ABSTRACT
ITB pumps are widely used in the treatment of intractable spasticity for many clinical indications, including cerebral palsy and spinal cord injury. High-dose intrathecal administration places the patient at significant risk for withdrawal in the event of device malfunction, necessitating rapid and complete evaluation of the pump-catheter system. This article reviews the approach to imaging evaluation of ITB pump-catheter systems, with specific emphasis on radiography, fluoroscopy, CT, and nuclear scintigraphy.
Subject(s)
Baclofen/administration & dosage , Fluoroscopy/methods , Infusion Pumps, Implantable/standards , Muscle Spasticity , Radionuclide Imaging/methods , Humans , Injections, Spinal , Muscle Relaxants, Central/administration & dosage , Muscle Spasticity/diagnostic imaging , Muscle Spasticity/drug therapy , Tomography, X-Ray Computed/methodsABSTRACT
SUMMARY: Conebeam x-ray CT (CBCT) is being increasingly used for point-of-service head and neck and dentomaxillofacial imaging. This technique provides relatively high isotropic spatial resolution of osseous structures with a reduced radiation dose compared with conventional CT scans. In this second installment in a 2-part review, the clinical applications in the dentomaxillofacial and head and neck regions will be explored, with particular emphasis on diagnostic imaging of the sinuses, temporal bone, and craniofacial structures. Several controversies surrounding the emergence of CBCT technology will also be addressed.
Subject(s)
Cone-Beam Computed Tomography/methods , Head/diagnostic imaging , Neck/diagnostic imaging , Radiographic Image Enhancement/methods , Radiography, Dental/methods , Radiography, Interventional/methods , HumansABSTRACT
Conebeam x-ray CT (CBCT) is a developing imaging technique designed to provide relatively low-dose high-spatial-resolution visualization of high-contrast structures in the head and neck and other anatomic areas. This first installment in a 2-part review will address the physical principles underlying CBCT imaging as it is used in dedicated head and neck scanners. Concepts related to CBCT acquisition geometry, flat panel detection, and image quality will be explored in detail. Particular emphasis will be placed on technical limitations to low-contrast detectability and radiation dose. Proposed methods of x-ray scatter reduction will also be discussed.
Subject(s)
Cone-Beam Computed Tomography/methods , Head and Neck Neoplasms/diagnostic imaging , Head/diagnostic imaging , Imaging, Three-Dimensional/methods , Neck/diagnostic imaging , Pattern Recognition, Automated/methods , Radiographic Image Interpretation, Computer-Assisted/methods , Algorithms , Humans , Radiographic Image Enhancement/methodsABSTRACT
Arterial selection for reference time-enhancement curve generation in deconvolution-based perfusion CT (PCT) studies of the head and neck is under-evaluated. This study of 11 patients with confirmed head and neck squamous cell carcinoma demonstrates significant correlation (range, r = 0.85-0.95) between perfusion parameter values derived with internal carotid artery (ICA) as compared to an external carotid artery reference, supporting the use of the ICA as arterial reference in PCT studies of the neck.
