusion tensor imaging can provide information about white matter injury. Patient treatment can be optimized using the diagnostic and prognostic information derived from current imaging techniques.Updated Imaging of Traumatic Brain InjuryWayne S. Kubal10.1016/j.rcl.2011.08.010Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-61541http://www.radiologic.theclinics.com/article/PIIS0033838911001539/abstract?rss=yesMaxillofacial skeletal injuries account for a large proportion of emergency department visits and often result in surgical consultation. Although many of the principles of detection and repair are basic, the evolution of technology and therapeutic strategies has led to improved patient outcomes. This article aims to provide a review of the imaging aspects involved in maxillofacial trauma and to delineate its relevance to management.The Imaging of Maxillofacial Trauma and its Pertinence to Surgical InterventionNisha Mehta, Parag Butala, Mark P. Bernstein10.1016/j.rcl.2011.08.005Radiologic Clinics of North America 50, 1 (2012)2011-10-25Radiologic Clinics of North America2011-10-25501S0033-8389(11)X0007-64357http://www.radiologic.theclinics.com/article/PIIS0033838911001552/abstract?rss=yesBlunt cerebrovascular injury (BCVI) is uncommon but potentially catastrophic; 80% are caused by vehicle collisions. Ischemic events secondary to untreated BCVI are common, with high injury-specific mortality. This has led to implementation of screening programs based on mechanism of injury, clinical presentation, and injury patterns identified on noncontrast computed tomography (CT) imaging. The standard of reference for diagnosis is four-vessel digital subtraction angiography. Given its availably in trauma service institutions, use of multidetector CT angiography has increased. This article presents the evidence and the controversies surrounding its use. Available protocols, injury description, and grading, as well as potential pitfalls are reviewed.Multi-Detector Row CT Angiography of the Neck in Blunt TraumaFelipe Munera, Mark Foley, Falgun H. Chokshi10.1016/j.rcl.2011.08.007Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-65972http://www.radiologic.theclinics.com/article/PIIS0033838911001527/abstract?rss=yesTonsillar infection is the most common cause of infections of the neck in children and young adults whereas odontogenic infection is the most common cause in older population groups. Other sources of neck infection include the salivary glands, nasal sinuses, middle ear and mastoids, cervical lymph nodes, and trauma. Computed tomography and magnetic resonance imaging have excellent sensitivity for the recognition of deep infections, particularly for the identification of abscess formation and its precise location and extension of disease. A careful assessment of potential severe complications, such as vascular compromise, osteomyelitis, and airway narrowing, should be performed routinely.Imaging of Acute Head and Neck InfectionsAldo Gonzalez-Beicos, Diego Nunez10.1016/j.rcl.2011.08.004Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-67383http://www.radiologic.theclinics.com/article/PIIS0033838911001503/abstract?rss=yesAlthough infrequently encountered in busy trauma centers, injuries to the aorta and branch vessels remain an important cause of trauma-related mortality. Advances in the diagnosis and management of these injuries have led to more accurate and timely imaging, and improved patient outcomes. Despite these advances, several challenges in evaluating the severely injured trauma patient remain. This review provides an overview of current concepts in the imaging of aortic and branch vessel injuries, and provides pointers to improve detection and interpretation of more challenging injuries.Imaging of Aortic and Branch Vessel TraumaMartin L. Gunn10.1016/j.rcl.2011.08.002Radiologic Clinics of North America 50, 1 (2012)2011-10-24Radiologic Clinics of North America2011-10-24501S0033-8389(11)X0007-685103http://www.radiologic.theclinics.com/article/PIIS0033838911001564/abstract?rss=yesEvaluation for splenic injury is an important component of patient assessment after blunt abdominal trauma. Key imaging modalities include ultrasound, particularly for rapid identification of hemoperitoneum, and computed tomography (CT), which permits a more detailed and accurate determination of splenic integrity. Specific findings at contrast-enhanced multidetector CT (MDCT) should prompt the consideration of catheter angiography with arterial embolization as an adjunct to nonsurgical management. This article reviews the roles of imaging in the management of splenic trauma, illustrates the MDCT appearance of various splenic injuries, and discusses imaging-based indications for operative and angiographic intervention.Splenic Trauma: What is New?Alexis Boscak, Kathirkamanthan Shanmuganathan10.1016/j.rcl.2011.08.008Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6105122http://www.radiologic.theclinics.com/article/PIIS0033838911001515/abstract?rss=yesDelayed diagnosis of a bowel or mesenteric injury resulting in hollow viscus perforation leads to significant morbidity and mortality from hemorrhage, peritonitis, or abdominal sepsis. The timely diagnosis of bowel and mesenteric injuries requiring operative repair depends almost exclusively on their early detection by the radiologist on computed tomography examination, because the clinical signs and symptoms of these injuries are not specific and usually develop late. Therefore, the radiologist must be familiar with the often-subtle imaging findings of bowel and mesenteric injury that will allow for appropriate triage of a patient who has sustained blunt trauma to the abdomen or pelvis.CT Imaging of Blunt Traumatic Bowel and Mesenteric InjuriesChristina A. LeBedis, Stephan W. Anderson, Jorge A. Soto10.1016/j.rcl.2011.08.003Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6123136http://www.radiologic.theclinics.com/article/PIIS0033838911001576/abstract?rss=yesThis article discusses the critical protocol considerations in imaging patients with abdominal pain in the emergency department, specifically, the use of oral contrast, intravenous contrast, image postprocessing, and radiation dose. These considerations related to the use of computed tomography imaging of abdominal pain are reviewed in an evidence-based fashion.Multi-Detector Row CT of Acute Non-traumatic Abdominal Pain: Contrast and Protocol ConsiderationsStephan W. Anderson, Jorge A. Soto10.1016/j.rcl.2011.08.009Radiologic Clinics of North America 50, 1 (2012)2011-10-17Radiologic Clinics of North America2011-10-17501S0033-8389(11)X0007-6137147http://www.radiologic.theclinics.com/article/PIIS0033838911001497/abstract?rss=yesThis article reviews the evolving radiology and clinical literature on imaging of suspected common and relatively common maternal nonobstetric conditions of the abdomen and pelvis, including appendicitis, urolithiasis, and biliary disease, as well as on trauma to the maternal abdomen and pelvis and to the fetus. Recommendations for imaging these conditions, based on the literature to date and on the authors' experiences at two tertiary-care institutions with busy obstetric services, are proposed. The potential and theoretical fetal and maternal risks from such imaging are also reviewed.Imaging of Abdominal Pain in PregnancyDouglas S. Katz, Michele A.I. Klein, George Ganson, John J. Hines10.1016/j.rcl.2011.08.001Radiologic Clinics of North America 50, 1 (2012)2011-10-14Radiologic Clinics of North America2011-10-14501S0033-8389(11)X0007-6149171http://www.radiologic.theclinics.com/article/PIIS0033838911001886/abstract?rss=yesGastrointestinal hemorrhage and mesenteric ischemia are two conditions that require rapid and accurate diagnosis. In this article, the author discusses these conditions in the light of current available diagnosing modalities, such as multi-detector computed tomography.Diagnosis of Acute Gastrointestinal Hemorrhage and Acute Mesenteric Ischemia in the Era of Multi-Detector Row CTJamlik-Omari Johnson10.1016/j.rcl.2011.09.001Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6173182http://www.radiologic.theclinics.com/article/PIIS0033838911002272/abstract?rss=yesIndex10.1016/S0033-8389(11)00227-2Radiologic Clinics of North America 50, 1 (2012)2012-01-01Radiologic Clinics of North America2012-01-01501S0033-8389(11)X0007-6183189