Intraspinal pseudomeningoceles: A rare complication of spinal trauma and surgery.

We present two cases of acute and delayed presentations of intraspinal pseudomeningoceles, which is a rare complication of spinal trauma or surgery. Our goal is to discuss the pathophysiology, clinical presentation, imaging findings, and treatment of this rare entity. This diagnosis should be considered in patients with unexplained neurologic symptoms in the setting of prior cervical spine injury or surgery.

Single phase computed tomography is equivalent to dual phase method for localizing hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: a retrospective review.

OBJECTIVE: This study aims to compare the sensitivity of dual phase (non-contrast and arterial) versus single phase (arterial) CT for detection of hyper-functioning parathyroid glands in patients with primary hyperparathyroidism. METHODS: The CT scans of thirty-two patients who have biochemical evidence of primary hyperparathyroidism, pathologically proven parathyroid adenomas, and pre-operative multiphase parathyroid imaging were evaluated retrospectively in order to compare the adequacy of single phase vs. dual phase CT scans for the detection of parathyroid adenomas. RESULTS: The parathyroid adenomas were localized in 83% of cases on single arterial phase CT and 80% of cases on dual phase CT. The specificity for localization of parathyroid tumor was 96% for single phase CT and 97% for dual phase CT. The results were not significantly different (p = 0.695). These results are similar to those found in the literature for multiphase CT of 55-94%. CONCLUSIONS: Our study supports the use of a single arterial phase CT for the detection of hyperfunctioning parathyroid adenomas. Advances in knowledge: a single arterial phase CT has similar sensitivity for localizing parathyroid adenomas as dual phase CT and significantly reduces radiation dose to the patient.

CT Dose Reduction Workshop: An Active Educational Experience.

PURPOSE: Improving patient safety by minimizing CT radiation dose, while maintaining diagnostic image quality, has become an important skill in diagnostic radiology. The aim of this study was to examine the value of an educational workshop for optimizing CT protocols in an academic department, and to assess its impact on resident education. METHODS: The CT Dose Reduction Workshop met monthly for 1 year, to teach and implement dose reduction strategies. Changes were made to CT protocols through group consensus while participants kept up to date with current literature. A survey was sent to 48 radiology residents and 32 attending radiologists in the department, including both participants and nonparticipants, after completion of the workshop, to assess its utility. The survey used a 5-point Likert-type scale. Average doses for a specific CT protocol before and after the workshop were compared. RESULTS: About 80% of respondents agreed or strongly agreed that the workshop was essential. Workshop participants expressed greater confidence in their knowledge of dose reduction techniques, with a mean score of 3.74 (95% confidence interval, 3.35-4.13), compared with nonparticipants, who had a mean score of 3.00 (95% confidence interval, 2.64-3.36) (P < .01). Dose reductions were established across numerous CT protocols. For instance, the average total dose-length product in renal mass protocol CT examinations decreased by 54% (P < .0001). CONCLUSIONS: A CT dose reduction workshop increases participants' confidence in knowledge of dose reduction techniques, fosters a culture of safety and quality improvement in the department, and reduces radiation dose to patients.