Diagnostic Neuroradiology Fellowship Position at Stanford

We are adding a new diagnostic neuroradiology fellowship position starting July 1, 2015.

The Diagnostic Neuroradiology Fellowship at Stanford is a two-year fellowship. It is designed to be a well-balanced academic training program that encompasses all of the basic and advanced clinical and research areas of both adult and pediatric neuroradiology. Neuroradiology fellows will be exposed to all imaging modalities used to evaluate neurologic disease, including CT, MR, myelography, angiography, and ultrasound during the course of the fellowship. Interventional neuroradiologic procedures are also performed at state-of-the-art levels at Stanford, and neuroradiology fellows will actively participate in these procedures.

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Interobserver Agreement in the Interpretation of Outpatient Head CT Scans in an Academic Neuroradiology Practice

Fellows’ Journal Club January 2015

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Repeatability of outpatient head CT interpretations performed in an academic practice was assessed in 119 randomly selected studies. These were blindly read twice by 8 neuroradiologists. Differences in location and severity of findings occurred in 9.2% of cases and contradictory findings in 15.1%. Thus, discrepancies in double-blind interpretations were more common than reported in peer-review quality assurance programs.

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Abnormal White Matter Integrity in Chronic Users of Codeine-Containing Cough Syrups: A Tract-Based Spatial Statistics Study

Editor’s Choice January 2015

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Because codeine is a popular drug and results in cognitive deficits, the authors assessed 30 chronic users and 30 controls with DTI. Chronic codeine users showed lower fractional anisotropy in 4 brain regions and higher scores on the Barratt Impulsiveness Scale. It appears that chronic codeine-containing syrup abuse may be associated with disruptions in brain white matter integrity and that these microstructural deficits may be linked to higher impulsivity in chronic users.

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Annotated Bibliography, January 2015

Please check out the accompanying podcast of this blog post: http://www.ajnr.org/site/Podcasts/January2015AnnotBiblio.mp3

1. Jensen OK, Nielsen CV, Sørensen JS, Stengaard-Pedersen K. Type 1 Modic changes was a significant risk factor for 1-year outcome in sick-listed low back pain patients: a nested cohort study using magnetic resonance imaging of the lumbar spine. Spine J. 2014;14(11):2568–2581. doi:10.1016/j.spinee.2014.02.018.

The authors evaluated 325 sick-listed LBP patients, of which 141 subjects were consecutively examined by MR, and 140 completed the study. They looked at the associations between baseline degenerative manifestations and outcome in these sick-listed LBP patients. Modic changes (MC) were identified in 60% of the … Continue reading >>

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Lumbar Punctures Increasingly Performed by Radiologists

A recent review of Medicare billing claims from 1991 through 2011 has verified what many of us anecdotally know to be true. While the data only account for fee-for-service Medicare patients, the analysis by Kroll and colleagues found a substantial increase in the proportion of lumbar punctures performed by Radiologists, from 11% in 1991 to 46.6% in 2011 (while the overall number of lumbar punctures remained essentially unchanged). Diagnostic lumbar punctures performed by Radiologists increased by 325% while those performed by neurologists, neurosurgeons, and primary care physicians decreased by 67-83%. The only other provider groups who have done an increasing … Continue reading >>

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Parathyroid Imaging Survey

There is significant variation among different institutions with regard to the imaging algorithm for primary hyperparathyroidism, and the role and technique of parathyroid 4D-CT.

Please take 5 minutes to share your experience by completing this short survey.

Thanks for your participation by January 26th!… Continue reading >>

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Neuroimaging Clinics of North America: Genetic Patterns in Neuroimaging

Hygino da Cruz Jr L, guest ed. Mukherji SK, consulting ed. Genetic Patterns in Neuroimaging. Elsevier; February 2015. Neuroimaging Clinics of North America; vol. 25, no. 1; pgs. 1–158; $360.00  

genet-patterns-nicna-feb-2015The increasing emphasis on relating alterations in genetic makeup to various disease states makes it important to gain understanding of how chromosomal abnormalities relate to what we observe on neuroimaging studies. As medical school recedes into the distant past of our formal medical training, many of the critical facts for appreciating genetics and disease are forgotten (or maybe never learned). Enter the newest addition to the Neuroimaging Clinics Continue reading >>

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Communication: Meeting Patients Face-to-Face

This post originally appeared on The Voice of Radiology Blog, run by the American College of Radiology.

At my institution, we have been putting radiology reports into our online patient portal for about two years and we are preparing to make images available with those reports in the portal. We make our pager numbers available in the report and have been taking phone calls from patients since reports started going into the patient portal.  With these changes, we have experienced more patients requesting consultations with the interpreting radiologist.

In a recent New York Times article, Drs. Jennifer Kemp and … Continue reading >>

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Detection of Carotid Artery Stenosis: A Comparison between 2 Unenhanced MRAs and Dual-Source CTA

Fellows’ Journal Club December 2014

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Three different techniques were used to assess extracranial carotid artery stenosis and correlated with the results of DSA: conventional TOF MRA, black-blood MRA, and CTA. There was good correlation among all 4 techniques with CTA having the highest sensitivity/specificity followed by black-blood MRA. CTA and black-blood MRA were also better for depicting plaque features.

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Dual-source CTA and black-blood MRA are recently developed techniques for evaluating carotid stenosis. The purpose of this study was to compare dual-source CTA with black-blood MRA and conventional TOF MRA in both detecting carotid

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Diagnostic Accuracy of Screening MR Imaging Using Unenhanced Axial CISS and Coronal T2WI for Detection of Small Internal Auditory Canal Lesions

Editor’s Choice December 2014

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T2-weighted and CISS images were compared with thin-section postcontrast T1 sequences for the detection of small (<10 mm) internal auditory canal schwannomas in 23 patients. The authors concluded that screening noncontrast MR imaging using a combination of axial CISS and coronal T2WI sequences can detect small internal auditory canal lesions with 100% sensitivity and excellent interobserver agreement.

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While enhanced T1WI is considered the “gold standard” for detection of internal auditory canal pathology, unenhanced fluid-sensitive sequences have shown high sensitivity for lesion identification. Our purpose was to evaluate the diagnostic

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