RSNA
‘91
77th
Assembly Meeting Notes
Scientific Annual
and Part2 Table 910
917
of Contents Neuroradiology Hervey D. Segall, MD, Chairman William S. Ball, Jr. MD David L. Daniels, MD Sylvie Destian, MD Charles R. Fitz, MD Norman E. Leeds, MD Robert M. Quencer, MD Arthur E. Rosenbaum, MD Eric J. Russell, MD Gordon K. Sze, MD Michael S. Tenner, MD William T. C. Yuh, MD Robert D. Zimmerman, MD Magnetic Richard
Resonance L. Ehman,
Warren Robert Theresa Mathias
B. Gefter, MD G. Levitt, MD C. McLoud, MD Prokop, MD Cornelia M. Schaefer, MD Paul Stark, MD
927
922
923
MD, 929
Applications Imaging L. Arenson, MD,
932
Pediatric Radiology Beverly P. Wood, MD, Chairman Charles R. Fitz, MD William H. McAlister, MD John H. Miller, MD Sheila G. Moore, MD Janet L. Strife, MD Richard B. Towbin, MD
935
Official
936
1991 RSNA Replacement
and
Chairman
Thoracic
Radiology
Reginald
Greene,
Dixie
J. Anderson,
MD,
MD
Cardiovascular/Interventional David W. Hunter, MD, Chairman Sandra Althaus, MD Michael D. Darcy, MD Steve Falconer, BA Xiaoping Hu, MD Deborah G. Longley, MD Louis G. Martin, MD Terence Matabon, MD Arthur Stillman, MD Robert L. Vogelzang, MD E. Kent Yucel, MD
Samuel J. Dwyer III, PhD H. K. Huang, DSc 925
PhD
Radiology
Technical Exhibits Joel E. Gray, PhD, Chairman Gary T. Barnes, PhD Joel P. Felmlee, PhD Cynthia H. McCollough, PhD Richard L. Morin, PhD Computer Digital Ronald
Radiology G. Baron,
MD, Chairman Melvin E. Cbouse, MD Antoinette Gomes, MD Robert J. Herfkens, MD Harold Mitty, MD Roderic I. Pettigrew, MD, Renate L. Soulen, MD Mark H. Wholey, MD Jack Ziffer, MD, PhD Murray
Chairman
R. Nick Bryan, MD, PhD John V. Crues, MD Robert J. Herfkens, MD Hedvig Hricak, MD Herbert Y. Kressel, MD Robert E. Lenkinski, PhD Donald G. Mitchell, MD Stephen J. Riederer, PhD Jeffrey R. Ross, MD Mitchell D. Schnall, MD
Cardiac
Chairman
Registration Program Abstracts
Figures
L
RSNA
‘9 1 Meeting
Notes
Neuroradiology Segall, MD, University of Medicine, Los Angeles S. Ball, Jr. MD, Children
Hervey
of Southern
D.
School William
‘s Hospital
California of Cincinnati,
Cincinnati
David
L. Daniels, MD, Medical College of Wisconsin, Milwaukee Sylvie Destian, MD, University of Soutlwrn California School of Medicine, Los Angeles Charles R. Fitz, MD, Children’s Hospital of Pittsburgh, Pittsburgh Norman E. Leeds, MD, University ofTexas M.D. Anderson Cancer
Center,
Houston MD,
M. Quencer,
Robert
University
ofMiaini
Miami Arthur E. Rosenbaum, MD, State University Health Science Center, Syracuse Eric J. Russell, MD, Northwestern University Chicago Gordon K. Sze, MD, Yale University School
School
of
of New
York
Medicine,
Neu’ Haven, Michael
Hospitals,
of Medicine,
Connecticut
S. Tenner,
MD,
New York
Medical
College,
T. C. Yuh,
MD,
University
of iowa
Hospitals,
Valhalla William
Iowa
City
Robert D. Zimmerman, Center, New York
MD,
Cornell
Llnivt’rsity
Medical
Index terms: Brain, MR, 10.1214 #{149} Brain neoplasms, diagnosis, 10.3 #{149} Cerebrat blood vessels, disease, 17.12 #{149} Radiological Society of North America, 77th scientific assembly and annual meeting #{149} Spinal canal, 3.12 Radiology , RSNA,
1992;
182:910-917
1992
The annual meeting of the RSNA continues to grow at an incredible rate, and activity in neuroradiobogy maintains pace accordingly. This neuroradiobogy committee reviewed all or part of 31 different scientific sessions and close to 100 exhibits at RSNA ‘91. Two special symposia were of great interest to neuroradiobogists, one on bumbar disk disease and the other focusing on fast magnetic resonance (MR) imaging. Stephen A. Kieffer completed his tenure as chairman of the neuroradiobogy program committee this year, and we salute him at this time for his superb contributions. The considerable amount of new information presented at the meeting is reflected in this review. It is hoped that this report will provide our readers with a useful memento of happenings in neuroradiobogy at our 77th annual meeting of the RSNA.
Cerebrovascular It was
Disease
evident
at RSNA ‘91 that morphologic and dynamic studies that contribute to the evaluation of ccrebrovascular diseases continue to be intensively evaluated by neuroradiobogists and others. Likewise, treatment of various vascular lesions by transluminab methods and by other techniques remains an active area of endeavor. Many advances in the diagnosis ment of cerebrovascular disease displayed ber meeting are reviewed in this section.
910
#{149} Radiology
and treatat the Decem-
.
.
MR angiography: technical considerations-A number of different technical refinements of MR angiography were demonstrated and discussed. Time-of-flight (TOF) MR angiography techniques based on inflow enhancement and phase-contrast MR angiography are now being used and studied at many sites. However, limited seetion resolution and insufficient flow-stationary-tissue contrast have stifled the development of two-dimensional (2D) and three-dimensional (3D) black-blood MR angiography. Nevertheless, Listerud and Atlas (149) continue to investigate a new 3D Fourier transform multisbab fast spin-echo (FSE) method of obtaining blackblood images, but artifacts in addition to other problems have thus far prevented them from perfecting the technique. Workers who introduced at RSNA ‘90 the multiple overlapping thin-slab acquisition (MOTSA) MR angiography technique compared it in 35 cases with the more conventional 3D TOF MR angiography. Davis and cobleagues (170) demonstrated that MOTSA provided supenor large and small vessel visualization and improved imaging of pathologic anatomy. Conventional angiography was available in 15 of the 25 abnormal cases studied with MR angiography. Some facilities are now using finer matrices to obtain higher-resolution MR angiography studies. Images of great clarity have been obtained, and the techniques employed have proved to be practical in the clinical setting (165, 996C). Hausmann and associates (166) introduced a new elongated transmit/receive coil that enables MR imaging from the circle of Willis down to the aortic arch without changing coils. Both 2D sequential acquisitions with traveling presaturation and 3D slabs can be obtained; there is a small sacrifice of signal-to-noise ratio (S/N) due to the larger field of view compared with that of studies with a conventional head coil. A new method of postprocessing of MR angiographic data was introduced by Atlas and Listerud (952). TRAP (traced ray by array processor) can be used to reconstruct sharply delineated projection images in which a sense of depth is created with vessel shadowing. The authors now prefer this method over conventional MIP (maximum intensity projection) for studies in the region of the circle of Willis. New work was presented in which gadolinium injection was used to improve the visualization of small-caliber vessels at 3D TOF MR angiography. Kanal et al (169C) initiate very short repetition time (TR)/echo time (TE) acquisitions through the circle of Willis during or shortly after a fast bolus injection of contrast material (delivered within 20 seconds). This method enables preferential enhancement of blood over adjacent tissue; if the acquisitions are delayed too bong, undesirable enhancement of stationary tissues results. Zimmerman et ab (1186) also used gadolinium-enhanced 3D TOF MR angiography to depict cerebral cortical vessels in infants, but imaging was impaired when there was damaged contrast-enhancing tissue. Stressing the importance of compensating for an infant’s normally slower cerebral blood flow, they showed that 2D TOF and velocity compensated-uncompensated TOF studies can also be sue-
March
1992
cessfully employed in newborns.
in evaluating
cerebrovascular
insults
associates (847C) demonstrated of intracranial vessels obtained angiography by using an eddy-current-free
Nishimura
imwith 3D
and
pressive
images
TOF
MR
0.3-T permanent-magnet were much better field-strength unit.
than
one
imaging would
system. anticipate
The
results from a low-
Investigators are now employing phase-contrast MR angiography methods to quantitate flow velocities within intracranial and extracranial vessels and in phantoms (994, 998C, 1124). Some of these are done with cine MR pulse sequences, and they are being correlated with Doppler ultrasound (US) results. Extracranial carotid stcnosis and occlusion-Two studies compared 2D TOF MR angiography with conventional angiography in evaluating the carotid bifurcation (164; exhibit 152). Data reported by Laster et al supported vascular MR imaging as a primary diagnostic screening technique (exhibit 152). Using selective common carotid arteriography, they graded 202 vessels as normal to mildly stenotic (0%-29%), moderately stenotic (30%69%), severely stenotic (70%-99%), or occluded. The accuracy of 1.5-T MR angiography was 95.8% for normal to mild stenosis, 71.4% for moderate stenosis, 91.1% for severe stenosis, and 100% for occlusions. Huston and colleagues (164) noted a consistent tendency for MR angiography to cause overestimation of the degree of stenosis and also observed poorer correlation with angiography in the moderate stenosis group. Ulcerations were noted with MR angiography in only one of 16 instances appreciated at conventional angiography. Smith and associates (165) obtained better lumen definition and improved delineation of carotid stenosis by using 512 (read) x256 (phase) matrix 3D TOF MR angiography, compared with a 256 x 256 matrix. The highresolution technique demonstrated less tendency to overestimate mild to moderate stenosis. The acquisition time was 10 minutes, and it required only a slightly longer postprocessing time (around 5 minutes) than their lower-resolution method. Moran and co-workers (420) reported on the use of spiral
computed
tomography
(CT)
with
intravenous
contrast extracranial
material and 3D reconstruction in imaging the carotid arteries in 10 patients. Atherosclerotic plaques could be readily distinguished, and correlations with conventional angiograms have been encouraging. However, adjacent structures that are dense (eg,
calcified
plaques
or
opacified
jugular
vein)
create
difficulties when superimposed on the contrast-enhanced carotids. Further work with additional technical modifications (such as subtraction) should be of interest. Polak and colleagues (251) compared color-assisted Doppler sonography with angiography in 96 patients to determine velocity parameters that best enable detection of 70% diameter stenosis of the internal carotid artery (the current threshold at which carotid endarterectomy has been found to be beneficial). The internal carotid artery-peak systolic velocity was found to be the most useful parameter. Fleiter et al (254C) introduced a new technique of color-coded duplex sonographic vascular
Volume
182
#{149} Number
3
reconstruction that enables a function-related 3D display. Peterman and associates (423C) described a method of identifying patients who clinically tolerate an internal carotid artery balloon test occlusion but who, nevertheless, will suffer a cerebral infarction following permanent occlusion. Patients who were asymptomatic with the balloon test occlusion were then given intravenous Tc-99m HMPAO during balloon inflation and single photon emission CT (SPECT) of the brain was then performed. Patients who display ipsilateral hypoperfusion are still at risk for stroke from carotid ligation, whereas the outlook appears to be better in patients with symmetric perfusion. Rosenkranz and colleagues (421) demonstrated that there is much potential for the use of an acetazolamide stimulation test to evaluate the cerebral vascular reserve capacity of patients with symptomatic extracranial internal carotid stenoses and occlusions. Transcranial pulsed Doppler and Tc-99m HMPAO SPECT measurements were made before and after acetazolamide injection in such patients. Cerebral circulation-The incredible versatility of MR and its various methods has provided numerous ayenues for investigation of the cerebral circulation. Many interesting studies in this area were reported at RSNA ‘91. Enzmann et al (1124) have been using phase-contrast cine MR as a new method of measuring blood flow in major cerebral arteries. This technique appears to have considerable promise for assessing blood velocities within cerebral vessels in the clinical setting. Gado and co-investigators (1125C) have been performing cerebral blood flow and transit time studies, acquiring rapid Serial MR images of both the internal carotid artery and brain tissue during the hand injection of Gd-DTPA. Cincinnati researchers (905) have been able to implement fast T2*weighted MR imaging to assess cerebral perfusion in children following injection of a Gd-DTPA bolus. This technique requires a software update but no hardware modifications. Thulborn et al (1122) demonstrated that the quantitative in vivo measurement of oxygen consumption within the brain and other tissues can be done in humans by employing echo-planar MR imaging. This was shown to be feasible by obtaining in vivo T2 measurements as an index of blood oxygenation, determining arteriovenous blood oxygenation differences by obtaining blood samples, and calculating global oxygen consumption with the Fick principle. Cerebral infarction-There have been numerous ongoing animal studies employing MR in the evaluation of cerebral ischemia (422, 425C, 426, 427). Finelli et al found dynamic gadolinium-enhanced magnetic-susceptibilityweighted imaging to be a superior method of imaging early acute cerebral ischemia (422). Experimental work continues at other centers that are employing contrast agents and echo-planar imaging to demonstrate perfusion deficits in stroke (863, 864). Serial MR imaging and ies were used to compare and incomplete ischemia
proton MR spectroscopic studanimal models of complete by Mathews and co-investiga-
Radiology
911
#{149}
RSNA tors
‘9 1 Meeting
Notes
(427).
Signal changes appeared earlier in incomplete and involved a larger area, possibly due to greater pathologic water influx. Aneurysms-In studying 15 patients with 18 circle of Willis aneurysms proved at angiography, Atlas and assoischemia
ciates
(171)
found
3D
phase-contrast
MR
angiography
superior to 3D TOF MR angiography. Images obtained with both techniques were reconstructed with TRAP and maximum intensity projection (MIP). TRAP improves luminal definition by eliminating signal variations; TRAP also provides depth cueing. TRAP images were judged superior to those generated with MIP. TRAP of 3D Fourier transform phase-contrast data enabled clearer delineation of aneurysms, their necks, and adjacent vessels compared to 3D Fourier transform TOF. With 3D Fourier transform TOF, false-positive interpretation
of spasm
rors
were
was
made
with
made
in five
cases,
phase-contrast
but
no
images.
such
er-
Further-
more, hematomas adjacent to vessels are not seen with phase-contrast MR angiography; therefore, they do not confuse interpretation as they might with 3D TOF MR angiography. Presentations by Levrier and colleagues (167C) and Lee et al (172) dealt with flow patterns observed with phase-contrast MR angiography in intracranial aneurysms. Peripheral slow flow may not be appreciated within larger aneurysms, so that their lumina appear smaller than they actually are. The use of lower velocity encodings can show this flow close to aneurysm walls. Atlas observed, however, that further work is required to determine the optimum velocity encodings that should be used when studying aneurysm patients. Detailed postmortem studies by Moody and co-workers
(exhibit
127)
established
microaneurysms
are
that
extremely
Charcot-Bouchard rare.
In
2,798
autopsy
such anfound, and none was associated with hemorrhage. It is believed that the numerous arteriolar coils and twists seen with conventional high-resolution microradiography were mistaken in many instances as microaneurysms on earlier vascular injection studies in investigations
over
eurysms
a 10-year
period,
only
five
were
hypertensive
sd walls rupture
specimens.
Also,
changes
weakening
yes-
circumstances can result in arteriobar when injected after death. Exhibit 127 was one of four Magna Cum Laude award winners; Moody is to be congratulated for his remarkable back-toback achievement, having also won the same award at RSNA
in such artifacts
‘90.
A rteriovt’nous
malformations-Marks
evaluated MR with cerebral
(956)
tients (AVMs)
to
identify
images and arteriovenous characteristics
a nd colleagues angiograms in 60 pamalformations that
highly
correlate
It was concluded that the findings of an intranidus aneurysm or central venous drainage enable excellent predictive ability for hemorrhages. On the other hand, the observation of angiomatous change is negatively predictive. AVMs with such changes bleed infrequently; they may have a bower perfusion pressure. Lunsford and collaborators (957) considered conventional cerebral angiography to be the most definitive diagnostic test to determine AVM obliteration by radiosurgery. High-signal changes on T2-weighted MR imwith
912
hemorrhage.
#{149} Radiology
.
.
,
. ... .
‘:
:-
.
-
..
ages seen during the course of radiosurgery resolve within 19 months in at least 80% of patients, but permanent changes persist in around 4% of patients. Radiosurgery is capable of obliterating over 75% of AVMs, but chances of success are much less with AVMs greater than 4 cm in diameter. Further critical assessment of radiosurgery is warranted; however, the technique appears to play a potent adjuvant role in the treatment of cerebral AVMs. Interventional neuroradiology.-Peters and colleagues (179) described their use of radiolabeled polyvinyl alcohob sponge particulate matter in staged embobization of cerebral AVMs. Gamma camera imaging of head and chest radioactivity determines the percentage of embobic material crossing the AVM nidus. This technique enabbes assessment of nidus vasculature and whether or not larger particles should be used for subsequent embolizations. Gugliebmi and co-workers (exhibit 176) were able to completely occlude anterior choroidal artery feeders to cerebral AVMs by using a small detachable platinum coil soldered to a stainless steel delivery wire. Detachment by electrolysis took 4-12 minutes and enabled blocking of feeders distal to the artery’s cisternal segment. Since presenting their experience in 16 cases at RSNA ‘89, Higashida et ab (964) have performed transluminab balloon angioplasty for symptomatic intracranial arterial vasospasm in an additional 12 patients. Clinical improvement is provided in over 60% of cases. However, balloon overdistention resulted in vessel rupture in two cases. In another, hemorrhage from reperfusion of a previously infarcted territory occurred because of treatment. These complications led to the deaths of the three patients. These authors also use balloon angioplasty for symptomatic stenosis of the posterior circulation refractory to medical therapy (967). The vascubopathies were mainly atherosclerosis and fibromuscubar dysplasia. Suecessful results were obtained in all but 10 of 156 angioplastics (112 subclavian, 41 vertebral, and three basilar arteries). Access to the area of stenosis could not be obtamed in two patients. A few complications occurred, including transient ischemia during the procedure, stroke, and vessel rupture. Vazquez et al (965) did follow-up angiography in 60 patients who earlier underwent carotid balloon occlusion for carotid-cavernous fistulas and carotid aneurysms. In six patients these studies showed progressive revascularization of the carotid siphon via collaterals but without recrudescence of the original lesion or symptoms. Several presentations described the use of animal models to test new devices and to assess the results of interventional treatment. Mehta and co-investigators (178) evaluated the intravascular use of small tubular hydrogel stents, which might be of value in occluding lesions such as carotid-cavernous fistulas and aneurysms. These hydrophilic stents swell with water absorption. Gonzalez et ab (175) have shown that MR appears to be a useful modality for studying aneurysm treatment with helical platinum coils; MR shows the location of the coils, amount of thrombosis within the aneurysm, and patency of the parent artery.
March
1992
.
Other
Brain
and
Skull
.
.
Conditions
Neoplasms.-Workers from Kumamoto, Japan, who introduced their method of dynamic MR imaging of the sellar region at RSNA ‘90 presented further observations at this meeting (16). They found that dynamic MR was useful for delineating recurrent macroadenomas; these tumors enhance with Gd-DTPA later than the anterior lobe of the pituitary (which, in turn, enhances 30 seeonds later than the posterior lobe, infundibubum, and cavernous sinus). On the other hand, surgical filling materials displayed an enhancement peak that was even more delayed than that for tumors. Bromocriptinetreated tumors behaved similar to surgical filling matenab at dynamic scanning. Pituitary imaging with dynamic and 3D TurboFLASH was also discussed (15C, 17). Carlier et al (15C), however, cautioned that hypointense-appearing areas are seen within the gland very frequently on noncontrast studies with this fast gradient-echo method. Elster pointed out that susceptibility artifacts projecting upward from the sphenoid septum account for some of these false-positive images. Baker and colleagues (18) attempted to categorize the various germ-cell tumors based on their imaging features. Enhancement patterns were not helpful in differentiation. CT studies demonstrating fat and calcium within teratomas were useful in confirming the nature of highand bow-signal areas seen within these heterogeneous tumors on Ti-weighted MR images. Hemorrhage was reasonably common in teratomas and also in choriocarcinomas. Yuh and associates (exhibit 164) updated their results in studies determining the efficacy of higher doses (0.3 mmol/kg) of gadoteridob in demonstrating central ncrvous system metastasis. Higher doses improved lesion detection (46 new lesions in 19 of 27 patients) and lesion conspicuity (in 80 of 81 lesions). The additional informalion resulted in a modification of treatment in 10 of 27 patients. Haustein et al (143C) and Maravilla and colleagues (435) also found that a triple dose of gadoteridol was well tolerated by patients. Using standard doses of this agent in children, Ball et al (83) and Darling et al (exhibit 138) observed no serious reactions. Several tumorlike lesions that were sharply marginated and homogeneously enhancing (as seen on axial MR images) were shown by Kioumehr et al (exhibit 177); these proved, however, to be infarctions in the subacute phase. These lesions were observed in areas where there were transverse sulci and deeply infobded cortices (occipitab lobes and cerebelbar hemispheres). Other features were observed that eventually made correct diagnosis easy. The patients presented acutely. The lesions had no mass effect in the subacute phase, and images in other planes occasionally showed a more wedge-shaped configuration. They occurred in a vascular distribution. On follow-up studies, enhancement was no longer diffuse, and encephabomabacic changes eventually appeared. Tumor spectra are remarkably different from those of normal brain tissue according to Jassoy et al (ii). Their work with proton spectroscopy showed increased inositol signals in two-thirds of gliomas and elevated saturated fatty acids and cholesterol peaks in all metastases.
Volume
182
#{149} Number
3
.
.
RSNA
‘.
1 Meeting
Notes
However, no characteristic patterns were seen with meningiomas. Kamman et ab concluded that MR spectroscopic imaging may be useful in assessment of brain tumor grading and response to radiation therapy (861). Ogawa and colleagues observed that methionine positron emission tomography (PET) was limited in the grading of gliomas (10; exhibit 018). Kim et al found that PET with F-18 fluorodeoxyglucose (F-18 FDG PET) missed recurrent microscopic and low-grade astrocytomas (12). On the other hand, false-positive uptake was seen with this agent due to nontumoral postoperative tissue response and within inflammatory changes. Workers at Johns Hopkins University (1 139) described the use of a multidimensional imaging workstation that can be used in real time at surgery to interactively implement previously acquired cross-sectional head scans. This system has been useful in determining craniotomy sites and has been used in roughly 100 operations (ineluding surgery for skull base and other intracranial tumor). CT and MR images to be used interactively are obtained prior to surgery. It is helpful to apply markers at various sites on the patient’s head prior to imaging and to keep them in place through surgery. These markers and other anatomic sites and prominences on the head are registered with a sensor in the operating room so they correspond to those of the original images (the data set of which has been loaded onto the workstation). The tip of this six-jointed mechanical sensor transfers the reconstructed radiobogic data to the surgical site. Thus, the tip of a probe at surgery can be viewed on a television monitor relative to pertinent imaging anatomy. Thus far, the use of this “surgical bocalizer” has enabled more accurate placement of incisions (with respect to underlying tumors) and the use of smaller craniotomies. Two other interesting presentations incorporated 3D reconstruction of MR imaging data in surgical and radiosurgical brain and skull base tumor planfling (1139C, 1140). Multiple sclerosis-Shah et al (696) used heavily Tiweighted 3D MP RAGE to identify multiple sclerosis plaques and concluded that the sequence was equally sensitive compared to axial T2-weighted spin-echo studies. Many lesions were better seen with MP RAGE. Positiorting is not critical with this volume technique; this should prove useful when doing longitudinal studies of plaque size. Ordinary Ti-weighted spin echo can be deleted in evaluation of patients with multiple sclerosis when using MP RAGE. Frank and colleagues (700) did monthly gadoliniumenhanced MR studies and neurologic examinations in 10 patients with relapsing remitting multiple sclerosis, some being followed up as long as 21 months. Sixty percent of patients exhibited cyclical variation in the number of enhancing lesions. Around 50% of new contrastenhancing lesions appear without new clinical signs and symptoms. Enhancement usually lasts for less than a month, but in a very small percentage it may persist for up to 11 months. Bydder et al (699C) found in patients with multiple sclerosis that heavy diffusion weighting causes most Icsions to display a decrease in MR signal intensity whereas others showed an increase compared to unsen-
Radiology
#{149} 913
RSNA
‘9 1 Meeting
Notes
sitized images. This new approach appears to merit further investigation, since it may show changes not seen on conventional T2-weighted spin-echo images. Workers from Vancouver (697) and Philadelphia (698) have found new and abnormal resonances on localized proton MR spectroscopic studies that appear to be mdicators of myelin breakdown in patients with multiple sclerosis.
Koopmans
et
ab (697)
also
observed
instances
where diminished N-acetyl aspartate (NAA) later returned to normal, suggesting that NAA may be a marker of neuronab dysfunction and not necessarily neuronal loss. Hiehle et al (698) also found that there was a correbation between increased amino acid bevels and abnormalities on magnetization transfer imaging (MTI) studies. MTI is being used to enhance contrast between pathologic and normal tissues not only in multiple sclerosis (698) but in other conditions as well (i127C, 1128). Head trauma.-Heier and Zimmerman (601) found that MR was more accurate than CT in documenting the nature and extent of intracranial injury in birth trauma. Another advantage of MR is that it may show unsuspected changes in the upper cervical cord on sagittab head images. With MR, undisplaced skull fractures are routinely missed, but by themselves these have little clinical significance. Sivit et al (81) showed that intracraniab abnormalities may be found on CT studies (albeit infrequently) in children with low clinical risk or high Glasgow Coma Scale (GCS) scores. Studies by Lenkinski and co-investigators (145) provided evidence that coma in head-injured patients is associated with a metabolic state in which energy demand is markedly reduced. Decreased glucose utilization rates on F-18 FDG PET studies and high PCr/Pi ratios at localized P-31 MR spectroscopy were found. Fetal, neonatal, and pediatric ncuroimaging.-The recipients of a Magna Cum Laude award, Hansen et al (cxhibit 140), presented what is believed to be the first in vitro sequential MR imaging study of human developmental anatomy. Normal central nervous system appearances were emphasized by using formalin-preserved embryos and fetuses with gestationab ages of 8-38 weeks. Newer techniques currently being evaluated in older individuals are being applied to studies in neonates as well. Bydder et al showed that diffusion-weighted imaging is possible in the neonate with good gating and immobilization (i188C). It may prove highly sensitive to myelination, showing suggestive diffusion patterns in four of 33 cases despite the apparent back of myelination on conventional Ti-weighted images. Philadelphia investigators (906, 907) reported the implementation of MR spectroscopic studies in preterm and term infants. Certain spectra suggesting abnormalities in term infants may not be necessarily abnormal in preterm infants (907). Taylor (903) demonstrated that most major venous sinuses and deep veins were seen consistently on transfontanelle color Doppler US studies in full-term newborns. This technique can be useful in detecting and monitoring abnormalities of venous drainage, as well as characterizing arterial flow in infants (903, 1i92C). Using neurosonography, Dovgan et al (il9OC) showed that surfactant, used in treatment of respiratory
914
#{149} Radiology
distress syndrome, decreased the incidence of intraventricular hemorrhage, particularly in low-birth-weight infants. The presence of a fibrovascular mass, representing caudally displaced fourth ventricular choroid plexus tissue in the Chiari II malformation, is well known to neurosurgeons and neuropathobogists. This tissue, found dorsal to the cervical cord in the upper cervical canal, may enhance intensely with Gd-DTPA. Stark et al (1185) observed this finding in three patients with Chiari II and cautioned that this tissue should not be confused with a tumor mass or inflammatory lesion. In a review of 124 male patients with severe hemophilia, Wilson et ab (86) found high-signal white matter foci (single or multiple) on T2-weighted MR images in 11%. The cause of these unexpected lesions has not yet been proved. White matter MR changes in hyperphenylalaninemia may represent toxic edema caused by high phenylalanine levels. These changes may regress markedly after 3 months of strict dietary control, according to Bick et al (1189C). Propofol, a new ultra-short-acting alkylphenol sedative, has been used primarily as an anesthesia induction agent. Goske et al compared intravenous propofol to intravenous Nembutal as sedative agents for pediatric imaging. A significant advantage of the new agent is its extremely rapid recovery time (85). Fast MR imaging-Acceleration of interest in faster imaging techniques in neuroradiobogy was evident at RSNA ‘91. Even ultrafast techniques have been empboyed. The main clinical applications have been dynamic imaging of the pituitary region (17) and sequential cerebral perfusion studies (905). Rosen (RSNA/ AAPM Symposium) showed wondrous echo-planar brain images obtained in a fraction of a second. Functional images of regional cerebral blood volume can be obtained by exploiting the alteration of paramagnetic properties of hemoglobin, rebated to its oxygenation state. These MR images are not unlike functional PET studies. An exciting example of visual cortical activity was shown manifesting as a sudden increase in occipital signal intensity following photic stimulation. Considerable attention was paid to FSE imaging (432C,
433,
434).
A number
of
experts
seem
to
be
nearby
convinced that conventional spin-echo imaging of the central nervous system will ultimately be replaced by other methods. The marked reduction of examination time made possible with an FSE sequence is a product of its ability to encode separately up to 16 echoes per TR. Atlas et al (434) challenged the effectiveness of long TR FSE by comparing it with conventional long TR spin echo in detection of focal brain lesions. All patients who had focal intraparenchymab lesions on spin-echo images also had focal lesions on FSE images. Cerebral contrast characteristics were deemed nearby identical. However, the lesser sensitivity of FSE to iron may be of some importance; it was noted that normal brain iron accumulation appeared less hypointense on the rapid examination. However, the brighter appearance of fat compared with intensities on conventional TR images seems to be less significant. Kalina et al (432C) displayed that higherresolution 2D and 3D T2-weighted FSE is capable of cx-
March
1992
;:
-,
cellent
resolution,
showing
anatomy and small and petrous bone. specific Elster
comparisons and Provost
details However,
fine
vascular
intracranial
within the cavernous sinus Kalina did not make many
in his general overview. described their experience
with
large-tip-angle spin-echo (LTASE) imaging (429). Examination time can be shortened by 30%-50% by reducing TR. These images appeared somewhat noisy; the availability of FSE may make LTASE imaging less important. Wehrli (RSNA/AAPM Symposium) presented an excelbent discussion of the theory and methods of fast MR imaging techniques in reviewing gradient-echo, half Fourier, and FSE pulse sequences. The speed of each of these was analyzed in terms of how data acquisition was obtained in k-space. Gradient-echo or spin-echo imaging requires a full set of phase-encoding pulses; thus imaging time is limited by TR. Half-Fourier imaging relies on symmetry of the echoes; it requires approximately half of a phase-encoding set, and, therefore, approximately half of the acquisition time is needed. As mentioned above, much effort has been expended recently in the acquisition of images very similar to T2weighted spin-echo images with greatly reduced imaging times. In accomplishing this, additional gradient pulses have been used to acquire multiple phase-encoded echoes from a single 90#{176}-180#{176} radio-frequency pulse pair. Other considerations.-Hudgins et al (430) found that 3D Ti contrast images generated with a spoiled gradient recall sequence are at least comparable to (or, perhaps, preferable to) conventional 2D Ti-weighted spin-echo studies. The 3D studies have superior S/N and graywhite demarcation, but they are more sensitive to patient motion. Others have shown, however, that routine Ti-weighted spin-echo sequences are superior to fast gradient-echo Ti-weighted sequences in detection of contrast-enhancing lesions (1129). Dabbey et ab (436) showed that fat-saturation, gadolinium-enhanced sequences may demonstrate slowly flowing blood within many venous structures at the skull base. These channels may result in symmetric ring, target, or tubular enhancement within optic, hypogbossal, carotid, and facial canals, foramina ovale, lacerum and rotundum, and other basilar structures. Mark and colleagues (1133) showed that enhancement of the third nerve on gadolinium-enhanced MR images is always abnormal, usually resulting from an inflammatory or neoplastic process. Ischemia may also be a cause. A third nerve palsy may or may not be present when enhancement is seen. In three cases both enhancement and symptoms resolved together. Hansman-Whiteman et al (702) reviewed MR findings in 47 patients positive for human immunodeficiency virus (HIV) with progressive multifocab leukoencephabopathy (PML). Posterior fossa white matter involvement was not rare (that may be the only site). The basal ganglia, corpus callosum, and temporal lobe may also be involved. Gd-DTPA enhancement in PML lesions is uncommon, but contrast material is needed in HIV patients for evaluation 30%). Mirowitz
and
Volume
#{149} Number
182
of concomitant colleagues
3
infection (139)
showed
(which significant
occurs
in hy-
RSTA
‘91
Meeting
Notes
perintensity (on Ti-weighted images) of the globus pallidus (especially the medial segment) in nine patients treated with long-term total parenteral nutrition. There was variable involvement of adjacent structures. This finding may be due to deposition of parenteralby administered manganese and/or other trace metals. Several papers described observations associated with radiation-induced injury to the brain. Gaensler et al (958) described single (five cases) or multiple (12 cases) lesions, punctate or up to 2.5 cm in diameter and within radiation portals in patients treated for central nervous system neoplasms. High and low MR signals corresponded to hematoma with hemosiderin in five cases with pathologic correlation (no tumor was present). Findings volvement
of normal-appearing (on pretreatment
brain imaging
in the area of instudies) and
records of high dose levels supported radiation treatment as the cause. Yousem et al found low NAA/creatine-phosphocreatine (NAA/CR) ratios in radiationinjured brain; this ratio separated radiation-injured from normal brain within the framework of their project. A number of interesting presentations dealt with findings in patients with seizures. Hugg et ab (146), in 10 patients with medically refractory epilepsy (studied interictally and blinded to the abnormal side) were abbe to lateralize correctly the ictal focus in each case by using P-3i MR spectroscopic imaging. Studies by Glicklich et al indicated that MR readings alone can be misleading in patients with temporal lobe seizures; qualitative MR has low sensitivity in the evaluation of mesial temporal sclerosis (147). Exhibit 109 (by Tampieri et ab) showed the value of MR in two patients with temporal lobe epilepsy by nicely demonstrating temporal lobe meningoencephaboceles. Orrison et al (exhibit 145) have successfully localized neuronal activity within somatosensory and auditory cortex by using a 37-channel biomagnetometer in eight volunteers. A display of electrical activity can be superimposed on MR images, thus creating a functional map.
Spine Disk disease-A
Special Focus Session entitled “Controversy, Communication, and Diagnosis in Lumbar Disk Disease” was one of the meeting highlights. The panel, chaired by Kricheff, also included Bryan, Haughton, Miller, and Modic. Terminology, diagnostic approach, relative value of the various imaging methods, anatomic-pathobogic considerations, and clinical considerations in diagnosis and treatment were actively discussed with vigorous audience participation. As expected, many differences of opinion emerged. It seems that this multifaceted subject is a complicated one for neuroradiobogists, and there are many variables that make scientific analysis difficult. At present, technology is changing rapidly. Disk disease may be a self-limited disorder. As Haughton observed, surgeons have difficulty separating bulging disk from true herniation at operation. Bryan’s comments reminded us that this is not strictly a radiobogic problem; the imaging approach should take into account the clinical picture, and, furthermore, patient outcome should be included in studies evaluating diagnostic accuracy of imaging methods.
Radiology
#{149} 915
RSNA Nevertheless, ganizing
‘9 1 Meeting
there a national
ogy as well problems.
Notes
seems to be much sentiment consensus conference on
as other
aspects
of imaging
for
for orterminol-
lower
back
of MR as a substitute for myelographic the evaluation of lumbar and cervical disk disease is increasing, and thorough data presented support this (596, 600). However, conservative clinicians and neuroradiologists at several outstanding institutions still continue to use myelography somewhat extensively. Several presentations documented that some of the newer MR techniques offer good images in patients with degenerative disk disease with decreased imaging times Acceptance
studies
in
(328, 598, 599). Deutsch et ab (868) both before and after ful lumbar diskectomy was
there
nucleus the disk
complete pulposus;
space
virtually
no
reviewed MR studies obtained (mean, 1.6 years) clinically successin 15 patients. In only a few cases imaging
resolution
of
the
herniated
extradural defects in continuity with persisted in most. In three cases there was
change
compared
with
preoperative
stud-
ies. Intense enhancement was noted in each extradural lesion when gadolinium was used, indicating fibrosis. A George Washington University team (869) showed an orderly progression of imaging changes (with a tendency toward stabilization by 6 months) on sequential postoperative MR images following successful diskectomy.
Contrast
enhancement
of
decompressed
nerve
roots gradually subsides. Correlation of gadolinium-enhanced MR findings with symptoms appears to be limited in postoperative patients; 13% of their asymptomatic patients showed persistent mass effect with rim enhancement at 3 months. Milwaukee investigators (871) showed that immature postlaminectomy scar has less enhancement than mature scar. Enhancement becomes more homogeneous with time in mature scar tissue. Thus, in an early postoperative patient an area thought to represent recurrent disk might possibly be immature scar tissue. These workers also showed that greater contrast enhancement in scar was appreciated when MR images were obtained at 2-15 minutes after injection (compared to later) and when higher doses were used. Vascular ina!formations.-Rolland and co-workers (i68C) reported on the use of phase-contrast MR angiography
in
the
follow-up
of
patients
undergoing
em-
bolization correlations draining treatment.
of spinal cord vascular malformations. With with conventional spinal angiography, veins were seen in their entire length before The disappearance or diminution of these
veins
postembolization
on
MR
studies
is a useful
nonin-
vasive criterion of the efficiency of embobization. Latchaw and colleagues (872) pointed out that cord congestion resulting from slow venous drainage of spinal AVMs may result in appearances suggesting hyperintense cord tumor on MR studies. This appearance, in conjunction with low-intensity structures (particularly those that are serpentine), makes further evaluation for cord vascular malformation necessary. Trauma-Several presentations dealt with the value of MR imaging in prognosticating outcome in cases of spinal cord injury (476, 477; exhibit 110). Takahashi et ab
916
#{149} Radiology
showed changes
that the extent on T2-weighted
compression initial study,
and duration images and
on the initial study were high-signal cord changes
of high-signal the severity significant. extending
cord of cord On over
the
two vertebral bodies indicate that improvement will be infrequent and that there is only a 5% chance of cornplete recovery (20 cases studied). When such changes over two segments persisted on subsequent studies, however, there was no improvement in any of five cases studied. Results are better when there are small areas of hyperintensity and when such abnormalities clear (476; exhibit iiO). Flanders et al (477) showed that the percentage of motor recovery was only 9% when a single MR study obtained within 14 days of injury demonstrated an intramedublary hematoma. Heier and Zimmerman (601) showed that MR demonstrated unsuspected cervical cord contusion and complete cord transection on sagittal head MR images in a series of neonates studied because of documented traumatic dclivcry. Pediatric spine-Byrd and associates (604) revealed that high-resolution, gadolinium-enhanced MR is very sensitive in detecting spinal canal spread of central ncrvous system neoplasms. In studying 55 children, there was very close correlation with findings at water-soluble myebography and cerebrospinal fluid cytology; in one case, however, cytologic results were positive, but both imaging studies were negative. Schumacher and Kroll (ll9iC) showed with US that the caudal spinal cord always moves both ventrodorsally and craniocaudally in normal children. A tense thick fibum or postoperative scar with tethering may hinder these undulatory movements. Meningomycbocele patients with cord motion fare better than those who do not exhibit cord motion. Technical advances..-Sze et al (478) observed that T2weighted FSE sequences are capable of producing images of spinal cord pathologic conditions diagnostically comparable to standard spin-echo studies. Yet, FSE may reduce imaging time in the spine by 70%-80%. Adjustment of several parameters (echo train length and echo spacing) is required to obtain optimum images. Optimization for extradural disease, on the other hand, involves use of a separate set of parameters at present (327). Osseous lesions (such as metastases) may be missed on ordinary T2-weighted FSE studies (433); this needs to be more fully addressed. Nevertheless, Modic (RSNA/AAPM Symposium) reminded us that the reduction of motion artifact related to relatively short acquisition time is an important factor giving FSE great potential for spine imaging. Miller et al (exhibit 175) demonstrated the advantage of a six-coil system for spine imaging. Once in place, the MR operator chooses which four coils will be active, depending on the site(s) to be imaged. Thus, multiple coil placements are not required. This multicoil system gencrates high-quality images of the spine in less time than conventional coils. Felmlee and colleagues (852) showed that patient motion during spine imaging can be compensated for by using an imaging pulse sequence with interleaved projection (non-phase-encoded) echoes located cranial and
March
1992
t
:
caudal to the axial image stack. Movement was evabuated with motion-detection algorithms, and weighted corrections were applied to the image echoes with a special reconstruction program. Other preventive measures were incorporated to deal with physiologic motion. By incorporating such corrections, excellent high-resolution Ti-weighted spine images can be obtained despite motion. Other considcrations.-Yu and Rosenbaum (330) emphasized that the thin posterior longitudinal ligament can be seen only as a discrete entity on midsagittal MR images below the L4-5 level because of fat in front and behind. Cryomicrotome studies showed that this ligament is intimately related to bow-intensity normal structures at higher levels. Phase-contrast studies to evaluate normal and abnormab cerebrospinal fluid motion in the spine continue (472, 473, 474). Bradley and colleagues (473) showed that phase-contrast studies with the patient in the prone position may be useful in excluding posterior tethering of the spinal cord. His group (473, 1126C) also showed that velocity images can help outline spinal arachnoid cysts by delineating their sharp margins; meanwhile cyst motion is easily appreciated since it is not in phase with surrounding cerebrospinal fluid (“rebound sign”).
Magnetic
Resonance
______________
Richard L. Ehman, MD, Mayo Clinic, Rochester, Minnesota R. Nick Bryan, MD, PhD, The Johns Hopkins Hospital, Baltimore John V. Crues, MD, Santa Barbara Cottage Hospital, Santa Barbara, California Robert J. Herfkens, MD, Stanford University School of Medicine, Stanford, California Hedvig Hricak, MD, University of California Medical School,
San
Herbert
Francisco
Y. Kressel,
Pennsylvania,
Robert
E. Lenkinski,
Pennsylvania,
Donald
MD,
Hospital
of the University
of
Philadelphia
PhD,
Hospital
ofthe
University
of
Philadelphia
G. Mitchell,
MD,
Thomas
PhD,
Mayo
Jefferson
Hospital,
Philadelphia
J.
Stephen
Riederer,
Clinic,
Rochester,
Minnesota
Jeffrey
R. Ross,
Mitchell
MD,
D. Schnall,
Pennsylvania,
Cleveland Clinic, Cleveland MD, Hospital of the University
of
Philadelphia
Index terms: Magnetic resonance (MR), contrast enhancement #{149} Magnetic resonance (MR), physics #{149} Magnetic resonance (MR), spectroscopy #{149} Magnetic resonance (MR), vascular studies #{149} Radiological Society of North America, 77th scientific assembly and annual meeting Radiology ‘ RSNA,
1992;
182:917-922
1992
Clinical magnetic resonance (MR) imaging years old, yet the growing impact of this most areas of diagnostic medical imaging apparent at RSNA ‘91. More than one-third
is less than 10 modality on was readily of the 1,272
RSNA refereed modality.
Neurologic
182
#{149} Number
3
abstracts
MR
in the
scientific
Notes program
involved
this
Imaging
The rapid pace of development of MR angiographic technology and techniques of the past few years is leveling off as the field matures. Comparison of different MR angiography techniques and comparison of MR angiography to more conventional modalities continues to drive the field. Two-dimensional (2D) time-of-flight (TOF) MR angiography was shown to be equivalent to ultrasound for evaluation of the carotid bifurcation (164), and three-dimensional (3D) phase-contrast imaging was considered superior to 3D TOF studies for intracraniab pathology (171). Multiple overlapping thinvolume acquisition (170, 582) was shown to be superior to a single-volume 3D TOF technique for intracranial pathology. Technical innovations for MR angiography included a higher resolution 512 x 256 matrix providing improved lumen definition (165); a new barge-field-ofview head coil allowing imaging of both head, neck, and arch vasculature (166); and the use of a timed injection of Gd-DTPA to correspond to the bow-order phase encoding to increase conspicuity of small vessels (169). MR angiography has also shown increased use at lower field strengths, both at 0.5 T (3D and 2D TOF) (410) and with a permanent magnet at 0.3 T (2D TOF) (847). New methods of postprocessing continue to improve MR angiography quality, such as TRAP (traced-ray with array processor), which was shown superior to conventional maximum intensity projection (MIP) (952). Simulated flow streamlines were created by using phase-contrast MR angiography in both aneurysms (172) and the cxtracranial carotid vessels (577), a subject that previously could be studied only intraoperatively or in vitro. Magnetic susceptibility contrast-enhanced MR imaging enables early visualization of cerebral perfusion deficits during temporary ischemia in the cat middle cercbra! artery model (425C). This approach is promising for clinical application. Studies evaluating the safety and efficacy of tripledose-O.3 mmol/kg-Gd-DTPA injection for MR contrast enhancement reported this dose to be clinically safe and produce greater conspicuity of enhancing lesions (143, 435). Localization of focal epilepsy foci remains a clinical challenge. P-31 MR spectroscopic imaging with a 3D technique found statistically significant differences in spectra from electrically abnormal temporal lobes versus electrically normal temporal lobes during the inner ectal period. pH was increased as was inorganic phosphate, while phosphomonoestcrs were decreased in the abnorma! temporal lobe (146). Standard MR imaging was found to be relatively insensitive to medial temporal sclerosis, in contrast to previous reports (147). Spine MR imaging also continues to be an active area of interest. Fast spin-echo (FSE) (RARE) imaging showed good results in the evaluation of spine degenerative disease and intramedullary disease (328, 433, 598, 478), compared to conventional T2-weighted spin-echo technique. Optimization is necessary to minimize artifacts and
Volume
‘9 1 Meeting
blurring
(327).
Focal
brain
lesions
are
detected
Radiology
with
#{149} 917
RSNA
‘9 1 Meeting
FSE imaging with an accuracy that matches the range intraobserver variation present in the routine T2weighted spin-echo images (434). Fat-suppressed T2weighted spin-echo imaging allowed an improved
of
cerebrospinal fluid myebogram effect compared to conventional T2-weighted imaging (326). The diagnosis of cord and caudal brain stem tethering or compression (as in Chiari malformation) and arachnoid cysts all benefited from cine phase-contrast imaging (473, 474). A 1-minute modified spin-echo acquisition allowed display of the cord motion without cine techniques (475). The role of MR versus computed tomography (CT) in the evaluation of spine degenerative disk disease was evaluated in two papers. MR was shown to be equivalent to CT myebography and plain CT for lumbar disk disease. It was suggested that in patients with a high probability of disease, MR should be used; in patients with a low probability of disease, plain CT is the test of choice (596). A bow-flip-angle volume gradient echo MR technique was demonstrated to be equivalent to CT myebography for cervical degenerative disease (600). Longitudinal studies of disk disease in the previously unoperated and operated lumbar spine were presented. Sequential studies in the unoperated spine showed decreasing size of herniations with time in 63% of cases (597). In the operated spine, persistent extradural defects were seen in patients with a mean of 1.6 years since successful
also, after
surgery,
an orderly diskectomy
mass
effect
representing
progression was seen
at
the
surgical
epidural
fibrosus
of postoperative (869), with 38% site
which
resolved
(868);
changes showing with
time.
Fat-suppressed MR after Gd-DTPA administration was shown to increase the depiction of epidural scar (870), and higher doses of contrast agent (0.3 mmob/kg gadoteridol) improved visualization of scar in a dog model (871).
MR
imaging
injuries
can
performed acutely after cervical spine predict ultimate neurobogic recovery. intermedulbary hematomas have a signifiprognosis than those with intermedullary
help
Patients with cantly worse edema (477). Spinal cord metastases in children were found to be equally well detected with gadolinium-enhanced MR as with CT myebography (604). 3D TurboFLASH of the pituitary was shown to have a high sensitivity but poor specificity and poor positive predictive value for adenomas. This was ascribed to the various hypointensities seen in the pituitary with this sequence (15). Dynamic TurboFLASH imaging with contrast material allows for detection of cavernous sinus invasion by adenomas (17). Head and neck MR imaging appeared to be dominated by the use of techniques with contrast material and fat suppression and those achieving improved resolution. Normal facial nerves can show enhancement,
even
if they
around brynthine riety of ment is foramina cause of
918
the
are right-left
symmetric,
and
particularly
geniculate ganglia (191). In comparison, baenhancement is abnormal and is seen in a vaconditions (20), and endolymphatic sac enhanceassociated with M#{233}ni#{232}re (21). Most skull are seen to enhance with fat saturation bethe skull base venous plexus (436). T2-weighted
#{149} Radiology
appear
studies cochlcar
useful
implant
obliteration
in the
.
.
by
of the cochlea
(26).
evaluation
showing
the
of
fibrous
MR appears
extension of adenoid overcall of bone disease
extension (712). correction with and Ti-weighted
.
preoperative
candidates
show intracranial but may cause
conspicuity
“
‘
.
useful
to
cystic carcinoma and perincural
Tumor margin and signal showed no the grade of parotid neoplasms (7i3), unenhanced images showed the best
of parotid
lesions
in 81 % of cases
Cardiothoracic MR Imaging Evaluation of MR contrast media
(714).
for cardiac
imaging
continues to be an active area of research (56, 59, 629, 746, 999). Fast MR imaging techniques were shown for first-pass contrast enhancement studies of cardiac shunts (742) and rapid measurement of cardiac ejection
fraction
(630)
ages of the (53). A variety
tion
and
have
proximal
of quantitative
were
reported
progress
provided
in the
of pulmonary
the
coronary MR
most
detailed
anatomy
reported
studies
of cardiac
(54, 58, 627, 740, 743, 744), use
of MR
artery
flow
volumetry
(626).
myocardial motion with contrast techniques were (628, 745). 3D myocardiab tamed with phase-contrast
for
Methods
the
imto date func-
including assessment
for measuring
saturation tagging and phasethe subject of further reports motion measurements obmethods correlated well with
radiographic measurements of motion obtained with tantalum markers attached to canine hearts (57). In a session on MR imaging of the vascular anatomy of the lungs, detailed images were presented that were remarkable for the wide variety of techniques used (386-388, 390). These included contrast-enhanced multisection gradient-echo images, electrocardiogram-triggered single-section spoiled gradient-echo images, and thick-section 2D gradient-echo images, all with echo times less than 3 msec. With all techniques, fifth-order branches of pulmonary arteries were depicted. While the optimum technique remains unestablished, it appears that high-quality pulmonary MR angiography is rapidly becoming a reality. With some of these techniques, thrombus may have similar signal intensity to
flowing
blood,
establish the bobus (388).
however,
so further
sensitivity
for
work
detection
is needed
to
of pulmonary
em-
Overall, the combination of more thorough examination of existing technologies and the continued development of more rapid and improved imaging techniques has
shown
significant
for evaluation RSNA
‘91 has
shown
which
suggest
that
the
chest
reached
in major
ent-echo
and
an exciting
the
rapid
vascular
capabilities
thoracic
progression
growth
of MR
diseases. of studies,
of applications
structures
has
not
in
yet
of the Breast
of fat-suppressed,
imaging
of the
contrast-enhanced,
of the breast
interest (260). The vious investigators than normal breast
evidence
in the
its peak.
MR Imaging A study
advances
of cardiovascular
generated
results supported that breast cancer tissue, and they
value
of MR imaging
3D
gradi-
considerable
observations of preenhances more provide preliminary
as an adjunct
March
to
1992
rt’::
conventional ported
mammography.
in a larger
echo
techniques
Abdominal Clinical uation sented
of patients
(263).
tiate between (709). Current methods for breast lesions
Similar
series
results
MR imaging
radiation research MR-guided (707).
MR Imaging experience with
gastrointestinal
agents
continue
re-
with
appears
MR contrasts
tract, (28-31,
The
lesions. of
in the
eval-
abdomen reprethe identification
investigations
33, 35).
oral
role
of
of distribution of the contrast material was emphasized (29), particularly the effect of viscosity and particle distribution as a function of the magnitude of the susceptibility-related artifacts, which can be identifled with some agent formulations. Particularly promising results were demonstrated with a new agent (consisting of ferric iron with inositol hexaphosphate) (33). This agent appeared to distribute uniformly and demonstrated minimal related artifacts. Thus, bowel lumen and the entirety of the bowel wall could reliably be visual-
ized
in a series
of animal
to weigh
administration
studies
the
benefits
against
the
that
were
or oral
financial
presented.
contrast
costs,
It
agent
logistic
the
metastases, Promising coborectal
homogeneity
is difficult
Limited investigation of pancreatic MR imaging continues. In one study, 52 patients from several institutions were studied with dynamic CT and MR imaging including Ti- and T2-weighted spin-echo, gradient-echo, and short-tau inversion-recovery techniques. There was no significant difference between CT and MR imaging for demonstrating
regarding
important
Notes
liver tumors. The signal-to-noise ratio was highest with T2-wcighted fat-suppressed images. Enhanced gradient-echo images helped characterize
to differen-
agents
1 Meeting
characterizing
spin-
fibrosis and tumor recurrence is also directed at developing percutaneous baser ablation
of the gastrointestinal tract and a major theme at RSNA ‘91. For
of the
were
imaged
RSNA”9
carcinoma,
tumor
or nodal
or hepatic
either
with
balloon
staging
of
insuffiation
or
surface coil imaging (686, 687, 690). The initial report of the Radiology Diagnostic Oncology Group in comparing MR and CT with body coil techniques in staging coborectal carcinoma showed that the two techniques were comparable at the present state of development (686). Additional experience in the usc of MR for evaluation of recurrent rectal carcinomas was presented (688, 689). Dynamic imaging with Gd-DTPA appears to offer improved ability to depict recurrent carcinoma and to differentiate it from scar and inflammatory conditions. Few new MR imaging.
diffi-
primary
or vascular invasion (968). results were presented in local
results were presented in the area of renal Further studies confirmed last year’s pre-
cubties, and impact on patient tolerance. Another major thrust in the application of contrast agents to MR imaging of the abdomen was a series of studies reviewing clinical experience with Mn-DPDP (181-183, 185, 971). This agent causes enhancement of normal liver parenchyma, thereby improving lesion de-
sentations on the value of contrast-enhanced images in the diagnosis and characterization of renal masses (197). Potential technical pitfalls in interpretation of contrastenhanced renal MR imaging studies were described (199).
tection
Pelvic
in Ti-weighted
pears facial
spin-echo
to be safe, although minor flushing are not uncommon.
images.
The
agent
adverse effects As the agent
ap-
such as is a di-
rect hepatocebbular contrast material, it may provide cvidence of hepatocelbular function and may be useful in distinguishing primary liver lesions, both benign and
MR Imaging
In evaluating
the
attention was with Gd-DTPA Once again,
paid to the role of contrast enhancement and similar agents (44-46). the technology of prostate MR imaging
was
a focus
bladder
of major
interest.
with
MR
imaging,
A number
significant
of presentations
malignant, from secondary liver neoplasms (185, 183, 6i8). Promising results with Mn-DPDP as a pancreatic contrast agent were also reported (971). Apparently, this agent improves pancreatic delineation and lesion detec-
dealt with various combinations of FSE (RARE) sequencing, closely coupled external radio-frequency (RF) coils or arrays, and endorectal RF coils (285, 286, 984, 985, 990). These papers showed excellent morphologic detail.
tion.
Mixed
Also
notable
at RSNA
‘91 was
some
increased
activity
in MR of the biliary tract and gastrointestinal tract. tiab results of 3D MR cholangiography with gradientecho techniques were reported (614, 615). Abnormal ducts could be delineated, likely with improvement to be an important MR (32) reported morphologic
tion
of the
different
to differentiate neoplasm.
Two phy with
papers
acute
mibile
as well as obstruction. It is in technique this might prove application. An interesting paper patterns based on observa-
layers and
reported
in the chronic
high
for displaying portal portal hypertension
wall
accuracy
venous (1142,
of the
cholecystitis,
gallbladder as well
of MR angiogra-
anatomy in patients 1143). Ultrafast T2-
weighted images acquired with echo-planar technique were highly effective for detecting liver tumors (1145). In paper 1i48, various MR techniques were compared with dynamic contrast-enhanced CT for detecting and
Volume
182
#{149} Number
3
as
reports
were
presented
on
the
use
of gadolinium
contrast enhancement of the prostate anatomy and pathology. While paper 988 demonstrated the usefulness of contrast enhancement in selective cases, paper 989 showed little benefit of contrast enhancement over noncontrast T2-weighted images. Contrast-enhanced MR imaging was also reported in the evaluation of testicular tumors (49) and penile physiology (347). In a single paper investigating the use of endorectal surface coil imaging in patients after radical prostatectomy (986), MR imaging
it was demonstrated that was valuable in attempting
high-resolution to detect
recurrence after radical prostatectomy. MR important role in studying the evolution of tatic hyperplasia (987). Gynecobogic MR imaging continues to be major interest, with considerable activity in technology. The FSE technique was shown tageous for imaging the female pelvis (454,
a local
may have an benign prosa focus of the area of to be advan456). Excel-
Radiology
#{149} 919
RSNA lent anatomic array RF coils
‘9 1 Meeting detail (454)
was shown and endorectal
with
Notes
the use of phasedcoils (458). Fat
.
ation of the arthritides. proper MR technique
suppression was shown to be helpful for characterizing ovarian masses, by distinguishing between hemorrhage and fatty tissue (458). Considerable improvement in the assessment of the depth of myometriab invasion of endometrial carcinoma was provided by administration of intravenous Gd-DTPA (455). The use of MR imaging in gynecobogic radiation oncology as a predictor of patient outcome (462) and the ability of MR imaging to distin-
postcontrast
guish
ation
of muscle
ising
clinical
ing
radiation a new
changes
field
from
of gynecologic
recurrent
tumor
are
open-
imaging.
tion
MR Imaging
of MR imaging in muscubowane at the RSNA ‘91. Joint imtopic of great interest, and wrist of particular interest. Refineof instability and ligament inju106). Motion studies may imof instabilities (99, 102). the clinical accuracy of MR of carpal tunnel syndrome was discussed with emphasis on the role of MR imaging in the setting of equivocal clinical and electrophysiobogicab findings (104, 105). New high-resolution techniques appear accurate in determining causes of operative failures (i03). Shoulder imaging was also a major topic of discussion. Data were presented in support of the accuracy of MR imaging for evaluating shoulder instability, in cases of superior babrab, anterior, and posterior (SLAP) tears (376), anterior and posterior labrab tears (377), and after acute dislocation (380). Morphologic criteria appear more useful than signal intensity in detection of labrab tears (377). The potential advantages of intraarticular (378, 379) and intravenous (1214) contrast agents were reviewed. MR arthrographic techniques are particularly useful in young athletes suspected of suffering from dynamic instabilities when the routine MR imaging study does not reveal an injury to the labrum or glenohumeral ligaments. Techniques for evaluation of rotator cuff disease (913-915), the coracoacromial ligament (916), and suprascapular nerve entrapment (917) were presented. Progress in MR imaging of the knee emphasized the evaluation of anterior cruciate ligament tears (515, 1226) and follow-up evaluation of anterior cruciate ligament surgical repairs (5i6, 518, i222-1224, i225C). Knowledge of the normal progression of intraligament signal changes after reparative surgery is necessary for proper interpretation. The patelbofemoral joint and tracking studies stated important robes for MR in studying the physiology and functional pathology of this articulation (514, 5i7, 519, 520). Dynamic imaging with muscular contraction is more sensitive to early tracking abnormalities than passive kinematic studies. Intraarticular (1228) and intravenous (1229) contrast agents show promise as adjuvants to standard MR knee imaging. The use of 3D techniques for meniscal tears was addressed (521), as was the significance of signal patterns in aging menisci (1227).
MR
920
imaging
#{149} Radiology
has
been
used
sparingly
in clinical
evalu-
is useful
in rheumatoid
in the
arthritis
with and
detailed
depic-
(1214-1217,
1219-
and the role was emphasized
of MR and
is essential in evaluation
clarified.
Imaging
cisc were imaging
detailed in multiple reports (107-ill, 113). MR has become an important modality in the evalu-
for locomotion, of this tissue
and
spectroscopic
physiology roles
for
to sports
treatment
Enthusiasm for applications skeletal diseases did not aging continued to be a MR imaging was a focus ments in the evaluation ries were presented (98, prove accuracy in detection Additional data confirming imaging in the evaluation
imaging
can be evaluated 1218). Routine
1221). Muscle imaging
athletes Muscuboskeletab
MR
of lesions
Cartilage (101, 1213,
and
the
use
injury
of MR
activities
after
are
actively
modalities
changes
(1i2,
after
114).
in timing
injury
and
under
exer-
Prom-
return
of
selection
of
investigation.
“Magic-angle” effects on normal signal from tendons were clarified (919). Patellar (920), sinus tarsi (921), and lateral collateral ankle ligament (922) injuries were reviewed.
The well-documented importance of MR imaging in evaluation of marrow disorders was further documented in scientific sessions. Refinement in the MR imaging assessment of ischemic disease was presented (268, 273-275). osteoporosis necrosis was
neoplasm cially
The possible close association and early, possibly reversible, suggested (269). Differentiation
and
in the
fracture
spine.
can be difficult
The
role
of MR
of transient avascular between
clinically,
imaging
espe-
in this
clinical
dilemma was addressed in multiple MR imaging criteria in the evaluation
papers (656-659). of primary and
recurrent neoplasia 948). Techniques
(792-794, 795C, 797, MR imaging of the
skeletal use
system
of MR
for
for metastases
imaging
eboma (944-946), transplantation Muscuboskeletal as well.
were addressed screening with in the
were
evaluated
evaluation
(943).
of multiple
bymphoma (949), beukemias (947, 95i) was addressed. soft-tissue masses received
Imaging
findings
in Morton
The
my-
(950),
and
attention,
neuroma
(1044),
extraskeletal osteosarcoma and chondrosarcoma (1047, 1048), and giant cell tumors (1049, 1050) were presented. The possible roles of P-31 spectroscopy in monitoring response
provide
to therapy
limited
were
specificity
shown
(1046).
MR
in differentiating
findings
benign
from
malignant solid soft-tissue masses (794). Techniques with MR in the evaluation of bone mmera! were presented with both T2* and spin-echo sequences as well as spectroscopy (800, 804, 808). The clinicab role of MR among other modalities in the evaluation of osteoporosis requires further clarification.
MR The rum and were
Spectroscopy annual meeting of the RSNA continues to be a fofor the presentation of new and exciting technical clinical studies involving MR spectroscopy. There a number of both technical and clinical developments reported at this year’s meeting that provide mdications
that
spectroscopy
is continuing
portant role in radiology departments Overall, there was an increasing
to pbay
across emphasis
an
im-
the world. on proton
spectroscopy in the brain in many of the clinical studies. Studies of brain tumors suggest that the concentration
of lactate the level
correlates of lactate
with the grade appears to stay
of tumor, and high in tumors
that that
March
1992
.
do not respond to therapy (861). A mathematical model for estimating the lactate concentration under a variety of conditions was presented (853). The role of proton spectroscopy
in studying
attention. (MS)
Studies
have
white
correct cases.
tion
baterabization Another study
of the
than system
that
proton
disease
to study
focal epilepsy phosphorus
of the seizure that received
demonstrated
sitive vous
provide
spectroscopy
refractory proton and
received
pathophysiobogy
may
patients
demonstrated spectra permitted
focus in all of the considerable atten-
spectroscopy
is more senof central ncr-
MR imaging in the detection human immunodeficiency
virus
infection
papers
for cardiac
presented the in model systems.
rejection
(856),
results These
fructose
of spectroscopic included models
loading
(862),
proton The
and phosphorus spectroscopy emergence of controlled and
studies
that
show
clinical
is an
important
trend.
MR
Imaging
Physics
applications
during
meeting,
oped imaging
spectroscopy
Thursday
to clinical
and
flow
and
period
brings gists. those based
of the
the
imaging,
area
182
per
in the
past
RSNA
of newer is that
it
as well as clinical radioboattended sessions were were presented that were that have been developed
1 or 2 years.
pulmonary,
of cardiac
meeting
imaging,
and
These
#{149} Number
3
unit
included
Images
in which as refined
were
magnitude about
flow
patterns
1
brain techof the
imaging.
However,
bevel. detail
this
The
field
cere-
into
number
so that
time
by
work
within
an FSE
spatial
sequence
standard
a breath
(308, 310). echoes an
measurements
hardware
is to provide
itself
resolution
to provide
of phase-encoding
using
contin-
FSE sequence
effects can be better understood were presented in which gradient
of this
images
in
(386-390).
in areas imaging,
to assess
in more
goal
high-quality
(685).
One
T2-weighted
hold.
Other interesting presentations that will likely lead to future developments included discussion of a miniature endoluminab detection coil (60), studies of magnetization transfer (683, 684), studies of the effects of susceptibility (304), the use of recursively determined RF pulses to provide excitation of saturation of arbitrary regions and
the
use
of MR
imaging
for
stereobogic
analysis
of bone (851). In summary, the clinical and physics MR presentations at RSNA ‘91 demonstrated the short delay time between development of new techniques and their clinical use. Additionally, there continue to be many areas in which future refinements are expected.
neuroradiologic
presentations
included
very recent work in the imaging of human coronary arterics (53), myocardial tagging with SPAMM or phasecontrast techniques (55, 57), and assessment of the passage of contrast agent with echo-planar imaging (59). Many of these talks made use of various fast imaging methods that are less than 3 years old. An entire session was devoted to the imaging of pub-
Volume
studied
the
in fast
used
at a technical
incorporated
imaginto deveb-
MR
to have an impact in routine Additionally, phase-contrast
in clinical
to grow
greater
advances
advances
development
of the
cardiac, cardiovascular, applications.
In the
being
even
(682),
strengths
only
are
were
MR
using
flow patterns equivocal. FSE
of the was
afternoon
assessment,
together basic scientists Some of the most highly in which clinical results on physics techniques
refined
assess are
is being
during
by
brospinab fluid (i4i, 472, 473). Vascular and flow imaging with MR continues to be an area of very active physics research. Specific areas of study include a fundamental understanding of the accuracy and precision of phase difference measurements of velocity (578), the determination of streamlines as based on phase difference methods (577, 584), and the suitabibity of FSE techniques for black-blood angiography (149). A number of fast imaging concepts are being used ues
techniques.
One
ously images
routinely
was devoted to fast talks can be categorized application of recently
techniques
techniques,
physics
time
the
Symposium the physics areas: the
imaging
as
valid
to be a major part MR physics session
available
additionally
physics
vascular
and
every
and
RSNA/AAPM ing. Overall, several major
for
flow
and contrast Also, results
MR imaging physics continued RSNA program. In general an offered
(907). statistically
blood
Notes
presented with short repetition time [“turbo”l 2D and 3D Fourier transform techniques. Imaging times ranged from several seconds per section for 2D acquisition to up to 9 minutes for the 3D case. In a number of examples from more than one presenter, fourthand even fifthorder branches could be visualized. Again, 2 years ago these techniques had not yet been attempted. Now they book very promising for assessment of pulmonary vasculature. High-speed phase-contrast imaging techniques are now being applied in a number of clinical cardiovascular imaging tasks (888, 993, 1000). As the acquisition time and data reduction times decrease, these techniques are being used more and more to quickly and unambigu-
niques
and
hyperthermia (857). Evaluations of the effects of proton decoupling on phosphorus spectra demonstrated improved sensitivity and spectral resolution in studies of brain (401), heart (402), and calf muscle (405). New RF coil designs for spectroscopy were also presented (855, 906). Such improved designs showed promise for applications such monitoring brain development in neonates by using
‘9 1 Meeting
.
year ago, is starting imaging (433, 434).
(701).
Several investigations
...
monary
multiple
alterations
that
standing the underlying (697, 698). A study that employed
medically localized
with
disease
sclerosis in the proton speca means of under-
demonstrated
tra of MS plaques
with that
matter
of patients
;
Industrial A number ent
at the
MR Imaging Research of trends in the MR marketplace scientific
sessions.
In the
past
were several
apparyears
it
has appeared that MR engineering and scientific dominance was becoming concentrated in the hands of only two or three major vendors. This year, the scientific program and the technical exhibits appeared to show increased engineering and scientific activity among other MR vendors, particularly the Japanese companies.
Radiology
#{149} 921
RSNA
‘91
Meeting
Notes
The research and development staffs of the MR equipment vendors have been very prompt in incorporating new techniques in their products. MR angiography was introduced only a few years ago and is still rapidly evolving, but most vendors now have a product offering in this area. The refinements of the RARE technique known as FSE, which were so new at RSNA ‘90 that they did not appear in the scientific program, were on display in prototype form by every major vendor of MR equipment only a year later.
Technical Joel
Exhibits
E. Gray,
PhD,
Barnes, Birmingham,
Gary
T.
Mayo
Clinic,
Rochester, ofAlabama
Minnesota at
Joel P. Felmlee, PhD, Mayo Clinic, Rochester, Cynthia H. McCollough, PhD, Mayo Clinic, Miii
L. Morin,
Index terms: cnmmunication 77th scientific Radiology RSNA,
(
Images, system assembly 1992;
PhD,
Mayo
Clinic,
critical
care
Florida archiving America,
and
system.
In bedside radiography, scatter is a problem. To address this issue, Eastman Kodak introduced the Flex Grid, which is similar in concept to a bow-aspect-ratio parallel-hole collimator used in nuclear medicine and has a scatter clean-up that is equivalent to that of a 6:1 linear grid. The advantage of the grid is that it is flexible and therefore difficult to damage. It is also less sensitive to misalignment than a 6:1 grid. The grid is produced by using lithographic (etching) techniques, as opposed to mechanical stacking of lead strips and interspace material. The technology of very large scale integrated chips continues to improve, and a number of manufacturers showed television cameras based on charge coupled de-
922
#{149} Radiology
Lorad camera
and
and
Fischer
stereotaxic
devices
had a number and indicated
employed
in their
as an
of images that they
1,023-line system. Fischer ing a 1,023-line system.
were aid
from were
Imaging
by
prone
mam-
to localization.
a 525-line CCD going to develop is currently
heart
catheter
laboratories
have
a
evaluat-
been
bulky
AOT
cut
film
changers,
roll
film
even more dated cassette changers. Although progress in digital technology hard- rather than soft-copy images continue
182:922-923
Imagelmnk
mography
Scientific
Systems
in exist-
the
1992
Ektascan
Sierra
Minnesota
A number of advances were introduced in the RSNA ‘91 technical exhibits. Fuji Medical Systems USA showed an interface for their low-cost AC-i computerized radiography (CR) system that allows digital images to be output to a workstation or network. An AC-i system with the interface is referred to as the AC-i Plus. At present, the AC-i acquires a digital image employing stimulabbe storage phosphor plates but has only a film hard-copy output. The interface was announced last year, but has yet to be delivered in the field. Previously purchased interfaces are scheduled to be delivered starting in the first quarter of 1992. Philips showed an interface similar to that for the AC-i, with the output coupled to a Unix workstation, and Du Pont announced plans to integrate the Fuji AC-i CR system into its existing local area digitab network, which previously was able to acquire images only by digitizing conventional radiographs. Eastman Kodak announced its CR system (referred to as KESPR, or Kodak Ektascan Storage Phosphor Reader)
and
by
Medical
Rochester,
Picture of North
#{149}
shown
Lorad
that were
ence for several years, and it is anticipated that Puck film changers will become a dinosaur among specialprocedure suite equipment in the near future, as have
Jacksonville,
display #{149} Images, processing (PACS) #{149} Radiological Society and annual meeting
also
camera
Siemens showed a new C-arm fluoroscope a CCD television camera. CCD cameras
Filmless
nesota
Richard
camera. employed
of a CCD television than a conventional
Digital fluorographic systems continue to be improved. Siemens introduced a totally digital biplane neuroangiography suite referred to as the Neuro Star.
_________________
PhD, University Birmingham
vices (CCDs). The advantage is that it is much more compact
mainstay
of the
medical
imaging
changers,
and
continues, to be the
community.
With
digi-
tab devices, state-of-the-art hard copies are obtained with laser multiformat cameras that employ conventional silver halide film and wet chemistry. A novel and competitive hard-copy technology was introduced by Polaroid that uses no wet chemistry: the Helios 810 dry laser imaging system. lios imaging system particles embedded
The process employed utilizes 50-100-A (5-10-nm) in a polymeric matrix.
in the Hecarbon
High-frequency duced only a few than the exception.
x-ray generators, which were introyears ago, have become the rube rather They were exhibited in essentially
every
x-ray
integral
booth
of an
part
of the
new
equipment
vendor
generation
of compact,
and
are
an
moder-
ately priced computed tomographic (CT) scanner designs that were introduced at this and previous RSNA meetings. As in the past several years, a large number
different
mammography
high-frequency x-ray tures and specifications.
units
were
generators. Most An exception
shown. had was
of
All utilized similar feathe OptiScan
AEC on the Transworld X-Ray mammography unit, which employs an array of 32 sensors to determine the location of breast features and optimize the density of glandular tissue. More than 50 technical exhibitors presented offerings in picture archiving and communication systems (PACS), teleradiology, and associated equipment. A!! major medical imaging companies currently market PACS products. The offerings at this year’s meeting demonstrated steady progress in the development and availability of PACS and teleradiobogy systems. Within most
vendors,
a variety
of computing
platforms,
ranging
from economical image display stations to sophisticated imaging manipulation workstations, were available. In general, PACS components and subsystems are capable of communicating with different modalities within the products
of a particular
either demonstrated the long-awaited gration through
vendor.
While
most
vendors
or offered an ACR-NEMA interface, ubiquitous presence of seamless intethe ACR-NEMA interface has not yet
March
1992
.
occurred.
.
.
Teleradiobogy
crocomputer mary
systems
platforms
difference
interface
were
among
(software
..
.
based
widely
vendors
on
primarily
offered.
continues
friendliness)
and
mi-
The
pri-
to be the
component
user
pricing.
fast scanning, breathing),
heat
mat
reconstruction
units
[MHU]),
CT
and
couches.
use
low-voltage
scanners
the
coach (about
potential
and
Most
multiforand
slip-ring
technology,
problems
incorporates
slip-ring
and
dynamic-focus
scanning to cover 60 cm in 30 materials claim tube hearing is somewhat misleading. Their
tube
other
with
industry
offerings
scanning, scanners
Siemens will in their product
by
announced
a thinner
ware
its entry
(1.5-mm)
into
section
improvements
helical
collimator
as part
and
as well
several
soft-
of its accelera-
tor
package due in the third quarter of 1992. The magnetic resonance (MR) imaging technical cxhibits can be summarized into two categories: innova-
tion
and
optimization.
The
innovation
includes
the
in-
troduction of new imaging techniques, as well as new manufacturers in the high-field-strength MR imaging market. Optimization includes refinement of imaging techniques that have been available for a number of years at high and bow field strengths. Otsuka Electronics (USA) (Fort Collins, Cob), a new
vendor
in the
introduced
imaging and
their
182
MR imaging
high-field-strength
system.
extremity
Volume
high-field-strength This
system
imaging
Number
#{149}
and
3
(1.5-T)
design includes
focuses
and
and
magnetic
times
were
could
field
also
pulses
followed
by
optimization workstations
be com-
shielding
introduced.
As in the
strated
useful
past,
the
(in-
A number
gradient-echo
RSNA
evolutionary,
changes.
changes reduction
fast
of data acquisition and software were
of
Most
readout.
‘91 technical
important,
Further
and manipulation shown.
as opposed
with
exhibits
demon-
to revolutionary,
however,
one
sees
continuous
resulting in the improvement of image quality, in the cost of some equipment, and new and applications of presently available equipment.
market, clinical
on head
application-specific
Ronald
Applications
L. Arenson,
MR
San Dwyer
MD,
and
University
Digital
of California
at San
Francisco
Samuel J. III, PhD, Angeles, Los Angeles H. K. Huang, DSc, University
be offering line as part
scanning
of an upgrade
Administration
storage,
Francisco,
University
ofCalifornia
of California
at Los
at Los Angeles,
Los Angeles
of a Siemens-Imatron joint marketing venture. Potential improvements in electron beam scanners as part of this collaboration can only be speculated at this point. Ima-
tron
optical
Computer Imaging
in the
5-MHU range; they simply multiply their heat rating two, as they arc imaging two sections with one exposure. Systems will not be available until bate 1992.
In electron-beam the Imatron C-iOO
Drug
technol-
ogy with helical volume seconds. Their promotion limits of 10 MHU, which
is competitive
and
acquisition schemes decrease the total imaging time and include fast spin-echo, variable repetition and echo time methods, as well as the use of contrast preparation
and down time. GE Medical Systems, Picker, and Sicmens introduced low-cost, compact (the complete CT system will fit in a conventional fluoroscopic room), slipring CT scanners. Elscint provided the only novel CT development with the introduction of their CT Twin system. Using a dualdetector ring design reminiscent of first-generation CT, they effectively doubled the system performance parameters by obtaining two simultaneous sections. Their sys-
tem
Food
reconstruction
continuous-rota-
for equipment
Notes
eluding the use of active shielding of the static magnetic field) was shown by a number of companies, including GE Medical Systems, Siemens, Toshiba, Philips, and Hitachi. Finer acquisition matrix size (5i2 x 512) and faster
patient 5 mil-
lower-profile
‘9 1 Meeting
gradient coils. This results in a smaller system with a larger clear area in the bore of the magnet and in a reduced price. The system is subject to approval by the
coils,
to allow
three-dimensional
patient
reduces
design
auto-voice (to heat capacity
software,
higher-weight tion
slip-ring
auto-filming, increased anode
lion
which
include
RSNA
mercially available in 1992. GE Medical Systems showed contrast material-enhanced, fat-suppressed, three-dimensional breast imaging, a new area of considerable interest in MR imaging. Hitachi Medical unveiled a new high-field-strength (i.5-T) system that uses an actively shielded magnet. Refinement of the fast spin-echo technique of rapid acquisition with relaxation enhancement was shown by a number of the vendors. Optimization of two- and three-dimensional angiography sequences, receiver
ume scanning. All major CT vendors offered helical scanning, although only Siemens and Toshiba have an installed base (Picker International has two beta test sites in operation). Other vendors are quoting availability in late 1992. Additional features found industrywide
models
.
U.S.
This year was most reasonably characterized as a progression in the evolution of both PACS and teleradiology into clinical practice, with continued evolution being likely in the future. Product development in the field of CT focused on fast acquisition times (1 second or less) and helical vol-
on high-end
..
Index terms:
as
Computers,
diagnostic
archiving and communication North America, 77th scientific Radiology ‘ RSNA,
1992; 1992
RSNA
‘91 continued
Picture of
#{149}
182:923-925
of even more and exhibits. greatly
aid #{149}Images, enhancement system (PACS) ‘ Radiological Society assembly and annual meeting
the
trend
computer-related The infoRAD
of the
past
scientific exhibits have
several
years
presentations expanded
as well.
Several papers were presented on the use of computers to help in the detection of microcalcifications in mammography. Scheck et a! showed computed radiography
for
screen-film dual-contrast presented images
mammography
to approach
high-resolution
systems for detecting microcalcifications images were presented. Newstead similar results obtained with magnified
compared
with
magnified
film
technique.
Radiology
if et al digital How-
923
#{149}
RSNA ever,
‘9 1 Meeting
problems
with
false-positive
Notes
findings
‘.
remain
largely unresolved. In addition to mammography, computer-aided diagnosis was used for chest and bone images. Lo et a! discussed the advantages of fractal analysis to enhance edges in chest radiography for the detection of pneumothoraces. They presented how fractal Brownian motion was used to model pixel-to-pixel intensity differences as an estimate of the fractal dimension. This fractal transformation of digital chest radiographs was shown to enhance the edges in the image without increasing the noise (areas of uniform tissue had large fractal dimensions, while areas with nonuniformities or edges had smaller dimensions). In chest radiographs from patients with pneumothoraces, visualization of the abnormal border of lung parenchyma and the peripheral pleural space was enhanced. A paper by Majumdar and Prasad used the fractal dimension to extract structural features of trabecubar bone in computed tomographic (CT) images with potential uses in assessing the severity of osteoporotic changes in patients. Fractal analysis may be a useful preprocessing tool for image segmentation and/or feature description. Katsuragawa et al demonstrated their success in using a gradient histogram analysis technique for the computer-aided detection of septab lines in digital chest radiographs. The earlier enthusiasm for large-scale picture archiving and communication system (PACS) implementations has now settled into a more realistic approach to the appropriate use of smaller systems for selected seetions of a department. Several papers discussed experiences with PACS dedicated for specific purposes. Terotzky et al presented their successful experience with remote monitoring of CT and magnetic resonance (MR) studies.
Teleradiology
systems
were
presented
and Telepak et a!, showing the utility especially for CT. Lear et ab presented periences with a Macintosh system for and presentation in nuclear medicine. described their continuing development for medical imaging applications. The scribed in this paper is a three-dimensional ing procedure in which specific regions be uncovered by “ erasing” or removing tures. A nice feature of their “paintbrush” is sensitive
ent the
across edge,
to
edges
gray
thus
within
levels)
allowing
the
data
(it
by
Shile
of these systems, their positive cximage processing Ney and Fishman of display tools new tool devolume-editof interest can obscuring structool is that it calculates
and will erase only very fine control
a gradi-
on one side of the editing
of
graphic
findings.
Although
not
neural networks of investigators for detection of radioready
yet
for
routine
use
in clinical
radiology, we should expect much more in the years ahead. Cheng et al discussed their use of a neural network to detect osteopenic changes in phalangeab trabecular bone. Wu et al used an artificial neural network for detecting breast cancer. Nelson et ab have simulated the use of a neural network localization of myocardiab activation sequences. Garg and Floyd presented their work with the Perception neural network model for the detection
924
of
#{149} Radiology
pulmonary
nodules.
Christy
et
al used
a
j
.
‘
neural network for analysis of avascular necrosis of the femorab head. Fujita et a! attempted to detect coronary artery disease in single photon emission CT with a neural network. At RSNA ‘91, over 500 scientific exhibits were presented. Many of these exhibits were based on computers and their utilization. There were 1 1 exhibits on the display of three-dimensional (3D) images. Oftomo et a! presented a rotary stereo-radiographic device for displaying stereoscopic angiograms. Joyce et al presented 3D real-time angiographic imaging at 30 frames per second for
intracranial lesions. Miki et a! presented
nique
for cerebral
sented images sented (0.50-T)
phy rate
MR
system
et al demonstrated in preoperative
ment
than
a 3D
stereoscopic
MR angiography.
a method for of the temporal a 3D method
display
Janioka
tech-
et al pre-
generating 3D reconstructed MR bone region. Nida et al prethat uses a bow-field-strength to display cerebral aneurysms. Murthat 3D images are more accuassessment and surgical manage-
conventional
imaging
of congenital
heart
disease and vascular ning CT to generate and concluded that ing coronary artery
rings. Anno et al used helical-scan3D coronary angiographic images this method was useful in evabuatcalcification and patency of coronary bypass. Stephensen et al presented 3D visualization of joint surfaces and soft tissue from CT data. Soyer et a! presented a study that used CT imaging to conclude that 3D images of hepatic metastases improves the information presented to the surgeon. Murakami et al presented 3D images of the abdominal organs and blood vessels obtained by using MR images. Moriyasu et a! presented a 3D color Doppler ultrasound technique for imaging of hepatic blood flow. Eleven scientific exhibits used a personal computer
(PC)
as the
tool
for processing
data.
Smith
et ab pre-
sented a PC radiology database and teaching package. Fishman et a! presented a teaching file consisting of over 1,000 body CT studies. Becker et ab presented a bevel III interactive videodisc program to enhance the understanding of imaging modalities used to image the urinary tract. Wehrbi developed a supercard-based teaching
module
for vascular
imaging
with
MR.
Hawkins
et al
demonstrated a PC system for the generation of graphics and a clinical-educational interface. Halimi et a! presented a computer atlas of head and neck anatomy. Mon et a! demonstrated a system for computer-aided
detection
process.
A number of presentations on showed the increasing enthusiasm this new technique for automated
z
of nodules
on chest
radiographs.
Arenson
et a!
presented a digital radiology image learning library for mammography on an imaging workstation for radiologic education. Doi et a! presented their intelligent workstation for computer-aided diagnosis for analysis of chest findings, microcalcifications in mammograms, and blood flow in angiography. MacMahon et a! presented a study of digi-
tized
film
and
laser
film
printed
images
that
were
dem-
onstrated to be comparable or superior to storage phosphor radiography. Kandoh compared conventional screen-film examinations with high-resolution (4K x 5K x 12 bits) storage phosphor images and found that storage phosphor images were not as good as the conventionab screen-film images for subtle interstitial changes.
March
1992
RSNA suspected
The infoRAD exhibits were excellent, presenting 73 exhibits. These exhibits were divided into the following areas: literature searches, networks, videodiscs, cornputer-aided instruction, practice management, and education. An infoRAD theater was introduced where exhibitors
could
present
their
that
Greene,
Barnes
M. Schaefer,
Hannover,
Paul
Stark,
General
School
of
West
County
MD,
Medizinische
‘s Hospital,
growing resolution parenchyma,
presentations
on
Boston
computed
‘91 show
tomography
(CT),
and
in-
technology. Notable clinical of diffuse lung diseases, airway lung, tuberculosis, chest dishost, lung cancer and and intensive care.
HRCT HRCT
Structure parenchyma
and
Function was the central
focus of this meeting. In addition to being the Annual Oration in Diagnostic Radiology cia! Focus Session, HRCT was the technique in a large number of papers and exhibits. Primary
interest
Volume
182
#{149} Number
centered
around
the
subject of and a Speemployed
HRCT
correlating
function. Controversial of specificity of HRCT
3
and
dependent
opacities
involved the specificity of at HRCT. Papers now report that can be produced by a wide vari-
topics findings
exhibit
415).
From
a pathologic
view-
honeycomb
acquired (exhibit
cystic lung 422), phrenic
adjust
lung
ILO-based reporting
spaces nerve
pneumonia fixed inflated
(International form was
of integrating HRCT reporting (157). note, it was reported window
not
(exhibit pathology
settings
(exhibit lung spcci-
Labour suggested
findings that increased
improve diagnostic displays in evaluating
Ofas a
with the
stan-
ability
to
interpreta-
performance diffuse lung
(163).
Spiral and Ultrafast CT Continuous fast scanning during a single breath hold with spiral CT is an emerging technical development. In the mediastinum, central pulmonary artery emboli are
and digital topics included imaging diseases, the transplanted ease in the immunosuppressed lymphoma, intervention,
with structure and eluded the question
found
a
imaging. High(HRCT) of the lung
magnetic resonance (MR) imaging of the pulmonary vasculature dominated the technical themes. Trends eluded increased interest in functional-pathologic-imaging correlation, quantitation of image data, computer
Correlation with of the pulmonary
sensitive
study
such as bronchiectasis, inter!obular thickening.
(1057C). An pneurnoconiosis
helpful method dard radiographic On a technical
60.1211 Society of #{149} Thorax, CT,
at RSNA
cross-sectional tomography
applications,
moderately larger
428), localized organizing methods of preparing
and
tion time but did over fixed window
chest
spiral
923;
findings, and
(exhibit 440), mens flee)
182:925-927
emphasis computed
(160,
ulomatosis (1060), 409), emphysema
Hochschule
Hannover, Germany MD, Brigham and Women
the
of 19 found
Several HRCT pathologic correlative studies were presented (exhibit 419), including lower-lobe bronchiectasis in immunodeficiency disorders (159C), progressive systemic sclerosis (158), sarcoidosis (i056C), Wegener gran-
Hospital,
disease
again,
opacities,
controversy opacities opacities
associated abnormality,
freely
Once
and
a much
a study
asbestosis
point ground-glass opacities can be found with alveolar wall thickening, partial alveolar filling, and granubomas in the alveolar walls (160). The differential diagnosis of ground-glass opacities relies on the detection of other
of
terms: Computed tomography (CT), high-resolution, abnormalities #{149} Lung, transplantation #{149} Radiological North America, 77th scientific assembly and annual meeting 60.1211 #{149} Thorax, MR, 60.1214 1992; 1992
specific
hand,
curvilinear
A similar ground-glass ground-glass
Hospital,
Index Lung,
Radiology ‘ RSNA,
highly
other
hand,
(161).
Theresa C. McLoud, MD, Massachusetts General Hospital, Boston Mathias Prokop, MD, Medizinische Hochschule Hannover, Hannover, Germany
Cornelia
the
smoking
Massachusetts
MD,
one proven
a large proportion of non-asbestos-exposed subjects findings that have previously been considered spefor asbestosis, namely, septal lines, parenchymal
cific bands,
Philadelphia
Robert G. Levitt, St Louis
the
pathologically
was
On
On
Notes
ety of diffuse lung conditions associated with chronic interstitial pneumonia, pneumocystic pneumonia, lymphangitic carcinomatosis, sarcoidosis, and cigarette
Dixie J. Anderson, MD, Washington University Medicine, St Louis Warren B. Gefter, MD, Hospital of the University
Pennsylvania,
HRCT
that had
material.
MD,
with
(156).
Radiology
Reginald Boston
asbestosis.
subjects
RSNA ‘91 continued to demonstrate the growing importance of computer applications in radiology. PACS, teleradiobogy, computed radiography, 3D displays, and PCs for education continue to dominate the presentations. Neural networks show increasing promise for the future.
Thoracic
‘9 1 Meeting
inin
easily
identified
appears
to allow
creased
volume
with
spiral
useful of contrast
CT
(1051).
vascular
The
opacification
medium
(1052;
technique
with exhibit
de420).
Because of diminished respiratory misregistration, spiral CT can produce less distorted two-dimensional (2D) and three-dimensional (3D) volumetrically rendered images, providing advantages over conventional CT in the identification of small pulmonary nodules, chest wall lesions, pleural disease, and the major airways (1053). Spiral CT with 2D and 3D rendering are most useful for anatomy aligned along the axis of table movement, such narrowing
of the
trachea
produced
by
cancer
and
benign
steno-
sis (1054C).
The advantages of iOO-msec, ultrafast acquisition of CT sections in functional assessment continues to be explored. In evaluating diffuse lung conditions for cvidence of airway obstruction (i055C), ultrafast CT identifled air trapping-that is, lung regions not demonstrat-
Radiology
#{149} 925
RSNA
‘9 1 Meeting
ing a normal expiration-in boma, chronic genie
increase tuberous interstitial
organizing
in attenuation sclerosis, pneumonia
pneumonia,
following forced cosinophilic granuand fibrosis, crypto-
cystic
mode
practical
of conventional of increasing
means
uncooperative quality
MR
point, CT the
patients
the
was speed
and
dynamic
thereby
On
as a convenient acquisition in
improving
image
(1059).
in Lung
Cancer
Staging
In lung cancer staging, MR papers continue to confirm the results of the recently published Radiobogic Diagnostic Oncology Group cooperative multicenter investigation. A prospective study of 202 consecutive lung cancers
found
that
MR
was
marginally
more
sensitive
than
CT for both T and N staging (58%-68%), but both were still relatively insensitive (119). Although discrimination of T2 versus T3 or T4 tumor extension was better with MR, the difference had little impact on treatment. The main application of MR appears to be in evaluating chest wall tumor invasion and as a supplementary method of problem solving after CT. An interesting paper found that Ti-weighted MR imaging appeared to be more sensitive than iliac crest biopsy and radionuclide bone scanning in identifying marrow metastases in small-cell lung cancer (120). MR appears to have an advantage over CT in staging malignant mesothelioma for apical, diaphragmatic, subdiaphragmatic, and pericardial involvement (121). Although the potential practical impact of MR in the staging of lymphoma is yet to be fully
demonstrated,
tage
over
CT
in
a few
in determining
patients
MR
radiation
has
port
visualized
neoplasms,
an
size
advan-
(uS).
parenchyma.
Pulmonary
Angiography
Great strides have been made in imaging the pulmonary vasculature with MR. Several new rapid imaging approaches show promise in visualizing normal and abnormal vessels down to the fifth and sixth branching generations, including (a) a breath-hold spoiled gradient-echo sequence with intravenous gadopentetate dimeglumine (386), (b) an electrocardiogram-gated ultrafast acquisition with phased-array coils for imaging of the entire lung in a single breath hold (387), (c) a highresolu tion syncopated three-dimensional fast low-angle shot (FLASH) sequence with a variable delay time between in-plane phase-encoding steps (388), and (d) a rapid
acquisition
method
arteries with aerosolized macromobecubar agent
showed
embolism
promise
evaluation
time-of-flight
found central
of
selectively
visualizing
pub-
and veins (390). An experimental study Gd-DTPA as a ventilation agent and polylysmne-(Gd-DTPA) as a perfusion
monary
and
(890). maximum
a technique
MR
for
pulmonary
venography
intensity
with projections
2D was
for showing normal and occluded Velocity-encoded cine sequence (VINNIE) was reported to be useful in identifying vascular malformations of relatively large size (389). These papers confirm that proximal-order vessels can be
926
to be useful veins (889).
as
#{149} Radiology
MR for evaluation and
of emboli,
hypertension.
Parenchyma
Lung
gadolinium in evaluating
cancer
greater enhancement 443). Other preliminary
nodules
appears to pulmonary
demonstrated
than tubercubomas work suggested
(122; exhibit that neoplasms
could be differentiated from granubomas and postoperative changes by using dynamic contrast-enhanced TurboFLASH (1230). Gadolinium-enhanced images (including FLASH with breath hold) demonstrated that contrast enhancement was increased (a) in proportion the severity of interstitial lung disease, (b) in malignant versus benign pulmonary nodules (1234C), and (c) in active sarcoidosis of the lung and mediastinum (1236).
Gadolinium
contrast
enhancement
was
also
found
to
to
produce superior visualization of pleural and chest wall lesions as compared to CT (1238). A number of other papers investigated various means of improving lung sig-
nab and 403). variety
hibits
reducing
artifacts
(1231,
1232,
1233C;
exhibit
Several presentations described MR findings in a of conditions, including pleural disease (121; cx427, 407) and mediastinal disorders (116, 117,
118C; exhibits 405, 430). A combination of low-density barium paste and gadopentetate dimcglumine was ported to improve MR visualization of the esophageal lumen
Lung Lung
re-
(1235C).
Transplantation transplantation
has
now
become
common enough CT is re-
to attract several imaging papers. Ultrafast ported to be useful compared to transbronchial
and
pulmonary
tive
bronchiolitis
plantation MR
with
malformations,
Contrast enhancement with show increasing application
half-scan
reported of image
readily
MR of Pulmonary
fibrosis/Swyer
James syndrome, and bymphangitic carcinoma (162). One wonders whether some of these same observations also might not be possible with more rapid spiral CT.
an everyday
I
Notes
function that
(535C).
tests frequently
Early
biopsy
in detecting
the oblitera-
complicates
CT findings
after
lung
trans-
transplanta-
tion include bronchial dehiscence, segmental airway dilatation, patchy ground-glass opacities, ARDS-like conditions, basilar lung opacities, pleural effusions, ischemia, infection, and rejection (1058C; exhibits 401, 421).
Later ture,
findings decreased
include hyperinflation, bronchial stricblood or air flow to the lung, and infecdevelopment of ground-glass opacities
tion. The bate may indicate rejection or other complications cytomegabovirus infection or pulmonary
of the protecting is reported
after
Radionuclide
mechanism
with
lymphadenopathy which is better
radiography,
has
the
opacity over the
of the bronchial
studies
show
an
lung versus complica-
transplantations are manialveolar opacities, and (811; exhibit 435). This detected with CT than
a favorable
munosuppression is reduced. detecting bronchial dehiscence entiating cardiac enlargement, hilar lymphadenopathy and from placed
vasoconstriction
in the transplanted Lymphopro!iferative of lung patchy
as Failure
(402).
ventilation-perfusion
increased V/Q mismatch that in the native lung. tions that occur in 2% fested by lung nodules,
mediastinal complication,
of hypoxic
transplantation
such fibrosis.
prognosis
when
im-
CT is especially useful in and for correctly differmediastinal mass lesion, retrocardiac consolidation
omental flap anastomosis
that
is normally (536C).
March
1992
.
.
.;
,
Emphysema and Abnormal Air Spaces Several presentations focused on quantification and imaging of emphysema, diagnosis of other abnormal air spaces of the lung, airway reactivity, and air trapping. A rapid automatic quantitation technique with conventionab CT calculates emphysema defined by a subrange filter for lung values with attenuation -900 HU (423; exhibit 530). HRCT is superior to standard CT in depicting panacinar emphysema, but it is unsuccessful in detecting mild or “early” emphysema (533C). Differentiation between the imaging characteristics of centrilobubar, panbobubar, perifocal, localized emphysema (exhibit 422) and acquired cystic spaces in the lung, such as blebs, bullac, cavities, pneumatoce!es and dilated bronchi (exhibit 409), continues to be discussed. Impaired ventilation in bulbous lung disease was studied with 3D images from helical CT by using 30% nonradioactive xenon (exhibit 412). In addition to demonstrating nondependent ground-glass opacities, HRCT more than conventional CT depicts the higher proportion of subpleural nodules, parenchymal micronodules, and upper lobe emphysema found in smokers (923). The extensive upper lobe lung emphysema that may be found at HRCT is often associated with little evidence of functional impairment (924). It appears that this upper lung pathology tends to be more functionally occult than lower lung emphysema (924). Compared with healthy subjects, asthmatics show a greater number of bronchi of larger diameter than the accompanying artery, suggesting that mild bronchial dilatation in asthmatics should not to be confused with cylindrical bronchiectasis (925). Intervention Topics on intervention concluded (a) that most intrathoracic air and fluid collections can be drained with smallbore catheters (667), (b) that self-expandable endoluminab prostheses are reasonable alternatives to surgery for tracheobronchial stenoses (668), (c) that advances in cytomorphology and immunophenotyping can compensate for some of the previous limitations in percutaneous biopsy diagnosis of malignant lymphoma (666), (d) that a spring-activated biopsy needle is a safe and reliable means of obtaining histologic specimens from various organs (670), and (e) that an extrapleural route is a safe method of approaching mediastinal lesions under CT control (669).
Digital
Radiography
and
Intensive
Care
physics sessions actually contained more on digital chest radiography than the per se, there were many interesting presentations on (a) the value of digital film duplication in correcting exposure errors (276; exhibit 432), (b) the potential of an experimental high-resolution storage phosphor system with 4K x 5K and 12-bit resolution (exhibit 439), (c) the utility of a scatter compensation technique to improve underexposed areas in digital images (278), and (d) an interactive display technique based on histogram analysis to improve selected tissue densities in dig-
Volume
182
#{149} Number
3
‘9 1 Meeting ,.
AMBER of (28iC).
Notes
-
.
No adverse effect on performance is reported as a result of reduced hard-copy size of unprocessed digital storage phosphor images of subtle lung disease (279C). Electronic displays of digitized radiographs on 1,024 by 840 pixel monitors are reported to be adequate for bocalization of chest tubes and lines (281C), but data were not presented to show that the soft display was adequate for other primary diagnoses. Barotrauma was confirmed to be a frequent complication of severe ARDS and most sensitively detected with CT (283). Observations continue to show very limited univariate correlations between cardiac status and radiographic findings in criticalby ill patients (284).
Other
Topics
Other topics of interest indicate (a) that 50% of patients who undergo median sternotomy without mediastinitis have enlarged mediastinal lymph nodes up to i.5 cm in diameter at CT (531); (b) that round atelectasis, unlike lung cancer, shows characteristic dense enhancement with a minimum of a 200% increase in attenuation at dynamic CT (534); and (c) that the positive predictive value of mediastinal invasion in lung cancer staging is only 67%, compared to a negative predictive value of 96% (538). Thus, CT evidence of mediastinab invasion may not preclude resectability. Other presentations of interest include (a) a detailed multimodality description of the venous anatomy of the chest (exhibit 437), (b) unusual appearances of tuberculosis in the diabetic and immune-compromised hosts (exhibit 442), (c) the anatomy of the intersublobar septum of the lung and inferior pulmonary ligament (539), and (d) the successful attempt to differentiate tubercubomas from cancer nodules with Gd-DTPA-enhanced MR (exhibit 443).
Cardiac
Radiology
G. Baron, Medicine, Atlanta Melvin E. Clouse, Boston Murray
Antoinette
Gomes,
Medicine, Robert
J.
Roderic
MD,
Emory
MD,
New England
MD,
University
University
School Deaconess
of California
of Hospital, School
of
Los Angeles Herfkens,
Medicine, Stanford, Harold Mitty, MD,
Although the presentations chest sessions
ital radiography (282). Beam equalization with technology is reported to improve visualization phrenic sulci superimposed on the diaphragm
RSNA
I. Pettigrew,
MD, Stanford University School of California Mount Sinai Hospital, New York MD, PhD, Emory University School
ofMedicine, Atlanta Renate L. Soulen, MD, Wayne State University School Medicine, Detroit Mark H. Wholey, MD, Pittsburgh Vascular Institute, Pittsburgh Jack Ziffer, MD, PhD, Baptist Hospital, Miami
of
Index terms:
Coronary vessels, disease #{149} Heart, CT, 51.1211 #{149} Heart, Heart, MR. 51.1214 #{149} Magnetic resonance (MR), rapid imaging arteries, abnormalities #{149} Pulmonary veins, abnormalities #{149} RaSociety of North America, 77th scientific assembly and annual
diseases Pulmonary diological meeting
#{149}
Radiology C RSNA,
1992; 1992
182:927-929
Radiology
#{149} 927
RSNA
‘9 1 Meeting
Notes
The advances in magnetic resonance (MR) imaging and ultrafast computed tomography (CT) for imaging of the heart and pulmonary circulation and for evaluation of cardiac function were substantial and further narrowed the disparity in information content available by means of cardiac catheterization and angiocardiography. In some areas, such as the study of myocardial motion, pertinent data can be provided with MR imaging that is not available by other means. A marked improvement was also noted in MR angiography, particularly in the delincation of the pulmonary vascular tree and, to a lesser extent, the coronary circulation. The rapidity with which new MR imaging techniques and their capabilities are being developed created the impression that within the next few years, MR imaging will likely emerge as the primary imaging modality for cardiac disease. Arteriosclerotic coronary artery disease is the most common cardiac disease and one of the most common of all diseases in the United States. Existing diagnostic techniques are not completely satisfactory as screening methods. The usefulness of ultrafast CT for the detection of coronary artery calcification has been previously demonstrated. A quantitative study (352) showed a correlation between the volume of calcium as determined with ultrafast CT and the presence or absence of significant coronary stenoses. A peculiar finding was that the calcific deposits did not always occur at the sites of greatest arterial narrowing and plaque formation. The most direct way to demonstrate coronary artery disease is to visualize the vessels themselves. At present, this requires selective coronary arteriography. With a fast gradient-echo MR sequence, the proximal portions of the coronary arteries could be imaged during breath holding (53). Despite the limited area of visualization of the vessels, the authors believe that their results warrant further development of the technique. Ultrafast CT with a bolus injection of iodinated contrast material can show the coronary vessels for a brief period, which is determined by the rate of clearing of the contrast agent from the blood and obscuration of the vessels by the contrast material-enhanced myocardium. A blood pool CT contrast agent, demonstrated in dogs (351), overcame these problems as it remained localized within the intravascular space for a protracted period. Another approach to coronary visualization involved three-dimensional reconstruction of the vessels from helical CT scans. None of the techniques could reliably show enough of the coronary arteries to be of the routine clinical use. Contrastenhanced spiral CT and three-dimensional reconstruetion was used effectively to evaluate patency of bypass grafts (355). Although angiography can demonstrate the patency of the coronary vessels, it may be difficult to gauge the effect of a stenosis, or series of stenoses, on the function of the dependent myocardium. One approach is to evaluate the adequacy of myocardiab perfusion, a perfusion defect indicating occlusion or stenosis of the supplying vessel. First-pass MR imaging, after intravenous bolus administration of gadopentetate dimeglumine with dipyridamole-induced stress, was reported to reliably depict hypoperfused myocardium in dogs and in 10
928
#{149} Radiology
human patients (56C). Other papers demonstrated increased contrast between injured and normal myocardium in rats by using gadolinium benzyboxypropionictetraacetate, as compared with gadopentetate dimeglumine (59, 746). The heart functions by orderly contraction and expansion of the myocardium. Thus, a more direct evaluation of the functional state of the myocardium can be gained by determining the magnitude and pattern of its motion during the cardiac cycle. Two different MR imaging techniques are used for this purpose. Presaturation tagging of the myocardium (SPAMM) can produce a grid of lines on the myocardium that move with the muscle as it contracts. The pattern of deformity of the grid, indicating directions of regional wall motion, was consistent in normal volunteers (628). A method to compensate for heart motion during SPAMM imaging was believed to increase its accuracy (942). Exhibit 515, using cine imaging with myocardial tagging, demonstrated abnormal patterns of contractility in cardiomyopathic muscle but not in hypertrophied cardiac muscle secondary to arterial hypertension. In the batter case, the alignment of the myocardial muscle fibers is normal, in contrast to that found in cardiomyopathy. The same method of myocardial tagging was also found to improve the distinction between the endocardial surface and the ventricular cavity, making measurement of ventricular volumes more accurate (55). The second method of quantifying myocardial motion involves measurement of phase shift in three dimensions. Phase contrast cine MR imaging was validated in animal models, by comparing the results against those obtained by tracking tantalum markers implanted on the heart (57). This technique was also used to successfully measure myocardiab motion and strain in cardiac patients (745). Experience with this technique is insufficient to judge its eventual clinical usefulness. A problem commonly encountered when dealing with areas of myocardiab ischemia is the differentiation of “stunned” myocardium from an acute infarct. Both may appear the same with echocardiography or on nuclear medicine studies or static MR images. Stunned myocardium is salvageable, however, and can regain function after reperfusion. In a study of dogs (58), a marked increase in systolic wall thickening was demonstrated with cine MR imaging in “stunned” myocardium when the heart was stressed with an infusion of isoproteronol. Another attempt to evaluate reperfused myocardium after thrombolysis (999C) utilized first-pass time-intensity curves after a bolus injection of gadobinium in 10 patients with acute myocardial infarctions. The effectiveness of the reperfusion could be demonstrated, but no conclusions were drawn regarding the viability of the perfused myocardium. The potential feasibility of direct imaging of infarcted myocardium was shown in rats by using a special iron oxide compound attached to a monocbonal antimyosin antibody (629). MR images show a decrease the areas of infarction. Substantial progress when compared with to image the pulmonary
in signal
intensity
localized
to
was demonstrated, especially last year’s meeting, in the ability arterial tree. Several different
March
1992
T eting
Notes
gradient-echo schemes were presented (386, 387, 388, 390) that were abbe to show opacified pulmonary arteries down to the subsegmental level. In one study (386), the visualization of the pulmonary vessels was improved by enhancing the images with intravenous gadopentate dimeglummne. Good-quality pulmonary angiograms can also be obtained by using cardiac-gated phase contrast imaging. This method was used effectively to demonstrate pulmonary vascular malformations (389). Contrast-enhanced ultrafast CT is also a viable means for detecting pulmonary emboli (exhibit 524), as a study can be completed within one breath hold, thus doing away with the motion artifacts that interfere with routine CT studies of the pulmonary vessels.
(1157) suggested that they were due to the ionic content of the contrast agent rather than its hyperosmolarity. The negative effect could be countered by adding cabcium ions to the contrast agent. Finally, there were several good review exhibits on obstruction of the inferior vena cava (exhibits 509, 538), radiographic appearances of implantabbe cardioverters and defibrillators (exhibit 535), and total anomalous pubmonary venous drainage (310).
The role of MR imaging in the study of congenital heart disease has yet to be determined. There is no doubt that MR imaging is effective in visualizing abnormalities of the great vessels and the pulmonary circulation (74iC; exhibit 328). It is also of use in the postoperative evaluation of patients after a Mustard procedure (627) for evaluating the patency of shunts and anastomoses, identifying areas of stenosis, and so on. Often the MR study will obviate repeated catheterizations. Nevertheless, for most intracardiac lesions, MR imaging alone is still not sufficient as a preoperative study. This may change in the near future. Two papers were presented on the quantification of intracardiac left-toright shunts. One (626) determined shunt volume by comparing aortic and main pulmonary artery blood flow, derived from velocity-encoded cine MR images, while the other (742C) measured the shunt by imaging a bolus of gadopentetate dimeglumine as it passed through the heart. MR imaging was also shown to be considerably more accurate than echocardiography for sizing the aortic anulus before surgery for valve replacement (743C). The standard method for evaluating a stenosis is to measure the pressure gradient across it. Another means to the same end involves measuring flow velocities on either side of the narrowing. This technique was suecessfu!by used in a comparison of 10 patients with coarctation of the aorta and 10 healthy volunteers (1000). The problem is more difficult with tighter stenoses because of marked poststcnotic flow turbulence. Laboratory studies involving phase contrast cinc MR imaging, however, validated the measurement of poststenotic flow velocities over a considerable velocity range (998C) and held some promise for estimating the grade of the stenosis (353). Two studies were concerned with the use of nonionic contrast agents. In one (1158), 92 patients, 13 of whom had documented pulmonary arterial hypertension, underwent pulmonary arteriography with full-strength nonionic contrast media. None showed a rise in pulmonary artery pressures or other complications. The other (1159) reported the results of a double-blind, randomized controlled trial from 23 centers. The effects of diatrizoate and iohexob were compared in 1,194 adult patients undergoing cardiac catheterization. lohexol proved to be significantly less renotoxic, especially in high-risk patients with an elevated creatinine level. A study of the negative inotropic effects of gadopentetate dimeglumine
David W. Hunter, MD, University ofMinnesota Hospital and Clinic, Minneapolis Sandra Althaus, MD, University of Washington Hospital, Seattle Michael D. Darcy, MD, Mallinckrodt Institute of Radiology, St Louis Steve Falconer, BA, University of Minnesota Hospital and Clinic, Minneapolis Xiaoping Hu, MD, University ofMinnesota Hospital and Clinic, Minneapolis Deborah G. Longley, MD, University of Minnesota Hospital and Clinic, Minneapolis Louis G. Martin, MD, Emory University, Atlanta Terence Matalon, MD, Rush-Presbyterian-St Luke’s Medical Center, Chicago Arthur Stiliman, MD, University ofMinnesota Hospital
Volume
182
#{149} Number
3
Cardiovascular/Interventional Radiology
and Robert
Clinic, Minneapolis L. Vogelzang,
Hospital, Chicago E. Kent Yucel, MD,
MD,
Northwestern
Massachusetts
General
Memorial Hospital,
Boston
Index terms:
Arteries, chemotherapeutic embolization, 9.1299 #{149} Arteries, stenosis or occlusion, 9.7214 #{149}Contrast media, comparative studies ‘ Magnetic resonance (MR), angiography #{149} Radiological Society of North America, 77th scientific assembly and annual meeting #{149}Thrombosis, venous, 9.751 Varicocele #{149} Veins, US, 9.1298 Radiology C RSNA,
1992; 1992
182:929-932
As members of the Cardiovascular and Interventional Radiology Meeting Notes Committee, we kept musing to ourselves throughout the meeting that there was “nothing happening, nothing new.” A review of the papers would suggest that there were fewer basic science papers and those dealing with new techniques or new devices. We speculated that this might be due to a decrease in the amount of scientific effort, a decrease in acceptance of that effort by RSNA ‘91 reviewers, or maybe a move of this type of paper to the subspeciabty meetings, which are yearly assuming a greater importance in our increasingly subspecialized field of radiobogy. When the papers presented at RSNA ‘91 are looked at carefully, however, one notices a steadily increasing quality of clinical evaluation and, most important, a healthy tendency to critically review previous work and attempt to substantiate and put it on a firmer footing scientifically or, in some cases, to refute it. The feeling
Radiology
#{149} 929
RSNA
‘9 1 Meeting
Notes
that there was “not much happening,” I think, is therefore just a small trend or cycle in a year of consolidation and what, on final review, appears to be ever-improving scientific efforts on the part of vascular radiologists around the world. The format of including works in progress with longer papers appeared to work well for the vascular section, although the difference in content between the two types of papers was usually not noticeable and te distinction between the two may be irrebevant. As in previous years, magnetic resonance (MR) angiography had more papers than any other vascular imaging modality. The faster and improved-resolution black-blood techniques (149, 1001) and the relatively new multiple overlapping thin-slab acquisition technique (582C) show promise in increasing blood-tissue contrast. MR angiography still appears to have a general problem with overcalling stenosis (154) but maintains its sensitivity for severe lesions. Four papers showed exeeptionalby promising results for MR pulmonary angiography (386, 387, 388, 390), with one technique not even requiring breath holding. The measurement of velocity in vessels is revealing itself to be not such a simple maneuver, and several papers dealt with methods for increasing accuracy by means of specific sequence adjustments (578, 580C, 992, 994, 998C). An exciting new method of velocity mapping was discussed as well (579). Peripheral duplex ultrasound (US) made the biggest leap forward and promises to be an extremely important component of peripheral vascular imaging for many years to come. Of the 24 total papers on this subject, 20 of them were excellent clinical investigations of the technique, many of which will have immediate effects on the way we practice. Color duplex imaging appears to be more sensitive than descending venography in assessing venous incompetence (206), although a standard for the accuracy is backing. Duplex imaging once again appeared to be proving itself equal to venography for lower-extremity deep venous thrombosis above the knee (213), although the two techniques appear to be complementary rather than competitive, and duplex images definitely benefit from rereading if results are questionable. Once again, as in 1990, duplex imaging showed itself insensitive for detecting calf deep venous thrombosis in asymptomatic postopera tive patients
(258). ing
Duplex papers
imaging of the
appears, meeting
in one of the more (470), to be predictive
interestof an-
gioplasty results at 2 years on the basis of the presence or absence of a greater than 50% stenosis at the angioplasty site within I week of the angioplasty. It also appears to be sensitive for the detection of renal artery stenosis or other intrarenal pathologic conditions on the basis of waveform changes in the native kidney (908, 909, 910). Its role in the evaluation of arteriogenie impotence is becoming clarified, in that peak systolic vebocities are being shown to have a gray zone between 25 and 35 cm/sec (1028) and some false-positive duplex studies may actually have disease involving the hebicine or smaller vessels (1029). Duplex imaging is clearly also becoming an important tool for the imaging of varicocebes (1033, 1034); color and
930
#{149} Radiology
gray scale were shown to be complementary, with color being the most important part of the examination. One exciting exhibit (exhibit 218) appeared to suggest that duplex US was predictive of mortality in intensive care units on the basis of renal pulsatility indexes. MR angiography and duplex US together accounted for 60 of i64 papers in the peripheral vascular field at the meeting. The largest other single category was stents, with 23 papers. There was a marked improvement in the clinical quality of these papers, with 18 of them showing careful clinical comparisons or evaluations of new techniques or devices. One of the most exciting things to emerge from the meeting was a clear movement toward the use of stents in aortoiliae occlusive disease as the primary treatment without adjunetive use of thrombolysis or angioplasty. Several groups showed excellent 2-year patency results of greater than 60%, with i-year patency results of 90% or better and technical successes of 90% as well (66C replacement, 68C, 70, 412, 419, 893). Femoral-popliteal stents are still plagued with poor long-term results (69, 412), although the proximal superficial femoral artery appears to be a more favorable site (413). In a repeat performance from last year, the one outstanding randomized prospective trial of stent placement versus angioplasty in the iliac area (411) showed progressive widening of the differences between stents and angioplasty. One very exciting paper (896) revealed an attempt to decrease myointimal hyperplasia by using intracavitary radiation therapy. Animal work in this field appears clearly indicated. In two outstanding exhibits that appeared to be overlooked in their quality and potential implications (exhibits 504, 506), the effects of angioplasty and stent placement on the vasa vasorum were explored in an experimental model; the underlying potential for control of myointimal hyperplasia by understanding its physiologic basis was clearly evident. Filters continue to be a subject of debate. The titanium Greenfleld filter came under some fire at this meeting with reports of asymmetric or crossed legs (208C) and the fact that such asymmetry can significantly reduce the efficiency of clot trapping (209C). One in vivo study (632) and one improved in vitro study (exhibit 503) further challenged the ability of the titanium and regular Greenfleld filters to trap small clots. It is surprising that the bird’s-nest-shaped filter appeared to trap clots with equal efficiency whether the wires were extended or compressed (2uiC). Another study demonstrating high rates of occlusive or nonoeclusive thrombus at insertion sites, even with the smaller filters (631), suggested that in patients with thrombus or occluding lesions in the pelvic system, an internal jugular approach or, as cxpbored in one paper, an antecubital approach (634) with the bow-profile Simon Nitinob filter might be a better option. The studies exploring various reactions to high-osmolality and low-osmobality contrast material were of high quality this year, with two outstanding studies by one group (90, lil8C) demonstrating that high-osmolality contrast media depress ereatinine clearance more than low-osmolality media, especially at 48 hours in patients
March
1992
‘Notes
L with previously decreased renal function, even when there is no difference in the serum creatinine level. They suggested that this difference may be related to the difference in adenosine production between the two media. Two other excellent randomized and double-blind studies clearly demonstrated that high-osmolality media have a worse effect on renal function than low-osmolality media in patients with previously decreased renal function (1119, 1159). In contrast to this, a third study that also appeared to have excellent methodology, being randomized and double-blind, showed no difference in serum creatinine level between high-osmolality and low-osmobality media (95). The differences between these studies appear to lie in their analysis of subgroups of patients, since two of the three studies showed no difference between high-osmo!ality and bow-osmolality media in evaluating serum ereatinine levels of all their patients, but showed distinct differences in those patients with previously depressed renal function. Large studies of the relative safety of nonionic media in pulmonary angiography are needed to counteract the older literature on the subject; one of these showed up at the meeting this year (1159), showing clearly that nonionic media are safe, even in patients with pulmonary hypertension. It appears from one study (92C) that patients receiving high-osmolality media may be able to receive a single dose of hydroxyzine 12 hours before the study and have a decrease in the severity and number of allergic-type reactions. Angioplasty, athereetomy, and lasers were subjects of very few papers at this meeting (a total of 13), but severa! of these papers had interesting results. Low-pressure heated balloons appeared, in one of the first reports on this technology, to have a restenosis rate similar to that of standard angioplasty, with an increase in the rate of myointimal hyperplasia with increasing heat (1003). Two studies of atherectomy in the femoral-popliteal region showed that atherectomy plus angioplasty improved overall results (1166, 1167), and both studies suggested that diabetes was the primary factor concerning the angioplasty site or clinical variables. An interesting study of athereetomy (1168) suggested that the Dotter effect of the athereetomy catheter and the inflation of the balloon accounted for 57% of the result in concentric lesions but only 12% of the result in eccentric lesions. A baser study with results similar to those obtained with the heated balloons showed that increasing thermal laser injury (1005C) increases the amount of myointimal hyperplasia. Several studies have reconfirmed that lasers are no better than advanced guide-wire techniques for recanalizing obstructed lesions (1006, 1007, 1008). Thrombolysis catheters are coming under some scrutiny, with two good studies showing a wide variation in the method of dispersing agents, especially in the drip mode (750C, 7SiC), with no correlation between price and quality of dispersion. Most of the catheters, except the Bookstein and EDM catheters, drip most of the solution out of the proximal holes. Thrombolysis continues to extend its usefulness in patients for limb salvage (753), with the only factor governing the adequacy of the result remarkably being the presence of a correctable
Volume
182
#{149} Number
3
lesion and not diabetes or adequate runoff. The reason for the discrepancy between this study and previous studies was unexplained. Although hepatic chemoembolization is still something that is simply reported as being performed but not carefully compared with other treatment modalities in terms of its effect on longevity, two interesting papers showed that these techniques can be performed through collaterals when the hepatic artery is occluded (221C), and that midgut carcinoid syndrome is treatable with the same technique (224). A fascinating study of military recruits with varicoceles (349) showed that the treated group had normal growth of the affected testicle and no decrease in sperm count as they aged, whereas the nontreated group had a decrease in both the size of the testicle and the sperm count with age. Although these results were not statistically significant, they are the first to suggest that the process of varicocebe-related subfertility is one that occurs slowly and that an early approach to this problem is definitely warranted. One group reported good results in closing patent ductus arteriosus with a cone-shaped plastic device (ii69C). An interesting exhibit (exhibit 536) suggested that gastrointestinal bleeding sites in the small bowel and colon coubd be treated with !vabon (polyvinyl alcohol) particles 100-500 m in size without significant bowel infarction. Angioscopy, a fascinating toy, was discussed occasionally but no papers on it were presented. Intravascular US seems to show more information after vascular interventions than angiography does (463, 791), but its actual effect on long-term outcome is still in doubt. Its use in other areas, including the evaluation of tumor invasion into vessels (464), may be more important in the bong run. Several groups reported on large series of patients who underwent placement of venous access devices entirely in the radiology department (219C, 220C, 417); the movement to perform this type of implantation with radiologic control seems firmly established. Two interesting papers (356, 358) came up with exactly opposite conclusions as to whether angiography should be performed in trauma patients without clinical evidence of vascular injury. Another interesting general angiography study showed that the only variable that is predictive of whether a patient will have a hematoma after angiography (35%) is the platelet count, which correbates with the clinical bleeding history. There also appeared to be a small correlation between catheter size and hematomas, which conflicts with a previous study on this subject. Spiral and fast CT techniques showed some outstanding promise in the evaluation of large vascular structures (ii6lC, ii62C, 1163) and even pubmonary embolism (exhibit 524). Computer-assisted learning technologies (infoRAD) were much more impressive this year. The switch to Macintosh or Macintosh-like menu and mouse systems in the IBM exhibits has made everything much more intuitive and user-friendly. This is particularly true of the Macintosh Supercard or Hypercard programming, which allows people to make programs that are booklike in feeling. Users understand better where they are
Radiology
#{149} 931
RSNA
‘9 1 Meeting
Notes
within the program and feel much more secure in controlling their motion within the program. This was particubarly true for a very impressive MR angiography instruetor (exhibit 004), which has all the best parts of a book combined with the good parts of moving video displays. The combination of videodisc and computer indeed appeared to be the winning one in terms of user friendliness and the amount of high-quality image information that was available in any format you can imaginc. Particularly good in this respect were the Society of Cardiovascular and Interventionab Radiology videodisc guide to peripheral vascular disease (exhibit 9319) and a superb early effort on the teaching of radiographic anatomy (exhibit 9310). This technology has finally reached maturity and will be an important learning tool for all of us in the years to come. When all is said and done, RSNA ‘91 cardiovascular and interventional papers appeared to be carefully cbsing some loopholes in previous understanding, rounding the rough edges of previous haphazard studies, and challenging some of the results of previous years, which may have been incomplete. To continue to have highquality scientific presentations at this meeting, the RSNA organizers should encourage rather than discourage resubmission of papers from subspeciality meetings so that they can be heard by this larger audience.
#{149}
The radiographic feature of primary tuberculosis in childhood noted most commonly was adenopathy, present in 92% of cases; parenchymal abnormalities were identified in 70%, occurring more commonly in the right lung. Children aged 0-3 years had a higher prevalence of adenopathy and lower preva!ence of parenchyma! consolidation. Twenty-six survivors of stage IV bronchopulmonary dysplasia were evaluated at ages 14-25 years for late outcome. Thirty-one percent (n = 8) of the subjects showed significant radiographic abnormabities, and 76% (n = 20) of the patients had pulmonary dysfunction. The respiratory complications of varicebla in immunocompetent children were compared with those in immune-suppressed children and were found to be present more often in immunodeficient patients. Bacterial infection accounted for the bronchopneumonic or bobar pneumonia in children who were not compromised, while the varicella virus itself produced the abnormality in children with compromise. Invasive aspergilbosis in immunocompromised children is a potentially lethal complication of prolonged neutropenia. Multiple rounded parenchymal nodules and larger confluent masslike infiltration is characteristic of Aspergillus infection; peripheral pleural-based nodules are also commonly identified.
Cardiovascular
Pediatric
Radiology
Beverly P. Wood, MD, Children ‘s Hospital of Los Angeles, Los Angeles Charles R. Fitz, MD, Children ‘s Hospital National Medical Center, Washington, DC William H. McAlister, MD, Washington University School ofMcdicinc, St Louis John H. Miller, MD, Children ‘s Hospital of Los Angeles, Los Aigek’s Sheila
G. Moore,
California Janet L. Strife,
MD,
MD,
Stanford
University, ‘s Hospital
Children
Stanford,
of Cincinnati,
Cincinnati
Richard
B. Towbin,
Index terms: Magnetic logical Society of North meeting . Radionuclide in infants and children Radiology :
RSNA,
A large
1992;
MD,
Children
‘s Hospital,
resonance (MR), in infants and America, 77th scientific assembly imaging, in infants and children
Pittsburgh children #{149} Radioand annual #{149} Ultrasound (US),
182:932-935
1992
number
of scientific
papers
and
exhibits
on
im-
.
Radiology
Pediatric cardiovascular papers included a review of 70 arteriograms obtained in children aged 0.3-18.3 years. The coronary arteries were accurately demonstrated in all, and complications occurred in 7% (n = 5), 3% (n = 2) of whom had major complications. Radiographic evaluation of transvenous atrial septab defect occlusion devices was undertaken in 13 patients. Chest radiographs are helpful in the evaluation of these devices, and knowledge of the radiographic appearance is important in identification of partial disbodgment or entanglement. MR imaging plays an increasing robe in the evaluation of congenital heart disease and has obviated angiography in the evaluation of disorders of the great vessels, anomalies of the aortic arch, aortic coaretation, and bilatera! pulmonary branch stenosis. Three-dimensional dinicab MR imaging of congenital heart disease and vascular rings with color-coded, rotatable, and sectional threedimensional images is helpful in the evaluation of cardiovascubar anomalies and the airway. Reconstructions are obtained from a single set of 3-S-mm sections. MR imaging is increasingly used in the evaluation of functionab abnormalities, with velocity-encoded dine MR imaging being an accurate, reproducible, and noninvasive method for measurement of Qp/Qs in patients with in-
aging in infants and children dealt with applications of ultrasound (US), magnetic resonance (MR) imaging, and nuclear scintigraphy for accurate and sensitive diagnosis of diseases that are specifically pediatric in nature.
creased pulmonary-to-systemic flow ratios. U!trafast MR cardiac imaging is used after a bobus injection of gadopentetate dimeglumine to evaluate intracardiac shunts. MR imaging evaluation of Mustard repair for D-transposition of the great vessels provides insight into
Pediatric Chest Radiology Videofluoroscopic examinations sleep apnea were abnormal and/or structural abnormalities functional and/or dysfunctional
the functional status and morphology of the heart after inflow correction procedures, supplementing clinical and echocardiographie evaluation of the patients. Venous anomalies are frequent in children with bibiary atresia and polysplenia. As part of the preoperative eva!-
932
#{149} Radiology
of 55 children with in 81%, with anatomic present in 52% and abnormalities in 29%.
March
1992
..
.
uation for liver transplantation, normality of the inferior vena ation in 12, left-sided inferior right hemiazygos continuation
Interventional
16 patients showed abcava with azygos continuvena cava in three, and in one.
Radiology
Technical developments have continued to occur in pediatric intervention. Percutaneously placed vena cava filters have been made smaller (i4 F) and can be safely placed in children. No series of pediatric patients treated thus has yet been presented. Another area of potential growth and development is placement of implantable infusion ports with either singleor double-lumen systems. Preliminary studies in adults have demonstrated that percutaneously placed infusion ports are safe and efficacious. Gallbladder intervention is becoming common, and the gallbladder may be used for access to the hepatobiliary tree for both diagnostic and therapeutic procedures. Applications reported in the adult population include percutaneous eholecystolithotomy and emergency cho!eeystostomy for acute chobecystitis. Comparison has been made between percutaneous transhepatic biliary drainage and percutaneous cholecystostomy for biliary drainage. Percutaneous eholecystostomy is technically easier and has a similar complication rate. Pediatric interventionalists are familiar with percutaneous puncture of the gallbladder for diagnostic testing; few therapeutic manipulations, however, have been performed with percutaneous cholecystostomy. Success in adults will open this area in the pediatric population. There is continued interest in pediatric percutaneous gastrostomy, and one group now places percutaneous gastrostomy tubes in outpatients. Stents are among the newest areas of interventional radiology and are currently used in the bibiary tree for treatment of both benign and malignant strictures, in the vascular bed for treatment of resistant or recurrent stricture, and to crcate portosystemic shunts. This technique also shows promise for a wide variety of pediatric conditions. Posttransplantation Radiology Posttransplantation studies in patients after liver transplantation showed transhepatie portal vein angioplasty was effectively used in the treatment of portal vein anastomotie strictures. Duplex Doppler US for evaluation of renal dysfunction before and after liver transplantation indicated that abnormal findings at renal Doppler US performed before liver transplantation indicated a greater risk for subsequent renal failure and hemodialysis requirement. Color duplex Doppler US was 100% sensitive in the diagnosis of severe renal artery stenosis with or without rejection. Quantitative ventilation-perfusion studies in patients after single-lung transpbantation indicated that increased perfusion to single transplanted lungs is generally seen. Increased perfusion over ventilation suggested a loss of vascular autoregulation in the transplant, and a progressive decline in transplant perfusion is associated with rejection.
Volume
182
#{149} Number
3
.
.
.
RSNA Endocrine
‘9 1 Meeting
Notes
Radiology
Congenital hypothyroidism may result from thyroid agenesis, hypoplasia, ectopia, or transitory malfunction. Congenital hypothyroidism was assessed with scintigraphy, US, and serum hormonal values. Scintigraphy demonstrated thyroid agenesis, ectopia, hypoplasia, and goiter. US accurately demonstrated the absence of the gland from its normal location in 51 of 52 newborns, with agenesis or ectopia seen by means of scintigraphy in 98%. US and hormonal values are sufficient the cause of congenital hypothyroidism, and phy may be delayed to confirm the diagnosis.
Musculoskeletal
to suggest scintigra-
Radiology
US examination and MR imaging examination for muscuboskeletal abnormalities are increasing in use. US of the pediatric elbow is sensitive in delineating the normal cartilage anatomy, extraarticular soft-tissue inflammation, and transphyseal fractures of the distal humerus. MR imaging evaluation of acute dislocation of the shoulder shows anterior glenoid labrum tear, Hill-Sachs besion, and Bankhart lesion with high sensitivity. Evaluation of patients with the human immunodeficiency virus-for the presence of osteomyelitis revealed a 2% prevalence of positive bone scans consistent with osteomye!itis in this group, with isolated organisms being those of the Staphylococcus and Salmonella species. Comparison of skeletal, metaiodobenzylguanidine (MIBG), and bone-marrow scintigraphy in the evabuation of neuroblastoma revealed that no method was clearly superior to the others, but MIBG 1-123 and skeletal scintigraphy are very sensitive to skeletal metastasis of neuroblastoma. Pediatric use of mercaptoacctyltriglycerine is helpful in following skeletal changes after bone marrow harvest to prevent the perception of such changes as being metastatic involvement by neuroblastoma. A previously unrecognized association among rib infarction, pulmonary infiltrates, and pleural effusion appearing as acute chest syndrome in children with sickle cell disease is helpful in the evaluation of patients with this enigmatic problem. MR imaging has been used to diagnose recurrent primary Ewing sarcoma and compared in accuracy with other imaging modalities. Local recurrence has been identified accurately in seven of eight recurrences, and MR imaging is more sensitive than computed tomography (CT) or bone scanning. Genitourinary and Gastrointestinal Radiology Detection of vesicoureterab reflux in infants by means of cyclic voiding cystourethrography (VCUG) is helpfub in increasing the sensitivity of VCUG to reflux. Seventy-six consecutively seen children aged less than 3 years with negative results of initial VCUG underwent a second cycle of bladder filling and voiding, with unsuspected reflux occurring in i7%. US was not found to be reliably sensitive in the detection of vesicoureteric reflux, and VCUG is still the modality of choice. Color Doppler US can be used to locate the base of the ureteric jet and corresponds cystoscopically to the position of the ureteric orifice. Measurement of the distance between the midline of the bladder and the ureteric orifice can aid in pre-
Radiology
#{149} 933
RSNA
‘9 1 Meeting
I
Notes
dieting vesicoureteral reflux, and a distance of 9 mm or less is accurately predictive of a negative VCUG result 90% of the time. Evaluation of mubticystic dysplastic kidneys in 48 patients who underwent sequential sonography showed a decrease in size in 71%, no change in size in 19%, and an increase in size of the involved kidney in 10%. Periphcrab vascular mapping of neurobbastoma by using color Doppler imaging represents a noninvasive method for mapping the relationship between neuroblastoma and retroperitoneal vessels preoperativeby and is considered extremely sensitive in such patients. The resistive index of renal lobular arteries in healthy children is relatively high compared with the expected bevel in adults. Resistive index is age-dependent, high in children aged up to 10 years, and commonly greater than .70 in children aged less than 6 months. Short inversion time inversion recovery (STIR) MR imaging has been compared with CT and lymphography for identification of retroperitoneal and iliac lymphadenopathy in patients with Hodgkin disease. STIR imaging allowed correct exclusion or depiction of lymphadenopathy in all 14 cases studied, and STIR MR imaging and CT were superior to lymphography in asscssment of the more cephalic periaortic nodes, with all lymph nodes more conspicuous on STIR MR images than on CT scans. Evaluation of a 5-year experience with pneumatic reduction of intussusception in 246 patients showed suecessful reduction in 199 cases (80.9%). Bowel perforation occurred in seven cases (2.8%), and intussusception recurred in 27 cases (11%). The single most important predictor of outcome in this series was length of duration of symptoms. Duplex Doppler ovarian sonography was used in 28 normal ovaries in 20 girls. The resistive index was .62 between days 7 and 22 of the menstrual cycle and .73 between days 0 and 7 and between days 22 and 28. Ovarian cysts identified at prenatal US in girls were evaluated and followed postnatalby. Forty-four prenatally detected cysts were seen, 38 purely cystic and six with an echogenie or mixed pattern. Twenty-three cases were followed sonographically, and 18 resolved within 1 year. Five showed a distinct reduction in volume during that time. The size of cysts varied between 2 and 86 cm3. Neuroradiobogy Neuroradiobogic assessment of pediatric patients mdieates that in the newborn evaluated with cranial US, coronal imaging alone successfully depicts all intraventricular bleeding, with no hemorrhage occurring that was detected on the parasagittal views alone. Color Doppler US is useful in identifying cerebral flow and the abnormal venous drainage of vascular anomalies. Fourteen color Doppler US examinations in patients with head and neck arteriovenous malformations indicated excellent correlation with angiographic findings and clinical evidence of high-output cardiac failure. Preembobization color Doppler US mapping of major feeders and estimation of arteriovenous flow and arterial peripheral resistance are used. After treatment, the effect
on flow to the arteriovenous malformation, normal brain circulation, and development of new feeders is assessed. Cranial CT examination of patients with herpes simplex encephalitis showed abnormalities in 15 of 16 scans, with bilateral hemisphere changes of low attenuation, ventricular compression, intracerebrab hemorrhage, and abnormal contrast enhancement identified as presentation of this encephalitis. MR angiography provides a clinically useful method for imaging vasculature of the pediatric brain and is an adjunct to spin-echo imaging. A bolus of gadopentetate dimeglumine can be used to detect asymmetry in blood flow dynamics of cerebral perfusion in children. Diffusion-weighted imaging in 33 infants is shown to be highly sensitive to myclination. Cerebrovascular results evaluated with MR angiographic techniques (three-dimensional time of flight, two-dimensional time of flight, and veloeity-compensated-uncompensated time of flight) were performed, and two-dimensional time of flight was useful in subtracting the high signal intensity from methemoglobin clot.
Magnetic
tion
934
#{149} Radiology
Resonance
(MR)
Use of contrast material-enhanced subtraction MR imaging in the evaluation of osteosarcoma response to adjuvant chemotherapy in 10 patients showed tumors appearing as high-signal-intensity masses, sometimes with enhancing capsules at beast 3 mm thick. These tumors had poor responses at histopathobogic evaluation. Osteogenic sarcomas, which were nonenhancing, with or without fully enhancing capsules, were good responders. Experimental work with periosteal implantation of the VX2 carcinoma and Ti- and T2-weighted and gadolinium-enhanced Ti -weighted images showed correlation with pathologic findings, although tumor boundaries depicted on MR images were larger than the actual tumor. This was due to the presence of a capsulebike hypervaseular connective tissue rim surrounding the tumor, which showed increased signal intensity on T2weighted and gadolinium-enhanced Ti-weighted images. The criteria of size, margin character, signal inhomogeneity, involvement of neurovaseular structures, tumoral vessels, and peritumoral edema did not allow adcurate distinction between benign and malignant softtissue masses at MR imaging. Similarly, the use of MR imaging in distinguishing benign and malignant vertebra! compression indicated that in the first 3 months after fracture, both benign and malignant vertebral cornpression fractures showed intermediate signab intensity on Tl-weighted images, enhancement with gadopentetate dimeglumine, and increased signal intensity on T2-wcighted and gradient-recalled-echo images. Posttraumatic fractures that were related to osteopenia and were more than 4 months old exhibited marrow signal intensity isointense to that of normal marrow, and neoplastic fractures exhibited diffuse decreased signal intensity on Ti-weighted images and either increased or no signal abnormality on T2-weighted gradient-recalledecho images. Investigation of the utility of MR imaging in cvabuaof hematopoietic
neoplasms
indicated
that
the
March
mo-
1992
:
...‘
A1RSNA9
,‘ S
dality
is useful
in patients
undergoing
77th
allogeneic
bone
ity with
Category
member
RSNA member-in-training AAPM member Nonmember program Nonmember radiologist
Nonmember
Hospital Qualified
participant
physicist
Nonmember Radiology
resident/trainee support personnel
executive non-health
Non-hospital-based
Other physician Commercial research Consultant Student Total
sciences medical
Total
Note-N/A * Medical
and
hospital
staff
personnel care provider
and development
professionals
Exhibitor
3
chemical
of North
shift
imaging
of the
pelvis
indicated
America
1991 Total Attended
1990 Total Attended
1989 Total
7,230
7,043
6,281
attendees
personnel
Attended
916 733
931 724
833 674
611 2,147
633 2,312
574 1,903
344 393
192
311
601 6,869 790
540 6,897 735
N/A
N/A
371
N/A
N/A 259
231 137
N/A 129 1,186*
N/A N/A 1,109*
21,700
19,457
279
Guest/spouse Press
#{149} Number
.,-
that the calculated fat fraction and the marrow Ti relaxation time calculated from water images were accurate in distinguishing marrow cellularity of less than 20% from marrow cellularity of greater than 20%, this information serving as a useful guide in directing bone marrow biopsy and harvest in patients before autobogous marrow transplantation.
Registration Figures: Radiological Society Assembly and Annual Meeting
RSNA
182
,
Scientific
Registration
Volume
1 Meeting
.
j
marrow transplantation. Marrow patterns indicated diffuse hypereel!u!arity before transplantation, and normal marrow signal intensity was recovered in all patients within a year after albogeneic transplantation. Many cxhibited the “band pattern” that is a typical response of the marrow to therapeutic intervention, including marrow transplantation. The time of response was variable. Correlation of biopsy-determined iliac marrow cellular-
Official
n-., ‘ Notes
,.
430
92 1,213 22,103
4,163 181
6,117 490
2,464 149
4,387 184 25,506
24,329
19,526
52,180
50,373
41,596
= not available. students only.
Radiology
#{149} 935
RSNA
1991
Program
Replacement
The following are abstracts of papers withdrawn after rectly in the program.
Abstracts
of papers (a) that were presented at RSNA’91 in replacement the program book was printed or (b) that were printed incor-
METHODS
has been imaged by using DSA and several MR The results of the dimension measurements revealed that the vessels were 0.42 mm ± 0.24 smaller than the computer model because of shrinkage of the polymer material used in manufacturing. A comparison of the physical phantom to x-ray measurements showed a difference of +0.18 mm ± 0.13. CONCLUSION: We have demonstrated that stereolithography can be used to
expanding
build a complex
66
Eleven an endovascular
patients stent.
PURPOSE:
with
with
total
occlusion
of the iliac arteries
angiography
MD
were
E.
#{149}
treated
AND MATERIALS: All the patients were treated with selfstents (Wallstent) that consists of stainless steel alloy filaments woven in a tubular fashion. All patients were men with a mean age of 66 years, ranging from 49 to 79 years. The length of occlusion varied from 3 to 15 cm. Three stents were placed in each of two patients, two stents in each of seven patients, and one stent in two patients each. The follow-up period ranged from I to 15 months, with a mean of 6 months. In all patients, a through-and-through guide wire was used; either both femoral arteries or the axillary and a femoral artery were used. The occluded segment was recanalized, and the stent was placed immediately after. RESULTS: There were no major complications related to the procedure. One of the stents occluded 3 days and 2 months after the placements. In both cases, the occlusion
was
resolved
asymptomatic CONCLUSION: surgical
with
urokinase
infusion.
up to 15 months. The use of endovascular
bypass
in
iliac
artery
The
rest
of the
patients
remain
occlusions,
may
especially
be an
when
long
to
segments
are
955 #{149}11:06AM Creation of a Complex Vascular Phantom for MR and X.Ray Anglography AR. Sanderson, ME, Salt Lake City, Utah #{149}E. Cohen, PhD #{149}W. Davis, MD
hollow
sions
We have
developed
representations
and
a technique
of complex
positions
to facilitate
to generate
vascular
research
beds
anatomically
of precisely
in quantitative,
middle
and
anterior
cerebral
AND
MATERIALS:
METHODS
creating
a computer
vascular
structure
produced based
dimensional by using
936
that
on x-ray
was
Phantom containing used
phantom.
to
The
dimensions
MR angiography and conventional
Radiology
#{149}
vessel
dimen-
multiple-modality
(MR
imaging.
artery
A
to the
arteries.
model
the physical
correct
known
angiography and digital subtraction angiography [DSAI) vessel phantom has been generated that represents the common carotid
was
D.
#{149}
PhD
PURPOSE:
construction the
drive
data set. The techniques.
representation
locations phantom
accomplished
by
representation
a stereolithography
geometric and
was
geometric
obtained dimensions
of the
machine
that
of the phantom from were
a
three-
vascular
phantom
can be imaged of the phantom
by
using
a geometric
with DSA and is in progress.
representation,
MR angiography
and
techniques.
11:24AM
957
#{149}
Imaging after Radiosurgery for Cerebral Arterlovenous Malformations LD. Lunsford, MD, Pittsburgh, PA #{149}D.S. Kondziolka #{149}A.H. Maitz, MS #{149}D.J. Bissonette, PA-C #{149} J.C. Rickinger, MD PURPOSE: To evaluate the role of cerebral angiography, MR imaging, and CT during and after stereotaxic radiosurgery for arteriovenous malformations Neurodlagnostic
(AVMs).
alternative
involved.
Parker,
that the phantom Further evaluation
MATERL4LS: In our first 3-year experience with gamma knife 227 patients underwent intraoperative stereotaxic angiography and were evaluated by means of serial posttreatment MR or CT imaging. RESULTS: AVM obliteration (defined as complete angiographic resolution) was obtained in 37 of 46 patients (80%) who were evaluated 2 years after radiosurgery. We reviewed sequential MR or CT images in 72 of our first 75 patients treated with radiosurgery. Twenty patients (2-year actuarial mcidence = 31%) developed post-radiosurgical imaging changes consisting of new regions of increased T2 signal on brain MR. Imaging changes were associated with headache or new neurological deficits in nine of 20 (45%) and were asymptomatic in 11 (55%). The onset of symptoms correlated with the presence of an AVM in an area of critical brain function and developed 5-18 months after radiosurgery. Imaging changes resolved completely by 19 months in 10 patients. In multivariate analysis, volume was the only factor significantly associated with the development of imaging changes. CONCLUSION: Cerebral angiography remains the benchmark by which suecessful AVM radiosurgery (total obliteration) can be defined. However, serial MR images, when possible, provide critical knowledge about the response of
METHODS
stents
The phantom techniques.
RESULTS:
#{149}11:33AM Endovascular Stent In Complete OcclusIon of the lilac Artery M. Maynar, MD, Minneapolis, MN #{149}A. Reyes, MD #{149}J.M. Puildo-Duque, Gornz, MD #{149} E. Otermin, MD #{149} W.R. Castaneda-Zuniga, MD
AND
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Gastrointestinal Disease. 4th Series Barry A. Siegel, MD, Elias G. Theros, MD, Anthony V. Proto, MD, editors, and David H. Stephens, MD, section editor 1990 #{149} Cloth #{149} 600 pages #{149} $110.00 (members) #{149} $175.00 (nonmembers) #{149} $90.00 (residents)
to Vascular for the Complete Donald Ridgway, RVT 1992 #{149} Paper #{149} 275 pages
Introduction
A Guide
Review
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Flashcards
Adult EchoNascular/Physics/ Abdomen/OB/GYN Lori Green, RT, RDMS, RVT, Lori Sens, RT, RDMS, RVT 1990 #{149} Approx 230 questions
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Nuclear Radiology. 4th Series Barry A. Siegel, MD, Elias G. Theros, MD, Anthony V. Proto, MD, editors, and James H. Thrall, MD, section editor
and
for $99.00
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to Adult Echocardiography. Lori Green, RT, RDMS, RIfT, and Lori Sens, RT, RDMS, RVT Vols 1 and 2 #{149} $125 each/$225 the set
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to Cardiac
Doppler/Color
Flow Ultrasound Lori Green, RE RDMS, RVT, and Lori Sens, RT, RDMS, RVT 1990 #{149} Approx 60 minutes long #{149} $140.00
(nonmembers)
(residents) Techniques Instructional -
Carotid
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of the Lower
Saphenous Vein Mapping Venous Imaging Jean Eiison, RVT 1989 #{149} Approx 30 minutes #{149} $99.00 each
Color Flow Carotid
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Wilson, RVT 30 minutes long
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Vascular Laboratory Operations Manual: A Guide to Survival Claudia B. Rumwell, RN, RVT, editor 1989 #{149} Looseleaf #{149} 226 pages #{149} $175.00 Vascular Technology Review, 3d ed Barton A. Bean, RVT, Donna E. Cox, RN, RVT, and Keith Mauney, RN, editors 1 989 #{149} Paper #{149} 208 pages #{149} $55.00
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Bioeftects and Management Barry A. Siegel, MD, David H. Stephens, MD, editors, and Louis K. Wagner, PhD, section editor 1991 #{149} Cloth #{149} 500 pages #{149} $110.00
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and
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Neuroradlology Barry A. Siegel, MD, Elias G. Theros, MD, Anthony V. Proto, MD, editors, and Peter E. Weinberg, MD, section editor 1 990 #{149} Cloth #{149} 1 050 pages #{149} $180.00 members) #{149} $300.00 (nonmembers) #{149} $150.00 (residents) #{149} (2-vol set)
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-
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Medicine #{149} $99.95
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MARCH
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.4
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U,.,
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RADIATION
IOEFFECTS
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available
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Cardiovascular Applications of Doppler Ultrasound Abdul-Majeed Salmasi, MD, PhD, FACA, and Andrew N. Nicolaides, MS, FRCS, editors 1990 #{149} Cloth #{149} 369 pages #{149} $150.00
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L.
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and
Digital Imaging in Diagnostic Radiology John D. Neweil, MD, and Charles A. Kelsey, PhD, FACR, editors 1990 #{149} Cloth #{149}163 pages #{149} $49.95
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Doppler Echocardiography: An Illustrated Clinical Guide Peter Wilde, MRCP, FRCR 1989 #{149} Cloth #{149} 153 pages #{149} $69.00
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1992 #{149} In preparation
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#{149} Videotape
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#{149} 497
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Pediatric Bone Imaging: A Practical Approach Saroosh Mahboubi, MD, editor 1989 #{149} Cloth #{149} 215 pages #{149} $85.00
MRI of MS and White Matter Murray A. Solomon, MD 1990 #{149} Videotape #{149} $125.00 MRI of Stroke and Hemorrhage Murray A. Solomon, MD 1992 #{149} Videotape #{149} $125.00
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1991
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#{149}Cloth#{149}2o8pages
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cine.
320
(including
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MARCH
Color
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Harrison’s
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#{149}$95.00
#{149} $85.00
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MRI of the Foot and Ankle Murray A. Solomon, MD 1 989 #{149} Videotape #{149} $125.00 MRI of the Knee Murray A. Solomon, 1992 #{149} Videotape
File Approach
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Gerald M. Pohost and Robert A. O’Rourke, MD 1991 #{149} Cloth #{149} 880 pages #{149} $175.00
Transesophageal Fiona Clements, de Bruijn, MD
Spines
of Cardiovascular
Imaging
Cranial MRI and CT. 3d ed S. Howard Lee, MD, Krishna C. V.G. Rao, MD, and Robert A. Zimmerman, MD 1991 #{149} Cloth #{149} 800 pages #{149} $150.00 Cranial MRI: A Teaching John Bisese, MD 1991 #{149} Cloth #{149} 382 pages
MRI of the Brainstem Murray A. Solomon, MD 1990 #{149} Videotape #{149} $125.00
Practical Pediatric Imaging. 2d ed Donald R. Kirks, MD 1 991 #{149} Cloth #{149} 800 pages (approx) #{149} $150.00 Principles
Disease
Order
Joseph Martire, MD, and E. Mark Levinsohn, MD 1991 #{149} Cloth #{149} 368 pages #{149} $89.00
Services
1 33 1 1 Monterey Avenue Blue Ridge Summit, PA (800) 822-8138 (717) 794-2191 Telefax (7 1 7) 794-5344
17294-0850
Applied Screen Film Mammography Gini Wentz, RT, and Ward C. Parsons, MD 1992 #{149} Paper #{149} 160 pages #{149} $32.00 (approx) Cardiac Nuclear Medicine Myron C. Gerson, MD 1991 #{149} Cloth #{149} 653 pages
#{149} $90.00
Clinical Doppler Echocardiography: Spectral and Color Flow Imaging Jose Missri, MD 1 990 #{149} Cloth #{149} 336 pages #{149} $80.00
RADIOLOGY
Interventional Radiology Renan Uflacker, MD 1991 #{149} Cloth #{149} 640 pages
#{149} $149.00
Mammographic Interpretation: A Practical Approach Marc J. Homer, MD 1 991 #{149} Cloth #{149} 368 pages #{149} $90.00 MRI Atlas of Normal Anatomy Anna K. Chacko, MD, Richard W. Katzberg, MD, and Aileen Mackay, MSR 1991 #{149} Paper #{149} 320 pages #{149} $79.00
71A
Publishers’ Orthopaedic Approach John Bisese, 1990 #{149} Cloth
MRI:
Row
A Teaching
File
MD #{149} 384
pages
#{149} $85.00
Pharmaceuticals in Medical Imaging Dennis P. Swanson, RPh, MS, Henry M. Chilton, PharmD, and James H. Thrall, MD 1990 #{149} Cloth #{149} 736 pages #{149} $95.00 Radiation Therapy Gunilla C. Bentel 1991 #{149} Paper #{149} 352
Atlas of Planar and SPECT Bone Scans Ignac Fogelman, MD, and B. David Collier, MD 1989 #{149} Cloth #{149} 320 pages #{149} $149.00 #{149} CV. Mosby/Martin Dunitz Publication
Planning
Pelvic Imaging: and MRI Arnold C. Friedman, MD 1989 #{149} Cloth #{149} 546 pages
An Atlas of Radiological Interpretation: The Bones J.F. Calder, FRCR, and G. Chessell, MEd 1 989 #{149} Cloth #{149} 286 pages #{149} $59.95 #{149} (Americas
pages
Clinical
An
Only)
Atlas of Roentgenographic ment. 6th ed Theodore E. Keats, MD 1991 #{149} Cloth #{149} 721 pages Atlas
of Ultrasonographic 2d ed Roger Sanders, MD 1 991 #{149} Cloth #{149} 256 pages
Measure-
#{149} 380
pages
File Approach
#{149} $95.00
Artifacts
and
#{149} $90.00
(approx)
Atlas of Ultrasound Measurements Barry B. Goldberg, MD, and Alfred MD 1 990 #{149} Cloth #{149} 477 pages #{149} $85.00
B. Kurtz,
BOOK, Industrial 63146
AFIP Atlas of Radiologic-Pathologic Correlation. Fascicle II. Cartilaginous Lesions of the Bone Richard Moser, Jr, MD 1990 #{149} Cloth #{149} 221 pages #{149} $50.00 & Belfus
Atlas of Normal Fetal Ultrasonographic Anatomy. 2d ed Richard A. Bowerman, MD 1991 #{149} Cloth #{149} 320 pages (approx) #{149} $72.00
(approx)
Atlas of Normal Roentgenographic Variants That May Simulate Disease. 5th ed Theodore E. Keats, MD 1991 #{149} Cloth #{149} 1,356 pages (approx) #{149} $169.00
72A
Cloth
#{149}
#{149} 302
pages
#{149} $94.95
of the Chest
#{149} $65.00
Current Practice of Interventional Radiology Sadoon Kadir, MD 1991 #{149} Cloth #{149} 779 pages #{149} $149.00 Publication
MD
Diagnostic Imaging in Emergency Medicine Peter Rosen, MD, et al 1991 #{149} Cloth #{149} 640 pages #{149} $115.00
Caffey’s Pediatric X-ray Diagnosis. 9th ed Frederic N. Silverman, MD, and Jerald P. Kuhn, MD, et al 1 992 #{149} Cloth #{149} 2,000 pages #{149} $300.00 #{149} (2-vol set)
Diagnostic Ultrasound Carol Rumack, MD, Stephanie Wilson, MD, and William Charboneau, MD 1991 #{149} Cloth #{149} 1 ,400 pages (approx) #{149} $225.00
Cardiovascular Magnetic Resonance Imaging Fernando Gutierrez, MD, Jeffrey J. Brown, MD, and Scott A. Mirowitz, MD 1991 #{149} Cloth #{149} 238 pages #{149} $99.00
Diagnostic Ultrasound of Fetal Anomalies David A. Nyberg, MD, Barry S. Manhony, MD, and Dolores H. Pretorius, MD 1990 #{149} Cloth #{149} 791 pages #{149} $162.00
Cartilaginous Tumors of the Skeleton (AFIP Atlas of Radiologlc-Pathologic Correlation. Fascicle II) Richard P. Moser, Jr, MD. COL, MC
Emergency Radiology. Theodore E. Keats, MD 1989 #{149} Cloth #{149} 526 pages
1990#{149}Cloth#{149} 221
Enhanced MR Imaging Val M. Runge, MD 1989 #{149} Cloth #{149} 367 pages
#{149} Hanley
& Belfus,
pages#{149}$50.00
Inc. Publication
Chesney’s Radiographic Imaging. J. Ball, TDCR, and I Price, HDCR, 1 989 #{149} Cloth #{149} 400 pages #{149} $34.95
5th ed editors
Chest Radiology: Plain Film Patterns Differential Diagnoses. 3d ed James C. Reed, MD 1991 #{149} Cloth #{149} 434 pages #{149} $75.00
and
Brain Imaging: Normal Structure and Functional Anatomy L. Anne Hayman, MD, and Vincent C. Hinck, MD 1 992 #{149} Cloth #{149} 284 pages (approx) Clinical
(approx)
Atlas of Nuclear Medicine: Artifacts and Variants. 2d ed U. Von Ryo, MD, Abass Alavi, MD, B. David Collier, MD, Carlos Bekerman, MD, and Steven M. Pinsky, MD 1 990
pages
II
Lithotripsy
INC. Drive
Advances in Hepatobiliary Radiology Joseph Ferrucci, MD, and Didier G. Mathieu, MD 1990 #{149} Cloth #{149} 460 pages #{149} $95.00
#{149} Hanley
Oncology
Cross Sectional Analysis and Abdominal Wall Richard J. Wechsler, MD 1989 #{149} Cloth #{149} 359 pages
#{149} B.C. Decker Biliary
Gustav Paumgartner, MD, H. Joachim Burhenne, MD, and Joseph I Ferrucci, 1989 #{149} Cloth #{149} 300 pages #{149} $94.95 1 1830 Westline St. Louis, MO (800) 633-6699 (314) 872-8370
Clinical Radiation CC. Wang, MD 1989 #{149} Cloth #{149} 480
#{149} $85.00
Treatment Planning and Dose Calculation in Radiation Oncology. 4th ed Gunilla C. Bentel, Charles E. Nelson, PhD, and K. Thomas Noeil, MD 1 989 #{149} 352 pages #{149} Paper #{149} $25.00
MOSBY-YEAR
Clinical Positron Emission Tomography Karl F. Hubner, MD, et al 1991 #{149} Cloth #{149} 336 pages #{149} $125.00
Comprehensive Radiographic Pathology Ronald L. Eisenberg, MD, and Cynthia A. Dennis, MD 1990 #{149} Cloth #{149} 393 pages #{149} $39.95
Variants. A Teaching MD
#{149} $98.00
#{149} $25.00
Radiographic Neuroanatomy: A Working Atlas Harry W. Fischer, MD, and Leena Ketonen, MD 1991 ‘Paper#{149}224pages #{149}$35.00 Spinal MRI: John Bisese, 1991 #{149} Cloth
CT, Ultrasound,
S
$99.00
(approx)
2d ed #{149} $110.00
#{149} $75.00
Essentials of Caffey’s Pediatric X-ray Diagnosis Frederic N. Silverman, MD, and Jerald Kuhn, MD 1989 #{149} Cloth #{149} 1,170 pages #{149} $139.95 The Fracture Classification Ramon B. Gustio, MD 1991 #{149} Paper #{149} 186 pages
Manual #{149} $45.00
Handbook
of Gastrointestinal and Radiology Stephen ElI, MD, PhD 1991 #{149} Cloth #{149} 250 pages (approx) #{149} $36.00 (approx)
Genitourinary
$95.00
#{149}
RADIOLOGY
MARCH
Publishers’
Row Magnetic Resonance Imaging of the Cardiovascular System Richard Underwood, MA, MRCP, and David N. Firmin, PhD 1990 #{149} Cloth #{149} 223 pages #{149} $99.95 #{149} Blackwell Scientific Publication
Handbook of Neuroradiology Anne G. Osborn, MD 1991 #{149}Paper#{149}411 pages #{149}$36.95 Handbooks In Radiology - Chest Radiology Howard Mann, MD, and David G. Bragg, MD 1989 #{149} Cloth #{149} 255 pages #{149} $24.95 Handbooks in Radiology Neck Imaging H. Ric Harnsberger, MD 1 990 #{149} Paper #{149} 563 pages
-
Magnetic Resonance Imaging of the Extremities: A Teaching File Leanne Seeger, MD, Vijay Chandnani, MD, and Richard Gold, MD 1 992 #{149} Cloth #{149} 320 pages (approx) #{149} $75.00 (approx)
Head and
and Neck Imaging. 2d ed Som, MD, and Thomas Bergeron, #{149} Cloth #{149} 1,165 pages #{149} $180.00
Imaging of AIDS P.M. Trotot,MD 1991 #{149} Cloth #{149} 304 pages
Magnetic Resonance of the Spine Dieter Enzmann, MD, Robert L. DeLaPaz, MD, and Jeremy R. Rubin, MD 1990 #{149} Cloth #{149} 599 pages #{149} $99.00
MD
#{149} $89.00
Mammography A. Le Treut, MD, and M.H. Dilhuydy, 1991 #{149} Cloth #{149} 216 pages (approx) #{149} $89.00 (approx)
Nuclear Medicine: A Teaching File Fredrick L. Datz, MD, et al 1 992 #{149} Cloth #{149} 300 pages #{149} $89.00 Nuclear Medicine Technology and Techniques. 2d ed Donald R. Bernier, CNMT, Paul Christian, CNMT, James R, Langan, CNMT, and L. David Wells, CNMT 1989 #{149} Cloth #{149} 623 pages #{149} $59.95
MD
Medical Imaging Physics. 3d ed William R. Hendee, PhD, and Russell Ritenour, PhD 1992 #{149} Cloth #{149} 592 pages #{149} $79.00
Radiology: Pattern and Differential Diagnosis Peter Renton, FRCR, DMRD 1 989 #{149} Cloth #{149} 31 2 pages #{149} $69.95
Orthopedic
Recognition
Imaging of Children with Cancer Mervyn D. Cohen, 1991 #{149} Cloth #{149} 756
MD pages
Imaging of CNS Disease: Teaching File Douglas H. Yock, Jr, MD 1991 #{149} Cloth #{149} 524 pages
#{149} $149.00
A CT and MR
#{149} $89.00
Imaging of Diseases of the Chest Peter Armstrong, MD, Paul Dee, MD, and Alan Wilson, MD 1989 #{149} Cloth #{149} 914 pages #{149} $149.95 Imaging of the Liver, Pancreas, and Spleen R.A. Wilkins 1990 #{149} Cloth #{149} 557 pages #{149} $230.00 #{149} Blackwell
Scientific
Nuclear Medicine: Self-Assessment in Radiology & Imaging. Vol 5 S. Karimjee, A. Thomas, and W. Taylor 1989 #{149} Cloth #{149} 191 pages #{149} $54.95 #{149} (Americas Only)
#{149} $29.95
Handbooks in Radiology - Interventional Radiology and Angiography Myron Wojtowycz, MD 1990 #{149} Paper #{149} 441 pages #{149} $29.95 Head Peter 1991
New Concepts in Cardiac Imaging 1989 Gerald M. Pohost, MD, Charles B. Higgins, MD, Navin C. Nanda, MD, James L. Ritchie, MD, and Heinrich R. Schelbert, MD, editors 1 989 #{149} Cloth #{149} 31 0 pages #{149} $69.95
Publication
Interventional Computed Tomography Ranier MM. Seibel, MD, PhD, and Dietrich H. W. Gronemeyer, MD 1991 #{149} Cloth #{149} 363 pages #{149} $174.95 #{149} Blackwell Scientific Publication Lithotripsy and Related Techniques for Gallstone Treatment Gustave Paumgartner, MD, and H. Joachim Burhenne, MD, FRCP 1991 #{149} Cloth #{149} 194 pages #{149} $99.00 (approx) Magnetic Resonance Imaging. 2d ed David D. Stark, MD, and William G. Bradley, Jr., MD PhD 1991 #{149} Cloth #{149} 3,000 pages (approx) #{149} $265.00 (approx) (2-vol set)
Merrill’s Atlas of Radiographic Positions and Radiologic Procedures Philip W. Ballinger, MS, RT(R) 1991 #{149} Cloth #{149} 2,987 pages #{149} $149.95 MR and CT Imaging of the Head, Neck and Spine. 2d ed Richard E. Latchaw, MD 1991 #{149} Cloth #{149} 1,445 pages #{149} $225.00 MRI and CT of the Musculoskeletal System Hossein Firooznia, MD, Cornelia Golimbu, MD, Mahrash Rafii, MD, Wolfgang Rauschning, MD, and Jeffrey Weinreb, MD 1991 #{149} Cloth #{149} 944 pages #{149} $175.00 MRI in Pediatric Neuroradiology Samuel M. Wolpert, MD, and Patrick Barnes, MD 1991 #{149} Cloth #{149} 512 pages (approx) #{149} $99.00 (approx) The MRI Manual Robert B. Lufkin, MD 1 989 #{149} Cloth #{149} 385 pages Musculoskeletal Imaging David Sartoris, MD 1992 #{149} Cloth #{149} 384 pages
Pediatric Gastrointestinal Imaging David A. Stringer, BSc, FRCR, FRCP, MBBS 1989 #{149} Cloth #{149} 667 pages #{149} $135.00
#{149} B.C. Decker
Peripheral Vascular Imaging and Intervention Ducksoo Kim, MD, and Dan E. Orron, 1991 #{149} Cloth #{149} 700 pages #{149} $99.00 Resonance
#{149} $45.00
Practical Alimentary Tract Radiology Alexander R. Margulis, MD, and H. Joachim Burhenne, MD, FRCP(C) 1992#{149}Cloth #{149}45opages #{149}$88.95
Workbook #{149} $38.00
H.
Prostate Ultrasonography Martin I. Resnick, MD 1 990 #{149} Cloth #{149} 1 91 pages #{149} B.C. Decker Publication Radiation CC.
I
MD
Therapy
#{149} $69.50
for Head
and Neck
Neoplasms
Magnetic Resonance Imaging of Children Mervyn Cohen, MD 1 990 #{149} Cloth #{149} 986 pages #{149} $169.50
MARCI
Publication
The Physics of Magnetic Imaging William Pavlicek, MD 1990 #{149} Cloth #{149} 300 pages #{149} B.C. Decker Publication
#{149} $39.95
Musculoskeletal Ultrasound Marnix Van Holsbeek, MD, and Joseph Introcaso, MD, DMD 1991 #{149} Cloth #{149} 327 pages #{149} $85.00
Patient Care in Radiography Ruth Ann Ehrlich, RTR(ARRT), and Ellen Doble (Givens) McCloskey, RN, BS, MN 1989 #{149} Paper #{149} 31 1 pages #{149} $29.95
1 990
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Wang #{149} Cloth
#{149} 436
pages
#{149} $74.00
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Radiology: An Illustrated History Ronald L. Eisenberg, MD 1991 #{149} Cloth #{149} 608 pages (approx) #{149} $99.00
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Radiology in Organ Transplantation Janis Gissel Letourneau, MD, Deborah Day, MD, and Nancy L. Ascher, MD 1991
#{149} Cloth
#{149} 375
pages
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1 990 Year Book of Diagnostic Radiology David G. Bragg, MD, editor, William R. Hendee, PhD, Theodore E. Keats, MD, John A. Kirkpatrick, Jr, MD, Franklin J. Miller, Jr, MD, Anne G. Osborn, MD, and William M. Thompson, MD, associate editors 1 990 #{149} Cloth #{149} 625 pages (approx) #{149} $54.95
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Medicine Paul B. Hoffer, MD, editor, John C. Gore, PhD, Alexander Gottschalk, MD, Dirk Sostman, MD, Barry L. Zaret, and I. George Zubal, PhD, associate editors 1 990 #{149} Cloth #{149} 853 pages #{149} $51.95
Stress
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Theodore E. Keats, MD 1990 #{149} Cloth #{149} 193 pages Radiology Disorders, Hooshang MD 1990
#{149} $85.00
957
#{149}
pages
#{149} $155.00
of the Liver, Biliary Tract Pancreas Arnold C. Friedman, MD, and Abraham Dachman, MD Radiology
1 992
#{149} Cloth
#{149} $149.00
#{149} 1 000
and H.
pages
Temporomandibular Joint Imaging Edwin L. Christiansen, DOS, PhD, and Joseph R. Thompson, MD, FACR 1 990 #{149} Cloth #{149} 253 pages #{149} $95.00 Ultrasonography.
Sandra Lynn Hagen-Ansert, BA, RDMS 1989#{149}Cloth#{149}1,113 pages#{149}$89.95 Transvaginal Sonography Thomas Sautter, MD, Alan G. Dembner, MD, and Thomas J. DeKornfeld 1991 #{149} Cloth #{149} 256 pages #{149} $69.50 Transvaginal Ultrasound David A. Nyberg, MD, Lyndon M. Hill, MD, and Marcella Bohm-Velez, MD 1 992 #{149} Cloth #{149} 386 pages (approx) #{149} $89.95
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Radiation Protection for Medical and Allied Health Personnel NCRP Report 105 #{149} 129
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Self-Assessment In Radiology and Imaging: Cardio-Thoracic Radiology and Imaging Michael B. Rubens, MB, BS, DMRD, FRCR 1989 #{149} Cloth #{149} 207 pages #{149} $54.95
-
CAT Scan
(PA-BE-001)
(PA-BS-001)
MEASUREMENTS
1991
of Diagnostic
Cardiac
-
-
Radiology of the Thoracic Skeleton William W. Scott, Jr, MD, Penelope D. Scott, MD, and Scott 0. Trerotola 1991 ‘Cloth#{149}251 pages#{149}$89.00 #{149} B.C. Decker Publication
Scan
-
-
NATIONAL COUNCIL ON RADIATION PROTECTION AND
Developing Radiation for Academic, Medical (approx)
Enema
- Bone
(approx)
Radiology of the Spleen Abraham H. Dachman, MD 1992 #{149} Cloth #{149} 250 pages #{149} $69.50
Textbook 3d ed
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of Syndromes, Metabolic and Skeletal Dysplasias. 3d ed Taybi, MD, and Ralph Lachman,
#{149} Cloth
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#{149} $119.00
of Musculoskeletal
Road
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1990 Year Book of Nuclear
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PALS Victoria
380
233 of
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Street NY
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(212) 620-8000 Biological
Magnetic
Spin Labeling:
Resonance.
Vol 8:
Theory and Applications
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Biological Magnetic Resonance. Lawrence J. Berliner and Jacques editors 1990 #{149} Cloth #{149} 264 pages #{149} $65.00
Vol 9 Reuben,
Breast Cancer Immunodiagnosis Immunotherapy Roberto L. Ceriani, editor 1989 #{149} Cloth #{149} 272 pages #{149} $65.00
and
Clinical Aspects of Neutron Capture Therapy Ralph G. Fairchild, Victor P. Bond, and Avril D. Woodhead, editors, and Katherine Vivirito, technical editor 1989 #{149} Cloth #{149} 384 pages #{149} $69.50 Treatment of Radiation Injuries Doris Browne, Joseph F. Weiss, Thomas J. MacVittie, and Madhavan V. Pilla editors 1990 #{149} Cloth #{149} 260 pages #{149} $75.00
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RSNA Today Video: The Journal of Imaging Science, Technology, and News Published
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August, October, December #{149} VHS or Beta #{149} Approx 1 hour long #{149} Available in PAL, SECAM, or NTSC #{149} RSNA or ACR member $185.00 #{149} nonmember $225.00 #{149} Corresponding member $275.00 #{149} Foreign nonmember $300.00 #{149} Single issue $55.00 #{149} RSNA designates that each issue meets the criteria for 1 hour of Category I credit
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CT and Sonography of the Acute Abdomen R. Brooke Jeffrey, Jr 1989 #{149} Cloth #{149} 448 pages #{149} $104.00
MRI of the Musculoskeletal (MRI Teaching File) John V. Crues, editor 1991 #{149} Cloth #{149} 242 pages
Film Screen Mammography: An Atlas of Instructional Cases Lawrence W. Bassett, Reza Jahanshahi, Richard H. Gold, and Vao S. Fu 1991 #{149} Cloth #{149} 256 pages #{149} $130.00
MRI of the Musculoskeletal A Teaching File Jerrold Mink 1990 #{149} Cloth #{149} 320 pages
High-Resolution CT of the Lung W. Richard Webb, Nestor L. Muller, David P. Naidich, editors 1991 #{149} Cloth #{149} 176 pages #{149} $89.00
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MRI of the Musculoskeletal System. 2d Thomas H. Berquist 1 990 #{149} Cloth #{149} 570 pages (approx) #{149} $130.00 #{149}In preparation
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MRI of the Shoulder Michael B. Zalatkin 1991 #{149} Cloth #{149} 240 pages
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MRI of the Spine Kenneth R. Maravilla and Wendy 1990 #{149} Cloth #{149} 440 pages #{149} $140.00
Magnetic Resonance Imaging of the Body. 2d ed Charles B. Higgins, Hedvig Hricak, and Clyde A. Helms 1991 #{149} Cloth #{149} 1 440 pages #{149} $169.00 Magnetic Resonance Imaging of the Brain and Spine Scott W. Atlas 1990 #{149} Cloth #{149} 900 pages #{149} $165.00
Magnetic Resonance Workbook NA. Matwiyof 1989 #{149} Paper #{149} 136 pages #{149} $29.50
Atlas of Chest Imaging: Correlated Anatomy with MRI and CT Marvin Wagner and Thomas Lawson 1992 #{149} Cloth #{149} 168 pages #{149} Price not set
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Magnetic Resonance Imaging of the Pediatric Brain: An Anatomical Atlas Georges Salamon and Claude Raynaud 1990 #{149} Cloth #{149} 368 pages #{149} $105.00
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MRI of the Brain II: Non-neoplastic Disease: A Teaching File William G. Bradley, Jr, and Michael Zawadzki 1990 #{149} Cloth #{149} 224 pages (approx) #{149} $60.00
MRI of the Spine (MRI Teaching File) Robert Quencer 1991 #{149} Cloth #{149} 242 pages
A. Cohen
(approx)
#{149}$60.00
MRI of the Wrist and Hand Murray A. Reicher and Lland E. Kellerhouse 1990 #{149} Cloth #{149} 224 pages #{149} $89.00 MRI Primer William Oldendorf and William Oldendorf, 1991 #{149} Cloth #{149} 240 pages (approx) #{149} $48.00
Jr
MRI Workbook for Technologists Carolyn Kaut 1 992 #{149} Cloth #{149} 256 pages (approx) #{149} $39.50 (approx)
Nuclear
Medicine Annual, 1989 Leonard M. Freeman, MD, and Heidi Weissmann 1989 #{149} Cloth #{149} 320 pages #{149} $103.50
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MRI of the Brain Ill: Neoplastic Disease (MRI Teaching File) Anton Hasso, Miyuki Shakudo, and Edla Chadrycki 1 991 #{149} Cloth #{149} 224 pages (approx) #{149} $60.00
Pediatric MRI (MRI Teaching File) Rosalind Dietrich 1991 #{149} Cloth #{149} 256 pages ‘$60.00 Pediatric
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#{149} $120.00
Sonography
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#{149} $132.00
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Pocket Atlas of Cardiac and Thoracic MRI Jeffrey J. Brown, MD, and Charles B. Higgins, MD 1989
‘
Paper
80 pages
#{149}
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Pocket Atlas of Head and Neck MRI Anatomy Robert B. Lufkin, MD, and William M. Hanafee, MD 1989 #{149} Paper #{149} 80 pages #{149} $14.95 of
Pocket Atlas of Spinal Magnetic Resonance Imaging Leo F. Czervionke and Victor M. Haughton 1989 #{149} Paper #{149} 84 pages #{149} $14.95 Practical Color Atlas of Sectional Anatomy Edward A. Lyons 1 990
#{149} Paper
#{149} 320
pages
#{149} $56.00
A Practical Guide to Ultrasound Anomalies Frederick N. Hegge 1991 #{149} Cloth #{149} 256 pages (approx)
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Cranial
Teaching Atlas of Breast W. Leucht, MD 1991 #{149} Cloth #{149} 236 pages
Computed Digital Radiology in Clinical Practice R. Greene, MD, and J. W. Oestmann, MD 1991 #{149} Cloth #{149} 224 pages #{149} $79.00
Ultrasound in Ophthalmic R. Guthoff, MD 1990 #{149} Cloth #{149} 204 pages
Diagnostic Ultrasound in Cerebrovascular Disease Drs. von Reutern and von Budingen 1991 #{149} Cloth #{149} 357 pages #{149} $150.00 (approx)
2600 SpringfIeld,
MD
#{149} 384
pages
MARCH
(217) (800)
#{149} $99.00
Imaging of the Temporal Bone. 2d ed J.D. Swartz, MD, and HR. Hamsberger, 1991 #{149} Cloth #{149} 384 pages #{149} $99.00
and
Diagnosis
East
Preston
Baltimore,
MD
Telefax
S. First
Street 21202
(301) 528-4000 Hysterosalpingography: A Text and Atlas David J. Ott, MD, and JamilA. Fayez, MD 1991 #{149} Casebound #{149} 144 pages #{149} $71.00 Imaging Anatomy of the Head and Spine: A Photographic Color Atlas of MRI, CT, Gross and Microscopic Anatomy in Axial, Coronal, and Sagittal Planes. 2d ed H.N. Schnitzlein, PhD, and FR. Murtagh, MD 1990 #{149} Cloth #{149} 480 pages #{149} $195.00 Imaging Anatomy of the Newborn Ernst Richter, MD, and Werner Lierse, 1990 #{149} Cloth #{149} 296 pages #{149} $175.00
MD
WILLIAMS 428
& WILKINS
East
Preston Street Baltimore, MD 21202 (301) 528-4000 (800) 638-0672 Telefax (800)447-8438
#{149} $65.00
C THOMAS,
PUBLISHER
Radiology
Barbaric,
428
Atlas
CHARLES
&
SCHWARZENBERG
#{149} $75.00
Vascular Anatomy in Abdominal Surgery J.-P. VanDamme, MD, and J. Bente, MD 1990 #{149} Cloth #{149} 142 pages #{149} $58.00
Differential Diagnosis in Conventional Radiology. 2d ed F. Burgener, MD, and M. Kormano, MD 1991 #{149} Cloth #{149} 824 pages #{149} $155.00
#{149} Cloth
Ultrasound
Ultrasound Diagnosis in Gynecology Obstetrics E. Merz, MD 1991 #{149} Cloth #{149} 336 pages #{149} $139.00
Diagnostic Imaging of AIDS W.A.J. Reeders, MD, PhD 1991 #{149} Cloth #{149} 144 pages #{149} $79.00
Zoran 1991
#{149} $59.00
Sonography of the Shoulder: Technique, Anatomy and Pathology B.D. Katthagen, MD 1990 #{149} Cloth #{149} 128 pages #{149} $57.00
Clinical Correlations in the Head and Neck: Vol 1 : The Larynx William N. Hanafee, MD, and Paul Ward, MD 1990 #{149} Cloth #{149} 96 pages #{149} $59.00
Genitourinary
Radiology of the Trachea P. Stark, MD 1991 #{149} Cloth #{149} 1 12 pages
Regional Atlas of Bone Disease: A Guide to Pathologic and Normal Variation in the Human Skeleton Robert W. Mann and Sean P. Murphy 1990 #{149} Cloth #{149} 224 pages #{149} $38.75
URBAN
Atlas of the Cerebral Sulci M. Ono, MD, S. Kubik, MD, and C. Abernathey, MD 1990 #{149} Cloth #{149} 232 pages #{149} $165.00
Clinical Anatomy of the Posterior Fossa and its Foramina J. Lang, MD 1991 #{149}Cloth#{149} 116 pages#{149}$99.00
Fuchs’s Principles of Radiographic Exposure, Processing and Quality Control. 4th ed Quinn B. Carroll 1 990 #{149} Cloth #{149} 400 pages #{149} $39.75
Street IL 62794-9265
789-8980 258-8980 (2 1 7) 789-9130
of Film-Screen
Mammography.
2d ed Ellen Shaw de Paredes, 1991 #{149} Casebound #{149} 528
MD pages
#{149} $135.00
Atlas of Human Anatomy in Cross Section Ronald A. Bergman, PhD, Adel K. Afifi, MD, Jean V. Jew, MD, and Paul C. Reimann, MD 1991 #{149} Cloth #{149} 464 pages #{149} $195.00 The Contrast Media Manual Richard Katzberg, MD 1991 . Spiral #{149} 256 pages #{149} $40.00
MD The Basic Physics of Radiation Therapy. 3d ed Joseph Selman 1990 #{149} Cloth #{149} 884 pages #{149} $120.00
RADIOLOGY
81A
Publishers’
Row
Diagnostic Imaging in Infertility. 2d ed Alan C. Winfield, MD, and Anne Colston Wentz, MD 1991 #{149} Cloth #{149} 336 pages #{149} $85.00
Edeiken’s Roentgen Diagnosis of Diseases of Bone. 4th ed Jack Edeiken, MD, Murray Dalinka, MD, and David Karasick 1 989
#{149} Cloth
#{149} $195.00
#{149} 1 888
(2-vol
Geriatric
Manuel 1991
#{149} Casebound
Magnetic Resonance Imaging and Computed Tomography of the Head and Spine (Revised Reprint) C. Barrie Grossman, MD 1991 #{149} Cloth #{149} 475 pages #{149} $125.00
#{149} 320
pages
MRI and CT of the Musculoskeletal System: A Text-Atlas Johan L. B/oem, MD, and David J. Sartoris, MD 1 991 #{149} Cloth #{149} 672 pages #{149} $150.00 MRI Atlas of the Joints: Normal and Pathology John D. Reeder and Samuel M. Andelman, MD 1991 #{149} Cloth #{149} 264 pages #{149} $85.00
Radiology Viamonte, Jr, MD #{149} 220 pages #{149} $65.00
in Trauma and Critical Stuart E. Mirvis, MD, and Jeremy Young, MD 1991 #{149} Cloth #{149} 736 pages (approx)
Care W.R.
Anatomy
Pediatric Skeletal Radiology Martin H. Reed, MD 1991 #{149} Cloth #{149} 704 pages #{149} $140.00
#{149} $140.00
Imaging of the Temporomandibular Joint Per-Lennart Westessen, DDS, PhD, and Richard W. Katzberg. MD #{149} 216
pages
Peripheral Vascular Sonography: A Practical Guide Joseph F. Polak, MD 1991 #{149} Casebound #{149} 456 pages #{149} $75.00
#{149} $65.00
Practical Interventional Radiology. Wilfrido Castaneda-Zuniga, Murthy Tadavarthy, MD 1 991 #{149} Cloth #{149} 1 408 pages #{149} $240.00
(2-vol
2d ed MD, and S.
to Diseases
of G.
Radiology Review Manual Wolfgang Dahnert, MD 1990 #{149} Cloth #{149} 583 pages #{149} $62.00
(approx)
Textbook of Uroradiology N. Reed Dunnick, MD, Ronald L. McCallum, MB, FRCP(C), and Carl M. Sand/er, MD 1990 #{149} Cloth #{149} 505 pages #{149} $125.00
Doppler
Ultrasound
for the
Alimentary
Endoscopy
and
Radiology. 2d ed John R. Bennett, MD, FRCP, and Richard H. Hunt, FRCP, FRCPEd, FRCPC 1990 #{149} Import #{149} 456 pages #{149} $120.00 Two-Dimensional Echocardiography and Cardiac Doppler. 2d ed Jay N. Schapira, MD, FACC, FACP, John G. Harold, MD, FACC, FACP 1990 #{149} Cloth #{149} 670 pages #{149} $105.00
and
Ultrasonography of the Urinary Tract. 3d ed Martin I. Resnick, MD, and Matthew D. Rifkin, MD 1991 #{149} Cloth #{149} 450 pages #{149} $95.00
Clinician
RaymondL. Powis, Schwartz, MD 1991 #{149} Casebound
PhD, and RobertA. #{149} 208
pages
#{149} $55.00
set)
Primer Interventional Ultrasound John P. McGahan, MD 1 989 #{149} Cloth #{149} 352 pages
of Sectional
Anatomy
with MRI
Workbook for MRI and CT of the Head and Neck. 2d ed Anthony Mancuso, MD, Ric Hamsberger, MD, and William Dillon, MD 1 989 #{149} Paper #{149} 250 pages #{149} $60.00
and CT Correlation $62.00
#{149}
Char/es P. Barrett, MD, and Lawrence 1990
82A
Approach
Irwin M. Freundlich, MD, and David Bragg, MD 1991 #{149} Cloth #{149} 572 pages #{149} $95.00
Therapeutic
#{149} $68.00
Imaging
1990
A Radiologic the Chest
pages
set)
Fundamentals of MRI Donald W. Chakeres, MD, and Petra Schmalbrock, PhD 1991
The Language of Fractures. 2d ed Robert J. Schultz, MD, FACS 1990 #{149} Cloth #{149} 372 pages #{149} $52.00
#{149} Paper
PhD, Steven J. Pollakoff, E. Holder, MD #{149} 128 pages #{149} $24.00
RADIOLOGY
Workbook for Quality Mammography Carolyn Kimme-Smith, PhD, Lawrence W. Bassett, MD, and Richard H. Gold, MD 1991 #{149} Paper #{149} 215 pages #{149} $60.00
MARCH
Moving? CT SCANNERS
FOR
SALE
Send
TECHNICARE
us your NEW address before you move
2060, 20600, I44OHPS ELSCINT 2002 SOMATOM 2 DR3 DRH
MRI
Send us a letter, card or Post Office change-ofaddress Indicate
present
corrections
label
with
G E TECHNICARE
form. and
your
us. Only
your
first
class
to your
new
At least five weeks Please
SIEMENS
mail
PUCK
SIEMENS
your
move, X-RAY
notify-
and Subscription
.,
.. ,
OR
EQUIPMENT AOT
FILM CHANGERS
OR PHILIPS MOBILE C ARMS WITH TV MAMMOGRAPHY UNITS :
.. . .
:
.
.. .
...
,.. ,
SECTOR AND DOPPLER ULTRASOUND. GENERATORS, TUBES, TABLES AND IMAGE SYSTEMS LINEAR,
CASH
Dues
,,
90/90
PHILIPS DIAGNOST 73 SIEMENS SIREGRAPH B (1983) SIRESCOP 3 & OPTOMATIC GENERATOR.
OTHER
is forwarded
address.
before
R&F SYSTEMS
G E DXS 650 MONITROL
to
,
FONAR AND SIEMENS
G.E. RFX 90/90
return
:
SYSTEMS PICKER
COMPLETE
address
new
...
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...
& LEASE
G.E. 8800, 9800
PAID FOR USED
EQUIPMENT
Dept.
ThE RADIOLOGICAL SOCIETY OF NORTh AMERICA, INC. 1991
Northampton
Easton, Pennsylvania
MARCH
St. I 8042
RADIOLOGY
83A
ThINKOFUSASA PART-TIMEMEDICALPRACTiCEWITh FULL-TIMEHOBBIES. Time.
It’s what
enjoy
your
much
or as little
premiums
backhand career,
all physicians
pastimes
and
radiology
as much as you
costly
to more
wish
time doesn’t
on life as a CompHealth
like
have locum
had
as your
practice.
in places
where
overhead. with
they
And
your
84A
your
expertise
to pursue
It should
to be a full-time physician,
We now work with
of. Fortunately
CompHealth
freedom
family.
tenens
more
sound
there’s
represents
other quite
where
Freedom
Freedom
passions-from tempting.
call 1-800-328-3084.
RADIOLOGY
freedom.
is appreciated.
job. For information
technokglsts,
CompHealth,
can
to practice
as
from
trips
After
you
malpractice
abroad
to your
all, at this point
in your
CornpHeaU’h T
1
5
t’
S
t C
t
A
N
C
R
0
U
P
tool Call today for details. MARCH
RadLoogy
CLASSIFIED
SERVICES
POLICY As
service
a
made
to its readers,
to ensure
ries include
that
for
employment and residents, ment considered since
RATES
the
positions
facilities
we
RADIOLOGY ads
are
relevant
available, malpractice
the
are offers
right
is
catego-
for sale, medical
apparatus available
for sale, medical posts for interns
to refuse
advised or claims
effort
Acceptable
practices
and filled,
We retain
respondents for the
and every
of radiology.
fellowships,
equipment posts to be
insurance.
(Per insertion) 50 words or less-$70.00 51-100 words - $105.00 Each word over 100 - $0.95 per Box Number-$20.00 additional
advertising
practice
sought,
radiological academic
not relevant, and assume responsibility
cannot
classified
to the
positions
rent or sale, used bureau advertising,
and
accepts
any
to investigate of advertisers.
advertiseeach
offer
sor
word.
per each
insertion
(this
service
is optional).
TERMS Payment
must
North
accompany
America,
Inc.
order.
Make
Advertisers
who
checks
cancel
payable
to the
ads will
not
Radiological
receive
Society
of
refunds.
must ad
be copy
received typed
by the 20th of the second and double-spaced.
DISPLAY
CLASSIFIED
customer
supplied
negative
Customer
supplied
customer
supplied
cost
mechanical
-
copy
to be
set
1/4
or
lx
(3/’
and
X
18X
$715.00
$570.00
24X 36X
$680.00 $655.00
48X
$630.00
$540.00 $520.00 $500.00
(215)
ad
-
prepared
20%
43/4M
1/9 page (2/4” X 3/4’)
or
X 2/8)
4’/?
equal
one
Production
word.
Telephone
UNIVERSITY OF CHICAGO seeks academic radiologists with a special interest CT,
ul-
trasound, body MRI, Cl/CU and mammography. The Department has been reequipped during the past few years and replacements/upgrades of equipment continue.
Interested
call or forward ton, Box
Chairman,
BC/BE
their
applicants
nity
Department
Lip-
of Radiology, Chicago,
312-702Opportu-
Employer.
RADIOLOGIST-Part approximately 6 hours nights
PPM, 204B, 358-8113.
MARCH
should
CV to: Dr. Martin
429, 5841 S. Maryland Ave., IL 60637 (312-702-6024, FAX 1 161). Affirmative Action/Equal
or
calls
on
Inc., 1075 Kingwood,
time position, per weekday. No
weekends.
These
$275.00
tional
procedures.
$260.00 $250.00 $240.00
strong
interest
Production
Department
Manager
numbers
with
area
code
equal
one
Send
CV,
Kingwood Dr., Suite Texas 77339. Tel. (713)
word.
RADIOLO-
GIST-Large Radiology group in the Southeast is seeking a board certified, fellowship trained radiologist to join our practice. Referral base includes extremely active orthopedic group with internationally recognized sports medicine institute. Opportunity for research available if desired. Should also have interest in general diagnostic radiology. State-ofthe-art equipment including GE 1.5T Signa MRI (3D capability), GE 9800 HiLite CT, LU digital angiography suite, digital fluoroscopy and SPECT nuclear medicine cameras. Please send letter of interest and CV to Box R-3206.
RADIOLOGIST NEEDED FOR SOUTHEASTERN OHIO, $160,000-$180,000This area is known as the little Switzerland of Ohio with rolling hills, lakes, streams, and wooded areas. Great area to raise a family, thirty minutes from city. Hospital based practice with CT scanner, cross coverage, employment or independent contractor. Call 800/255-4419.
RADIoLoGY
are
tenure-
radiology,
CT,
MRI,
Section
provide
a
wide variety of case material in all interventional procedures-vascular, biliary, urology-with use of investigational devices such as C02, angioscopy, atherectomy and holmium lasers. Angiographic suites are available and an animal laboratory with veterinarian and instrument shop. The staff position in thoracic imag-
$375.00
MUSCULOSKELETAL
including,
skeletal
$305.00 $295.00 $285.00
$360.00 $340.00
AVAILABLE
imaging
level.
MR spectroscopy, metabolic bone disease, TMJ pathology and image processing. Active clinical and academic programs in the
$450.00 $430.00 $410.00 $395.00
250-7287
or abbreviations
abdominal
Please
page X
(2t/4M
add
RADIOLOGY Advertising 1991 Northampton Street Easton, PA 18042
INFORMATION Hockin, Advertising
POSITIONS
in
date.
10%
43/45)
$745.00
Lorraine
to publication
below
page
12X
FURTHER
Initials
add
$615.00 $590.00
ADDRESS FOR: AD COPY and BOX NUMBER REPLIES FOR
as noted
$640.00
$810.00 $775.00
6X
Professor
Angio/Interventional
-
X 43/4W)
4/2”
prior
ADS
1/6
page X 10”
1/3
(21/4”
month
and
track positions. An M. D. and Board certification or Board eligibility by the American Board of Radiology are required. Applicants must be eligible for licensure in the State of Florida. The Musculoskeletal Section includes clinical, research and teaching opportunities in diagnostic
DEADLINE Copy submit
THE DEPARTMENT OF RADIOLOGY AT THE UNIVERSITY OF FLORIDA IN GAINESVILLE-The Department is actively recruiting to fill three positions in the following subspecialties: Chest, Musculoskeletal and Angio/Interventional at the Assistant Professor, Associate Profes-
ing will dalities
be involved including
CT,
in all diagnostic moMRI and interven-
For in
teaching,
all
positions, patient
a care
as well as research is required. Systems available in the Department include: intravascular ultrasound, color-flow Dopplers, a new Toshiba Vascular Lab, angio suites with Philips C-arms and 1024 ADAC digital, a 1.5 T GE Advantage MRI with spectroscopy, a 1 .T Siemen Magnetom MRI, two GE 9800 Advantage CT scanners, three dimensional workstations, ICU electronic image display stations and Computed Radiography (CR) with an advanced PACS program. Application deadline for these positions is June 30, 1992 with a starting date as soon as possible thereafter. Applicants should send a CV to Jonathan Williams, M.D., Professor & Associate Chairman, Department of Radiology, University of Florida, Box 100374, JHMHC, Gainesville, Florida 32610-0374, Tel (904) 395-0291 . An Affirmative Action, Equal Employment Employer.
BC/BE DIAGNOSTIC RADIOLOGIST-Opportunity to join three man group in general radiology practice including all modalities (angio and interventional limited at this point). Hospital based with limited itinerant schedule. Generous salary leading to early partnership in prof. corp. Outstanding benefits with liberal fringes and vacation. Wonderful small midwestern community with great schools and bountiful cultural and recreational opportunities. Send CV to James P. Zachman, M.D., Radiology Dept., Rice Memorial Hospital, Wilimar, MN 56201 or call (612) 231-4530.
85A
INTERVENTIONAL
CLASSIFIED
SERVICES
sistant with
TWO
RADIOLOGY
terventionalist
General
Diagnosti-
cian. One of the most progressive hospital systems in the country is seeking a BE/BC Interventional Radiologist to join its 27-physician radiology department. There is ample opportunity for teaching and research. Utilizing state-of-the-art equipment, 60-80% angiography is possible, with two procedures per day with
CT, and
1-1 /2 days
for
general
ing. A General Diagnostic sition is also available with
film
read-
Radiology
po-
all modalities present including CT, DX, and MRI radiology. Excellent benefits package with a lucrative salary structure is available. For more information, please contact Michael Kirschner 1-800-327-1585.
GENERAL tablished sachusetts
RADIOLOGIST BC - Esprivate group in Western Masis seeking a general diagnostic with experience in CT, Ultra-
radiologist sound, MRI, and tional procedures.
nonvascular intervenPrimary assignment
is
at an 800 bed teaching hospital with diology residency program. Practice
a raalso
includes
and
three
community
hospitals
six private offices. Full partnership after one year. Available by July 1, 1992. Interested candidates should send CV’s to: W. Max Cloud, M.D., 130 Maple Street,
Springfield,
MA 01103.
level
bed
public
Cancer 60 bed
for
sites
hospital,
Hospital National Comprehensive
Departat as-
a radiologist
in Interventional
Clinical activity geles County/USC
POSITIONS-In-
and
professor interest
ABDOMINAL
RADIOLOGIST-
University of Southern California ment of Radiology has an opening
Radiology.
include Medical
the Center,
Kenneth
Los Ana 1500
Norris
Jr.
and Research Institute, a Cancer Institute desigCancer Center and
RADIOLOGIST-The
Department
of
Diagnostic
Radiology
of
the Montreal General Hospital, McGill University, has a position open for a Radiologist in Abdominal Imaging. Interest in interventional procedures and angiography would be an asset. The department is fully equipped with two new CT scanners, high field MRI, one new Angio
room
and
one
Interventional
room.
The
nated the new USC University Hospital, a 275 bed private facility. Experience or fellowship in interventional radiology is expected. Board Certification by ABR and eligibility for California licensure is
academic
mandatory.
Radiology. Please apply in writing to Dr. Patrice M. Bret, Department of Radiology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4.
submit
Interested
CV to James and Chairman,
fessor
applicants
should
M. Halls, M.D., ProDepartment of Ra-
diology,
LAC/USC Medical Center, 1200 North State Street, Box 329, Los Angeles, CA 90033. The University of Southern California is an Equal Opportunity/Affirmative Action Employer.
DIAGNOSTIC diate opening join
group
RADIOLOGIST-Immefor BC/BE Radiologist
of (8) in active
ing (2) hospitals
(480 beds)
practice
includ-
and
multispe-
to
cialty clinic. 1 10,000 examinations a year. Practice includes substantial CT, nuclear medicine, ultrasound, MRI, angiography and interventional. Located in pleasant community on Lake Michigan with easy access to Milwaukee and Chicago. Locums needed in interval. Contact Arnold Strimling, M.D., Dept. of Radiology, St. Mary’s Medical Center, 3801 Spring St., Racine, WI 53405. Phone 414-636-4311.
with
rank
will
be
the applicant’s
fications.
The
commensurable
experience
applicant
and
must
be
quali-
certified
by the Royal College of Physicians and Surgeons of Canada and have at least one year Fellowship training in Abdominal
OZARK MOUNTAINS-Immediate opening for recent American trained BC general radiologist, ideally with fellowship or interest in neuro/angio. Join group
of 4 in growing
ams.
Hospital
practice,
serves area population patient office being angio/interventional,
mammography, place.
ing and
of built.
a typical
city,
but
amenities. doors, drum,
200
radiology
home
in
practice.
Grow-
excellent Two
schools hours to
provides
Generous
ex-
beds,
120,000+. OutMRI, CT, NM, color doppler,
rural
community with family environment.
“big”
time
surprising
for family,
out-
and CME. Send CV to William LanMD; P.O. Box 1137; Mountain
Home,
AR 72653.
PEDIATRIC cal College pediatric diologist ing. These eral and services, services
RADIOLOGY-The
help
plan services
and implement for
Children’s
associate,
radiol-
upcoming
175-bed
Center.
positions
senior Pediatric
write
pediatric
the
Medical
non-tenured
sistant,
Medi-
of Georgia seeks one general radiologist and one pediatric rawith expertise in pediatric imagindividuals will provide genspecialized pediatric radiology guide the integration of imaging within pediatric radiology, and
ogy
The the
to
general
Not
60,000
expanding
are
or full
Tenured
at as-
professor
levels.
appointee will become Radiology Section.
Dr. Charles
or
available
G. Howell,
head Call
of or
Jr., Pediatric
Radiology Search Committee, Pediatric Surgery Section, Medical College of Georgia, Augusta, GA 30912-4070. (404) 7213941. MCG is an equal opportunity/affirmative action employer.
BC/BE
DIAGNOSTIC
RADIOLOGIST:
The
Veterans Affairs Medical Center, Salem, VA, is recruiting for a staff radiologist with general experience plus exper-
tise in CT. This
598-bed
affiliated with and is located
the University in the beautiful
Valley which has 200,000. Academic ing and
Medical
Center
a population appointment
to qualifications. new salary rates.
of over accord-
Excellent Call-back
benefits limited
with use of Teleradiology package Scanner. Interested applicants contact
Peter
ology Salem,
Service
Ext.
86A
RADIOLOGY
VA
2271.
P. Sforza,
M.D.,
or
call
for CT should
Chief,
(1 14), VA Medical 24153;
is
of Virginia Roanoke
Radi-
Center,
703-982-2463,
EOE.
MARCH
PEDIATRIC RADIOLOGY POSI’flONThe Department of Radiology, Children’s Medical Center and The University of Texas Southwestern Medical Center, is seeking a fellowship trained pediatric radiologist for entry at an associate or assistant professor level. Applicants should be interested in expanding their areas of expertise
and
interest
ing modalities. is a 263 bed Texas
and
hospital 1 12,000
into
high-tech
imag-
Children’s Medical Center tertiary referral hospital for
the
regional
states.
Last
year
the
had 7700 admissions and outpatient visits. The hospital
a busy
transplant
liver,
and
service
kidney
across
the There vice which
over has
including
with
from
United States and South Amenis an active neurosurgical serhad over 44 children with pri-
ca.
mary brain tumors referred in over the past year in addition to a large practice of children with congenital anomalies. The Hematology-Oncology team has 7 fulltime physicians and a 5 day a week clinic. The
Cardiology-Cardiothoracic
to general and subspecialty vices staffed by private and
MRA,
cardiac,
CT,
pediatric university-af-
ser-
and
3D
3D work
Diasonics
a dedicated
tional
digital
with
a
a Philips
Acuson
ultrasound, suite,
functions
station;
and
LX
Duplex
color
angio-interven-
fluoroscopy,
and
will
soon acquire updated nuclear medicine equipment. The department of radiology performs over 49,000 examinations annually including 2500 MR. nearly 4000 CT studies, over 250 interventional procedures, 3100 US, and 2200 fluoroscopic examinations. Staff radiologists also cover the
NNICU
tal, one There
at Parkiand
of the largest are
radiology
Medical
Center
hospital gressive
which enjoys administration
with
Memorial
The
is an
University
Hospi-
NNICUs
3 radiology
pediatric
in the US.
residents
and
3-4
fellows.
Children’s
exciting
innovative
a supportive, proand affiliation of Texas
em Medical School, one leading medical schools.
Southwest-
of the
country’s
Duties include clinical responsibilities in performing and interpreting pediatric radiology procedures, share resident and medical student teaching responsibilities and participate in ongoing research projects. Salary and benefits are among the best offered. Flexible work schedules are available for
parents letters
with
domestic
of inquiry
demands.
to Nancy
M.D.,
Director
of Radiology,
Children’s
1935
St.,
Dallas,
902-2305.
The
University
of
Southwestern opportunity/affirmative
Medical
Center action
is an em-
75235. Texas equal ployer.
(214)
Medical
DIAGNOSTIC RADIOLOGIST, izing in angiography, with some CT,
for
South
in confidence cian Group Dunwoody
30328,
Texas
specialMRI and
of
is an US/CT
fellowship.
Pennsylvania
Medical
The Uni-
Center,
Spruce Street, Philadelphia, call (215) 662-3046/3123.
PA
3400 19104
or
FAIRBANKS,
ALASKA-Four
tic radiologists
seek
diagnos-
partner
for di-
practice including General RaUltrasound, Nuclear Medicine, 1.5 T) and CT (GE 9800). Hospital and office practice. Desirable life style advantages in a university town. Unlimited access to the outdoors. Excellent sala-
ry,
benefits,
retirement
and
One year to full Douglas Hutchinson,
partnership. M.D.,
#5
99701,
Fairbanks,
AK
Permanente, P.C., a sIthle, multispeciaity group scring 3S0,00() members of Kaiser Permanente in the \orthwest Region, has an immediale opportunity al one of or two medical centers in the Portland area for a BG’BE
general Radiologist with au inlerest in mammography. Our I 2-member radiology department at Kaiser Sunnvside Medical Center is one of two departments providing a full range of services to this membership.
We offer a competitive
saiars and benefits package. including professional liahilit coverage, pension programs. sabbatical leave. For further information, please
(907)
M.D., at (503)
EOE.
vacation.
1919
Rahatzad,
652-2880. Forward CV to: Fred M. Nomura, M.D., Regional Medical Director, NORTHWEST PERMANENTE, P.C., 2701 N.W. Vaughn St., Suite 300, Portland, OR 972 10-5398.
KAJSER
Contact Lathrop
PERMANENTE
Northwest Physicians
Permanente PC and Surgeons
452-5092.
DIRECTOR OF ABDOMINAL IMAGING-The unified Department of Radiology at the Albert Einstein College of Medicine/Montefiore Medical Center is seeking a Director at the Associate Professor or Professor level for the newly organized Division of Abdominal Imaging. Based primarily at Montefiore, the successful candidate will be responsible for the practice and teaching of abdominal Radiology at two 800-bed teaching hospi-
tals
(Montefiore
and
Bronx
Municipal
Hospital Center). This is a unique opportunity to build the Division as organ systern imaging will go into effect for the first time in July 1992. The department currently has two MR units and is pursuing the acquisition of two further units. The salary and fringe benefits are highly competitive. Manhattan and Westchester County offer alternative life styles that are within an easy commute of the Bronx. If interested, please forward a CV to E. Stephen Amis, Jr., M.D., Professor and Chairman, Department of Radiology, Montefiore Medical Center, 1 1 1 E. 210th Street, Bronx, New York 10467. Einstein/ Montefiore is an affirmative action/equal opportunity employer.
NORTH
CAROLINA-Staff
available
for
$175-$200K+ base salary benefit package. Send CV
near
Wilmington.
ities.
Must
1-800-354-4050.
fifth
Oregon
Portland, Northwest
call: Mat
eastern
practice.
DIAGNOSTIC RADIOLOGIST
appoint-
versity of Pennsylvania is an equal opportunity affirmative action employer. Minority and women candidates are encouraged to apply. Please contact Peter H. Arger, MD, Chief US/CT Body Section, Radiology Department, University
this
hospital
to Samantha Lloyd, PhysiDevelopment, 5901 Peachtree Road, Suite C-65, Atlanta, GA
or call
a faculty
University of Pennsylvania at the Assistant or Associate Professor of Radiology level. The position is in the Ultrasound and Computed Body Tomography section. The level of the position will be determined by the applicants experience and expertise. Applicants must be Board Certified in Radiology and have experience in ultrasound and computed tomography. The minimum experience
BC
Jersey
or in process. plus excellent
M
Direct
Rollins,
Center,
Motor
available:
in the
versified diology, MRI (GE
pediatricians. The Radiology dehas state-of-the-art equipment a Philips 0.5T MRI which has
dedicated
position
ment
surgery
service sees a wide range of complex congenital heart disease. The hospital has a busy pediatric surgery service in addition
filiated partment including
ing
needed
heart,
referrals
THE RADIOLOGY DEPARTMENT OF THE UNIVERSITY OF PENNSYLVANIA MEDICAL CENTER has the follow-
North
Carolina Wide
be comfortable
tional radiology. Contact: Bonnie
sician 27715;
position Radiologist
Diagnostic
R
ADIflI
.OGY
provides
I
form
liability
medical
insurance
all ofour
locum
Rr tene,.5
Physicians
Temporary and
assignments
physicians
insurance wait
available. worries.
call
Rob
No
No
hassles.
Berton
Why
today:
1-800-878-3500 . . .
in
community
variety of modalwith intervenhospital facility. AM Care Phy-
Modern Jefferson, Search, P.O. Box 2816, 800-477-0600.
MDA
I o(’cllrrf),zce
Durham,
NC
UDA Medical
L()curn 3495 Holcomb
Tene
DoctorAssociates,
Bridge Road
Inc.
Permanent
Phvsicitn
Norcross.
GA 30092
#{149}
.
Srarcli .
(404) 2469191
87A
CLASSIFIED
SERVICES -
PHYSICIAN/RADIOLOGIST time opening for board-certified gist
in
shore ing,
a desirable
location.
southern
This
expanding
Must have and Nuclear
available
immediately.
P.O.
Box 729,
New
is an active,
hospital
practice. sound,
Full-
radiolo-
and
Jersey
challengoffice-based
training in CT, ultraMedicine. Position Send
Mt. Holly,
CV
to RABC,
NJ 08060.
NEURORADIOLOGIST-The section of Neuroradiology of the Department of Radiology at Northwestern Memorial Hospital, Chicago, Illinois, is seeking a fulltime staff member to participate in all clinical, educational and research activities, beginning on or before July 1, 1992. Applicants must have completed an approved residency in Diagnostic Radiology,
be certified
by
the
American
Board
of
Radiology, and be eligible for senior membership in the American Society of Neuroradiology. The applicant should have experience in all aspects of clinical neuroradiology, preference may be given to applicants
with
expertise
in current
MR
Michigan
and
proved
Water
three
fellowship).
tional
Avenue
Tower). has three fellows
(ACGME
An
active
ap-
intervenservice
by an integrated
brovascular
of
The section neuroradiol-
neuroradiologic
supported
area
service.
is
clinical
cere-
Diagnostic
equip-
ment includes a new DFP 65 biplane 1024 matrix Toshiba DSA system with stereo fluoroscopic capabilities, two MR scanners with a two scanner acquisition in progress, and 3 GE 9800 CT scanners, all well staffed with excellent ancillary personnel. Northwestern University is an Affirmative Action/Equal Opportunity Employer.
Hiring
is contingent
upon
eli-
gibility to work in the United States. Salaries and benefits are maintained at high levels. Address inquiries and a current curriculum vitae to: Eric J. Russell, M.D., Director of Neuroradiology, Northwest-
.
Scheduling
.
Personal
Responsibility
em Memorial Hospital, Ct/Suite 3420, Chicago, (312) 908-2462.
710
will have recently completed residency training and be interested in pursuing a career in academic radiology with an emphasis on research. Collaboration with the basic science departments is encour-
aged.
For uncompromised to quality locum tenens call:
commitment
1-800-366-1884
VISTA 675
East
Salt Lake
Tenens
STAFFING 2100
Group
City, Utah
Suite
and
successful
candi-
in clinical of research.
radiolThe
can be tailored
of the individual; provide a competitive
and fringe benefits support for a period
it
to
is desalary
as well as ancillary of two years at which
390
84 106-9813
spoiling prove
of the
employ
this
de-
Street,
Bronx,
Montefiore
Department of Radiology, Medical Center, ill E. 210th New
York
is an affirmative employer.
RADIOLOGY
10467.
Einstein/
action/equal
applying
technique
to imaccuracy;
combined
to
with
study metabolism. or Biochemistry
quired as well as strong biophysical chemistry, electrical
the
surface
field gradient localization
technique in Chemistry
engineering
re-
background mathematics,
and
computer
skills and abilities for the application
in pro-
in NMR rein biochemis-
try and medicine. These involve 1) spin relaxation time T, and T2 and NOE effect measurements in vivo; 2) RF and shaped
pulse sequence design and improvement; 3) NMR image technique; 4) NMR detection probe design and spin decoupling optimization; 5) development and application of NMR spatial localization method in particular the inhomogeneous surface-spoiling magnetic field gradient method,
experience
with
ISIS
and
STEAM localization method; 6) employing the surface-spoiling gradient method to detect carbon-13 and proton-i NMR signals from deep-lying tissues (such as brain, liver, leg, muscle) in vivo; 7) development of computer software for RF magnetic field and gradient field calculation coil
and for simulation NMR phenomena
of the surfacein biomedical
8) application NMR spectrum Knowledge
in
and developediting techmetabolic
path-
ways, reaction cycle modeling, biochemical molecular structure (e.g. glycogen), chemical kinetics and exchange
processing
in tissue
in vivo;
expe-
rience in tissue extraction and animal preparation. $28,000 per year. Send resume to Job Service Technical Unit, Connecticut Department of Labor, 200 Folly Brook 06109-Job
Boulevard, Order
Wethersfield, #3095235.
CT calls
No
please. LOUIS
TAL,
A. WEISS a 372
bed
MEMORIAL
affiliate
of The
HOSPIUniversity
of Chicago. Facilities include two new Acuson ultrasound machines and a GE Highlight Advantage CT. Both inpatient and outpatient areas are being redesigned. Applicants should have broad experience in general diagnostic radiology and
angiography.
or research
An
would
mensurate should be board
provide
and
magnetic spatial
tan and
County
and
inhomogeneous
successful the faculty Academic
Westchester
improving
improving
time the individual is expected to have obtained at least partial grant funding for the continuation of their work. Manhat-
opportunity
88A
is flexible
the interests signed to
Chairman, Montefiore
SOLUTIONS South,
program
can be spent to the area
sirable alternative life-styles within an easy commute of the Bronx. Interested candidates should submit their CV to E. Stephen Amis, Jr., M.D., Professor and
VISTA A Locum
Up to 50% of the
date’s time ogy related
mechanism;
technique
nique.
IMAGING RESEARCH POSITIONThe Unified Department of Radiology of the Albert Einstein College of Medicine/ Montefiore Medical Center is offering imaging research positions beginning either July 1992 orJuly 1993. The ideal candidate
posi-
the sensitivity of NMR signal improve spatial localization
application; ment of
N. Fairbanks Illinois 60611,
Flexibility
Freedom
and
accuracy;
gram; search
North
rate
enhancing detection;
in
ogists
Professional
over
POCE Ph.D.
the
ASSOCIATE
tion in New Haven, CT. NMR research involving biochemistry and biophysics. Position involves studying spin relaxation properties of glycogen and other molecules; investigative studies of insuun resistant diabetes in man; determination of human cerebral metabolic turn-
applications or interventional procedures. A demonstrated interest in and facility for clinical research and teaching is highly desirable. Northwestern Memorial Hospital is an 800 bed general hospital Chicago (near of neuroradiology
.
POSTDOCTORAL
in teaching
The
applicant will be appointed to at the University of Chicago. rank and compensation cornwith experience. Candidate
practice
in
should
send
Chambliss, gy, Weiss
interest
be advantageous.
certified
Illinois.
their
M.D., Memorial
and
licensed
Interested
CV
or phone:
Department Hospital,
to
parties
James
of Radiolo4646 North Illinois 60640,
Marine Phone Chicago
Drive, Chicago, 312-878-8700. The University is an Equal Opportunity/Affir-
mative
Action
of
Employer.
MARCH
‘.,
--‘.
vie have an excellent private practice opportunity fcr a Radiologist to join a very successful two-man group in a hospital-based practice with separate billing. Our radiology group is affiliated with Marietta Memorial Hospital, a 225bed acute care facility and we also provide services for Sistersville General Hospital, a 30-bed facility nearby. Our encatchment area is over 100,000 and we also receive referrals from peripheral counties. The radiology department at Marietta Memorial Hospital is fully equipped with state-ofthe-art technology including: CT, color-doppler ultrasound, angiography, mammography and nuclear medicine. Our new MRI unit will replace our mobile unit and will be installed October 1991. We perform approximately 50,000 procedures annually. A well-rounded general radiologist with experience in interventional procedures is preferred, hut not required. Candidates should be board certified or in the examination process. An extremely attractive salary and benefit package is being offered leading to full partnership. Marietta is nestled in the confluence ofthe Ohio and Muskinghum Rivers in Sutheastem Ohio and is approximately 2 . 5 hours from Cleveland and a two hour drive to Columbus for an easy “getaway.” Please forward your CV and/or call Susan Panther, Radiology Specialist, Physician Services of America, Suite 250, Browenton Place, 2000 Warrington Way, Louisville, KY 40222, 1-800-626-1857, ext. 236.
MARCI
I
RADIOLOGY
89A
CLASSIFIED
SERVICES
INTERVENTIONAL
RADIOLOGIST-
MARYLAND-The ology, University System/Hospital additional faculty
of Maryland Medical in Baltimore is seeking members for the Sec-
tions
Radiology,
Department
of Pediatric
Nuclear
(double
of Radi-
Ultrasound,
boards
desired),
G.I.,
Marshfield Clinic Department of Radiology is seeking a fellowship-trained Interventionalist to join its thirteen members. The department is subspecialized and
Mammography, ma/Critical
Care
Fellowship
training
provides
quired where appropriate. The medical center is an 800 bed acute care hospital and tertiary referral center with an active
cians
services in all
to more
branches
than
rience
350 physi-
of medicine
and
sur-
gery. State-of-the-art equipment is available including two fully-equipped angiographic suites, two MRI scanners, four CT scanners, and three active cardiac cath labs. Very busy clinical and hospital practice.
Total
mately and year.
examinations:
1,300
friendly,
small
town
of
atmosphere.
For ad-
Radiology,
Marshfield
Clinic,
with
quality
lifestyle
54449
to
join small
comprehensive diagnostic modalities, and two freestanding imaging centers. Generous time off available with
in Oklahoma
affiliated
is now
versity of new a
VA
under
City.
Prefer
young radiologist with MR training. Call Dept. of Radiology at Bethany General Hospital, (405) 787-3450 ext. 280, Dr. Killebrew.
department
per-
hospital
to and
and
commensurate
teaching.
radiologists
are
rank
with
experience.
and
as a pro-
fessional corporation offering excellent fringe benefits. Baltimore is a superb place
in which
to live
of the problems ty values, etc.)
ington,
and
work.
a large enough
It has
Philadelphia,
all
metropolitan to avoid most
(traffic, inflated of our largest cities.
and
New
properWash-
York
are
readily accessible. Only 3 hrs. from the Ocean City Maryland. Submit CV to: Geraid S. Johnston, M.D., Department of Di-
agnostic
Radiology,
Baltimore, 8667 ext.
Equal
22 5. Greene
MD 3477.
21201 or call “Affirmative
Opportunity
Employer”
courages minority
applications groups.
Street,
North Shore Radiology’s four Board Certified Radiologists are recruiting a fifth full time individual. This rapidly
expanding
group
provides
cover-
age at five Community Hospitals and two Offices in North Eastern Wisconsin.
Approximately
56,000
exams
per year. No Angio. Teleradiology for call. Inhouse CT at most locations planned for summer I 99 1. Mobile MR available soon. Group
members
choose their own can live in any of our towns, or in nearby cities, areas or surrounding country-
life style, hospital resort
side. County
Green
and
Easy
drive
and
to Wisconsin’s Door University of Wisconsin
Bay.
Excellent compensation and vacation package. Early partnership for Board Certified Associates. Contact
of
Fax:
90A
(608) (608)
clinical
255-6262
833-9234
is
of large core breast biopsies. 12,000 mammograms, 1,000 wire localizations, 500 guidand 150 core biopsies are annually. This wealth of clinicoupled with an excellent
staff
provides
nity
for
tion.
Candidates
cation.
Please
Director
SCHOOL,
RADIOLOGY,
a full-time diagnostic radiologist the Breast Imaging Section. This based facility has four mammorooms, two with ultrasound. In there is a mammo-test unit for
performance More than preoperative ed aspirations performed cal material
unlimited
collaborative
opportu-
clinical
must contact
of Diagnostic
have Jack
US/CT/MRI diologist,
- LOS with
M.D.,
established
practice
Mark 9 US Competitive
units and a 2T salary leading
Hospital
is an equal
MEDICINE
University
opportu-
PHYSICIAN-
of
California,
Davis
School of Medicine has a full-time faculty position available in the Nuclear Medicine Division of the Department of Radiology. Appointment will be at the Assistant/Associate/Full Residence
Professor Professor
or
level (InClinical
of
Radiology Series). Candidates must Board Certified in Nuclear Medicine, gible for licensure in California, an academic background
be eli-
and have Nuclear
in
Medicine. Since this position will be open until filled please forward curriculum vitae, a letter outlining background and interests in teaching/research and the names
of
possible.
five
references
as
Applications March
will
31, 1992.
promptly
as
not be accept-
Reply
to: William
of Radiology, 2516 Stockton Ticon II Building, Sacramento, 95817. The University of Cali-
Action
groups
Opportunity/Affirma-
Employer
plications
in
300
bed
Siemens to full
partnership. Contact A. K. Raja Rao, M.D., St. Vincent Medical Center, 2131 W. Third St., Los Angeles, CA 90057, 213/484-7901.
RADIOLOGY
Ear
employer.
NUCLEAR
tive
hospital near downtown LA and private office in adjacent building. Equipment includes-two GE 9800 CT scanners, two ATL MRI.
and
imaging inecho-planar
Massachusetts. Interested individuals should contact Dr. James Thrall, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114. Massachu-
California fornia is an Equal
needed to 1992. This
includes
Eye
from and
and
encourages
members
of
ap-
minority
women.
ra-
training
body imaging group in July
Massachusetts
Department Boulevard,
Brigham
ANGELES-BC
fellowship
cross-sectional join 8 member
radiation oncology, neck radiology at the
E. Brant, M.D., Chairman, Search Cornmittee for Nuclear Medicine Physician,
certifi-
E. Meyer,
Radiology,
supervi-
bilities. The applicant must be able to secure a license to practice in the state of
ed after
investiga-
board
and Women’s Hospital, 75 Francis Street, Boston, MA 02115; (617) 732-6269. Brigham and Women’s Hospital/Harvard Medical School is an affirmative action/ equal opportunity educator and employer.
well
0. Adhur Stiennon III MD Suite 220, One South Park Street Park Regent Medical Building Madison, WI 53715 Phone:
seeking to head hospital graphic addition,
OF
and
en-
members
MEDICAL
DEPARTMENT
referral research will in-
capabilities), color-flow doppler and pet scanning. Interventional procedures also possible for interested individuals. We are seeking assistant/associate professor 1evels, but rank and salary will be commensurate with experience and qualifications. Generous fringe benefits and retirement package offered. Liberal vacation and meeting policy, limited on-call responsi-
nity
DIRECTOR OF BREAST IMAGING, THE BRIGHAM AND WOMEN’S HOSPITAL/HARVARD
teaching
Infirmary. State-of-the-art cludes MRI (with advanced
The
NORTh SHORE RADIOLOGY ASSOCIATES OF MADISON S.C.
care,
setts General
1-800-866Action/
and
from
patient
neighboring
Academic organized
dude
opportunity
a high-quality both clinical and Responsibilities
Uni-
in the Spring of 1992. The duties faculty members will include re-
salary
is an exciting in
gery, neuropathology, as well as head and
324
and to the
This
will
with
connected
radiology.
sion of neuroradiology fellows and radiology residents. Both clinical and basic research opportunities are available within radiology and in cooperation with strong programs in neurology, neurosur-
a year.
construction
search The
re-
examinations
the amenities of center, yet is small
FULL-TIME RADIOLOGIST group of three. Pratice includes hospital
1000
WI
new
The
200,000
expe-
certification
Depart-
Massachusetts
General Hospital is seeking a radiology board-certified, fellowship trained senior member of the American Society of Neuroto participate practice offering opportunities.
TrauRadiology.
or equivalent ABR
practice.
over
beds
per
send letter/ Department
North Oak Avenue, Marshfield, or call collect at (715) 389-3474.
varied
be adjacent
in
please M.D.,
A
cases
catheterizations medicine
ditional information, CV to Thomas Gallant,
desired.
forms
approxi-
angio/interventional
2,700 cardiac State-of-the-art
and
Neuroradiology, and Skeletal
NEURORADIOLOGIST-The ment of Radiology at the
-
PHYSICIAN/RADIOLOGIST radiology
group
with
multiple
private
Large of-
fices seeks a board-certified radiologist interested in a full-time position. Responsibilities
include
general
Special
training
in CT,
and/or cellent
Nuclear Southern
Medicine New
radiography.
ultrasound,
MRI
is preferred. ExJersey location.
Competitive salary and benefit Position available immediately. to RABC, P.O. Box 729, Mt. 08060.
package. Send CV Holly, NJ
MARCH
THE DIVISION
OF NUCLEAR
CINE-Oregon
Health
RADIOLOGIST
MEDI-
Sciences
sity, Portland, Oregon invites applications for a faculty position available immediately either part-time in nuclear medicine
or
nuclear
medicine
full-time
divided
between
and another
division
of
diagnostic radiology. Position requires that Radiologist be certified by either American Board of Radiology (Special Competence in Nuclear Radiology) and/ or American Board of Nuclear Medicine. Send CV and references to William Weidner, M.D., Chairman, Diagnostic Radiology, UHN-72, Oregon Health Sciences University, Portland, OR 972013098. OHSU is an affirmative action equal
opportunity
employer.
OREGON, TAINS ON group tirement.
NORTHEAST 1-84-Three
MOUN-
radiologist because of repractice; prima-
needs new partner Three hospital
ry hospital is trauma and referral center for three counties and has CT, angio, interventional, US with color Doppler, and SPECT Medical
NM staff,
most
equipment. 40 physicians
specialties.
annually, the
same
start.
Full
for experienced dential. Eastern Box
849,
MRI in 1992. representing
Community
with four year college reational opportunities. dry climate. Minimum
of
13,000
and
abundant Intermountain of 12 weeks
as other financial person.
partner Inquiries
Oregon
La Grande,
recoff
partners
from first
year confi-
Radiology,
OR
97850.
P.O.
(503)
963-
1474.
retired.
affiliated
FULL-TIME
FACULTY
individual
selected
will
be in charge
University Medicine.
Hospital Candidates
should Board
be of
trained
in interventional
of
within the Section in at Stanford
and the School of for this position
diplomates Radiology
of the American and fellowship
radiology.
Can-
didates should have extensive clinical experience with all aspects of diagnostic and therapeutic vascular procedures. Non-invasive vascular laboratory experience is preferable. Stanford University is corn-
mitted
to
increasing
women
and on its faculty applications
curriculum
representation
of
members of minority groups and particularly encourages from such candidates. Send
vitae
and
the names
of at least
three references to Michael Dake, M.D., Chairman, Vascular Radiology Search Committee, Department of Radiology,
Room
H-2333,
Center,
Stanford
Stanford,
University CA
world
CALIFORNIA
Medi-
94305.
famous
CENTRAL
MR. cine fied
Interventional, skills to join Radiologists.
offices, Centrally
RADIOLOGIST
in a town
of about
20,000
the
in
35,000
surrounding to David
send inquires/CV M.D., Professional
X-Ray,
Suite
2, Lompoc,
US, group Two
Nuclear of 7 Board hospitals,
CT, MediCertiprivate
service to nearby communities. located to San Antonio, Austin,
Houston, Corpus Chnsti. Good family environment. Contact James Neumann, M.D., Box 3610, Victoria, TX 77903 (512) 578-0317.
MARCH
with
another
area. Please L. McAninch, 1 1 1 1 East Ocean CA 93436.
FOOTHILLS-General
radiology position with emphasis on imaging. Progressive radiology group looking for fourth B.C/BE. partner with MRI training. 124 bed community hospital and private office practice. All imaging modalities covered, including Nuc Med,
U.S., CT, Mammo and interventional. California R-3202.
and
some
community.
INTERVENTIONALIST/NEURORADIOLOGIST-The Cleveland Foundation
has
a staff
in the Division emphasis Candidates agnostic
of Radiology
available
with
special
cerebrovascular techniques. must be board certified in DiRadiology, eligible for Senior
Membership
sure
Clinic
position
on
in the
in the state
ASNR
of Ohio,
as well
and
as licen-
have
a clini-
cal background in interventional neuroradiologic procedures. This position within neuroradiology will fulfill a cornplement of five full-time neuroradiologists at a 1,200 bed teaching hospital and large out-patient facility serving the clinical disciplines of Neurosurgery, Otolaryngology, Neuro-opthalmology, Adult and Pediatric Neurology. Diagnostic irnaging and interventional equipment are state of the art and well staffed with excel-
lent
ancillary
personnel.
For further
de-
Thomas J. Masaryk, of Neuroradiology, CCF, 9500 Euclid OH 44195, Phone:
tails please contact: M.D., Head, Section Division of Radiology, Avenue, Cleveland, (216) 444-6653.
DIAGNOSTIC RADIOLOGIST SANTA BARBARA,CALIFORNIA A large muftispecialty clinic is seeking a Board Certified/Board Eligible diagnostic radiologist. Competence necessary in CT, Ultrasound, and MRI. Send CV to: M.D.
Monica
Micon,
or Ella
Wong, M.D.
Sansum
angiography
Growing Send
Northern CV. to Box
Medical
Clinic
P.O. Box 1239 Santa
Barbara,
CA 93102
Make Track&.. . . .
CHAIRPERSON, RADIATION ONCOLOGY
to your nearest
mailbox
and
thelatest
for of the
send
copy
free Consumer InformatIon Catalog.
The Albert EInsteIn College and Its University Hospital,
of MedicIne
Medical
a Chairper-
son
Center,
for
the
are seeking Department
Montefiore of Radiation
Oncology.
It lists about 200 free or low-cost government publicatIons on topics like health,
with
COAST-
general radiologist position immediately for challenging in a three-man general radiology This includes a hospital-based and office-based practice. Must be qualified in all aspects of general radiology, including xeromammography, CT, ultrasound, diagnostic nuclear medicine, and MRI scanning. Limited invasive radiology, with no angiography or invasive vascular work. Location on the central coast of California
careers,
DIAGNOSTIC
Greenbrier
Full-time available practice group.
CALIFORNIA
POSITION
vascular radiology activities Cardiovascular/Interventional the Department of Radiology
with
Hotel and Resort located in the Greenbrier Valley, garden spot of West Virginia. Quiet lifestyle with abundant recreational opportunities and easy access to large Eastern metropolitan centers. Candidates must be board-certified in diagnostic radiology and have some practice experience. Contact: Herbert Pope, M.D., The Greenbrier Clinic, White Sulphur Springs, West Virginia 24986.
Avenue,
AVAILABLE, STANFORD UNIVERSITY - VASCULAR RADIOLOGIST-The
cal
NEEDED-Senior partFree-standing diagnostic medical clinic seeking second Radiologist for non-interventional type practice in small culturally oriented community in Southeast West Virginia. Rare opportunity to associate with nationally known group where highest quality medicine is the standard, under unparalleled working conditions. The Greenbrier Clinic is ner
Univer-
nutrition, money
management, federal
send
your
address Consumer Center Department
Pueblo, Us
and name
and
to: Information
be Board certified in have admlnistrative experience in an academic hospital environment, and be eligible for an academic appointment at the professor 1evel. Qualified applicants are invited to respend. The Albert Einstein College of Medicine/Montefiore Medical Center is an Affirmative Action/Equal Opportunity Employer. Radiation
Colorado
81009
must
Oncology,
Inquiries and applications should sent to Stephen Arnie, M.D., Chairman, Departmnt
MT
GeneralServlces
RADIOLOGY
Just
benefits.
The applicant
MedIcal Bronx,
of
Radloio9y,
be
Montefiors
Center, 111 East 210th Street, New York 10467.
Admlnlstrauon
91A
CLASSIFIED
DIAGNOSTIC HO-Four a fifth qualified ology. sound,
SERVICES
- IDA-
RADIOLOGIST
man radiology group seeking Board Certified radiologist; highly in all aspects of diagnostic radiThe practice includes: MRI, ultranuclear medicine, angiography/
interventional, tunity activities
ASSISTANT OLOGIST-The
for
and
CT. Excellent
oppor-
someone who enjoys such as skiing, fishing,
camping and frequently Community has a four college and a community within 40 minutes versities. 13 weeks two years leading
outdoor hunting,
year round golf. year liberal arts college, and is
of two major state univacation annually and to partnership. If inter-
ested please send CV to Mark W. Peterson, M.D., 531 4th Ave., Lewiston, Idaho 83501. ABDOMINAL Harvard Medical
Women’s position
RADIOLOGIST-The School, Brigham
Hospital for
an
has a full-time
facilities
exciting yen inal
make M.D., Brigham
ab-
Outstanding case mix this
opportunity.
E. Seltzer, Imaging,
an
Please
hospiand re-
unusually
contact
Ste-
Co-Director, Abdomand Women’s Hos-
pital, 75 Francis Street, Boston, tel. (617) 732-6301. Harvard School, Brigham and Women’s an affirmative educator and
faculty
academically-inclined
dominal radiologist. tal setting, equipment, search
and
action/equal employer.
MA 021 15, Medical Hospital is
PROFESSOR,
MR
RADI-
CHEST/BREAST
Department of Radiology at The University of Texas Medical School at Houston and the Hermann Hospital are recruiting for a full-time MRI Radiologist at the Assistant Professor level,
beginning
July
1, 1992. Preference
will
be
ence.
ABR
certification
Responsibilities
will
required.
include
and interpretation neuro MRI, as well resident and fellow clinical and tunities are MR facilities
is
monitoring
of both body and as medical student, teaching. Extensive
basic science research opporavailable. The Department’s are state-of-the-art and locat-
ed in a beautiful spacious setting, which include a l.5T GE Signa unit with proton spectroscopic capability. A second 1.5T GE System, with spin echo (FSE), will be installed
MR Angiography, fast and phased array coils, in the first quarter of
1992. The Department basic science research facilities
include
also has an active program; research
a small
bore
MRI
system
employer. encouraged
curriculum to:
vitae
Bharat
terim gy,
and
Raval,
three
M.D.,
Chairman, The
Women to apply.
University
School-Houston, 2.132, Houston,
of
and
In-
of RadioloTexas
RADIOLOGY LTD. OF TUCSON, ARIZONA OPENING FOR A RADIOLOGIST WITH ANGIO/INTERVENTIONAL EXPERTISE-Radiology Ltd. is
hospitals,
three
three
separate
in Tucson,
private
CT/MRI
Arizona.
tional. with vidual
and two who are services offices,
imaging
We
are
cruiting another general fellowship training in
and
centers
currently
re-
radiologist with angio/interven-
This individual will be employed three years to full partnership. Indiis to be based primarily at Tucson
Medical Center, the largest hospital coyered by our practice. Currently TMC has the greatest load of interventional cases. Cross-coverage
hospitals and
of advanced
will
the
other
cases
be shared
by
radiologists
at other
this
with
person
advanced
interventional skills as needed (for exampie when cross-coverage is needed to coyer an interventionalist tion). General radiology
and
MRI
is also
individual If interested
Broome, ondelet BC/BE
to be performed
by this
responsibilities. to: Robert
0.
MD, Radiology Ltd., 6516 E. CarDr., Tucson, AZ 85710. DIAGNOSTIC
KANSAS CITY, openings Kansas Kansas University MRI,
who is on vacaincluding CT, US
as part of core send CV
VA
affiliated
Center.
hospital.
CT,
NM, special procedures. Staff physician and department chief position available. Reply to Dr. Sarah Taylor, Chair, Radiology Search Committee, VAMC Kansas City (1 1 1), 4801 Linwood Blvd. Kansas City, MO 64128, (816) 861-4700 Ext. 3491.
92A
US,
Medical
RADIOLOGY
tion and eligibility for or licensure state of Florida required. Academic and
compensation
by the rank,
commensurate
qualifications.
Interested
with
parties
should
forward CV’s to: C. A. Poole, M.D., Professor and Chairman, Department of Radiology (R-308), P.O. Box 016960, Miami, FL 33101. The University of Miami is an
equal
opportunity/affirmative
action
DIAGNOSTIC
em-
RADIOLOGIST-The
Regional
Center
group
clear
of Fort Myers,
diagnostic radioloa new associate. The
covers
two
private
offices
acute
care
hospital
with
fluoroscopy,
Medicine,
radiology.
MRI,
The
and
group
ing
of diagnostic
Nuclear
Nuinterven-
new DO! a versatile is skilled in
radiology
Medicine,
a
has recently
assumed coverage of a growing MD hospital. We are seeking M.D. or DO. radiologist who
all aspects
and general
ultrasound,
CT,
includ-
neuroradiology
and interventional radiology, preferably with fellowship training in MRI, including musculoskeletal, neuroradiology, or interventional. A competitive salary, excellent benefits and partnership are being offered. Dunwody, Regional Myers,
Please forward CV to Barbara Office Manager, Radiology Center, 3680 Broadway, Fort FL 33901.
DALLAS,
cialty
TEXAS-12
group
radiologist
seeks for
member
board
sub-spe-
certified
immediate
general
opening.
lowship training preferred sider qualified individual pertise. CT/ultrasound,
Fel-
but will conwith special exMRI, nuclear
medicine, or angiography background particularly helpful. All imaging modalities available (state of the art CT, angio,
ultrasound, MRI
R & F, SPECT
center).
Salary
and
nuc.
med.,
bonuses
are
and excel-
lent. Health and malpractice paid. No buy-in to partnership. Send CV to H. Stuart Peake, M.D., P.O. Box 814129, Dallas, TX 75381.
(214)
THOUSANDS AWAY WITH
888-7055. OF DOCTORS IT-KRON pioneered
curn tenens so you could tice, and your life, where
RADIOLOGISTS/
MISSOURI-Immediate City
cluding mammography, ultrasound and needle localization required. The University of Miami/Jackson Memorial Medical Center is a tertiary referral and level 1 trauma center that will soon be opening a state-of-the-art breast center. Extensive teaching involved and an interest in clinical research is assumed. Board certifica-
tional
opportunity
at four
procedures. imaging in-
radiology,
Suite
a group of twenty three full-time part-time diagnostic radiologists the major providers of radiology
and interventional expertise in breast
400-bed
Medical
643 1 Fannin, Texas 77030.
or equivalent all aspects of CT, MR. ultra-
Florida, an eight-man gy group, is seeking
(3) references
Department
in
Radiology
and minorPlease send
Professor
RADIOL-
ployer.
with spectroscopy capabilities. The University of Texas at Houston is an equal opportunity ities are
with subspecialty training experience and interest chest imaging including
sound Similar
given to candidates with fellowship training in MRI, body imaging, neuroradiology or one year of academic MRI experi-
IMAGING
OGIST-The Department of Radiology of the University of Miami School of Medicine is seeking an academic radiologist
take
GET lo-
your
you want to go. You work as much as you when you want. While we guarantee
income. Pay your expenses. And the best malpractice insurance
practhem want, your
provide around.
It’s a total package. And it’s only available from KRON. Call KRON at 1-800-MEDICAL. KRON is Locum Tenens Practice Made Perfect.
MARCH
r
-
-
-
-
-
-
-I
I AREYOU I LOOKING FORA I NEWJOB? I I I I \I I 1-000-077-3080 I L Most Radiologists find selecting a new practice a confusing and tedious process. This should not be the case. Since Meridian Radiology Recruiting specializes in Radiology, we understand your needs. Our stafftakes the time to learn your specific interests, modalities, practice preferences, and professional objectives. Our experience enables us to make informed, accu rate assessments regarding practice opportunities. We pre. sent to you only those practices that fulfill your personal and professional needs.
\
11d
If you are serious
right practice,
I
‘
about finding the and your time is valuable,
then call Meridian today.
MERIDIAN k’
Suite
556, 1507 E. Franklin
ALL INQUIRES
-
MARCH
-
Street,
Chapel
Hi/I. NC 27515
ARE KEPT IN COMPLETE -
-
RADIOLOGISTS
I I I I I I I I I
Enjoy
the
Best
ofBoth
Worlds
Demand is high nationwide for temporary radiology coverage. Attractive positions are available to meet your personal and professional goals.
a
Residents - explore practice options before signing that first contract.
.
Physicians
in
Mid-Career
escape the hassles, politics paperwork associated medicine today. R Retirees - work as little much as you want to.
and with
or as
Step up to the lifestyle that offers you the best of both worlds. .. excellent compensation coupled with the freedom and flexibility you seek. If you are call LOCUM
ready for Medical
a change, Group.
CONFIDENCE.
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-
RADIOLOGY
93A
COME
#{149} ---.-
CLASSIFIED
SERVICES
L
WITH
A LI-
CENSE FROM ANY STATE, Loma VA Hospital has positions available
Linda for a
board
certified/eligible
and
DIAGNOSTIC
DOMINAL
RADIOLOGIST
IMAGING-The
of Missouri-Columbia
desirable.
Tenured
available
at Assistant
fessor levels. J. Churchill, ogy,
with CT,
able.
expertise US, MRI). Fellowship
ski
and nontenured and
Address inquiries M.D., Department
University
of
to: Robert of Radiol-
Missouri-Columbia
Hospital and Clinics, One Hospital Drive, Columbia, MO 65212. An Equal Opportunity/Affirmative Action Employer.
State
CHIEF pital
to: Radiology Street,
Trenton,
838 W
Center,
Valley
HosN.Y.
Stream,
Veterans
Hospital,
management
422Op-
accepting
is currently
has
equipment.
all
Send
state-of-the-art
illa, M.D., Radiology Medical Center, Bay
applica-
9363.
trauma
ography Skill in
and interventional teaching, interest
patient,
use of radiography, computed tomography,
curriculum Professor
mative
in
vitae to: C. and Chairman,
action
in-
ultrasoangi-
procedures. clinical
re-
A.
Poole, Depart-
employer.
IMMEDIATE
TLE
OPENING
IN THE SEAT-
AREA-Diagnostic
seeks
BC/BE
Radiologist
associate
to join private
con-
ventional radiology outpatient practice. Early buy-in possible. Modern equipment in comfortable, established surroundings. Good referring physician base. ACR Accredited Mammography. Call 206-283-
call J. Bon-
Service (114), Pines, FL (813)
the
the
ment of Radiology (R-308), University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33101. The University of Miami is an equal opportunity/affir-
imaging
CV and/or
of
cluding nography,
send M.D.,
Medicine,
is recruiting staff a new, opening in
search, and licensure to practise medicine in the state of Florida required. Academic rank and compensation commensurate with qualifications. Applicants should
Benton
(714) Equal
VA Medical Cenaffiliated with the Florida School of
VA 398-
8144
EOE.
CHIEF HARBORVIEW
I
for further
OF
information.
RADIOLOGY MEDICAL
CENTER
The
U.
.,.
CaIif#{244}ikj
Growing six-physician panership requires radiologist (BC by 7/92) competent in standard modalities incIudinr trasound, mammograp and CT-little or no interventional. Requires competence in MR and independent reading in multiple out-patient multi-site clinics and at central imaging center (system has 80,000+ yearly examinations and is rapidly growing). Reasonable hours, minimal weekend and call responsibilities. Excellent salary leading to full partnership. Great opportunity to enjoy career and life. Call, or submit CV to: ,
I/,
Ruthan 338-4798 825-4401
1826 Orange Redlands. 94A
1 1201
RADIOLOGIST-The ter, Bay Pines, Florida, University of South
Carve Your
(714)
parks.
Employer.
Center
ous salary and fringes. CV. and inquiries to Magill Associates, 475 Northern Blvd., Great Neck, N.Y. 11021. Telephone (516) 482-9303. Fax (516) 482-2646.
(800)
mountain theme
De-
University
the spring of 1992. The unit will be a selfcontained facility within the Jackson Memorial Medical Center, a 1500 bed tertiary facility and level 1 trauma center. Candidates must be Board certified with fellowship training and/or experience in the
east
coast of Florida in the St. Petersburg/ Tampa metropolitan area, only minutes from the Gulf of Mexico. The Medical
seeks an experienced Radiologist for its four member group. Excellent facilities indude MR 1ST. Affiliate of N.Y.U. Gener-
Southern
70 miles
beaches,
southland
A
is accept-
tions for a board-certified staff radiologist in general diagnostic radiology preferably with MRI experience. This Medical Center is located on the beautiful west
08618.
OF RADIOLOGY-Franklin Medical
state
is located
near
and
portunity
BUCKS
Jersey
Angeles
resorts
morial
NEW
Affiliates, New
Linda
radiologist.
any
Street, Loma Linda, CA 92357. 3069 TELEFAX (714) 422-3106.
COUNTY, PENNSYLVANIA seeks general radiologist with good ultrasound and mammography skills. Excellent benefits. No weekends, no call. Full or part time.
Respond
from
RADIOLOGISTS-The of Radiology of the
of Miami School of Medicine for trauma radiologists to state-of-the-art trauma center
This is a 500 bed full service hospital with a comprehensive diagnostic facility including ultrasound, CT and MRI, integrated with Loma Linda University Medical Center Residency Training Program. Opportunities to pursue clinical or academic interests. For additional information contact: Peter Dure-Smith, M.D., Chief, Radiology (114), Jerry L. Pettis Me-
Pro-
LARGE PRACTICE IN CENTRAL JERSEY AND ADJACENT
Loma
TRAUMA partment
neuroradiologist
diagnostic
license
of Los
tracks
Associate
a general
current
University and Clin-
Hospital
ics is seeking a radiologist in abdominal imaging (GI, Board certification required.
AB-
-
TO CALIFORNIA
Richard
Chairman,
Smith outside
University of Washington School of Medicine, Seattle, WA, invites nominations and applications for the position of Chief of Radiology at Harborview Medical Center, a University of Washington teaching hospital. We seek an experienced physician/administrator with strong commitment to academic radiology, patient care, and teaching. The candidate must be board certified by the American Board of Radiology and meet the academic requirements for Professor or Associate Professor at the University of Washington School of Medicine. The individual chosen as Chief of Radiology will be responsible for all professional radiologic and nuclear medicine services and must have vision, vigor, and will to build an academic radiology program commensurate with the mission of Harborview Medical Center. The University of Washington is an affirmative action, equal opportunity employer. Please send CV to:
University
CA
in CA
Tree Lane CA 92374 RADIOLOGY
K. Root,
MD
Professor of Medicine HMC Radiology Search 325
of Washington Ninth Avenue ZA-65
Seattle,
WA 98104-2499
Committee
MARCH
ANGIOGRAPHER/ crossroads?
A one
able at a nationally in the Washington certified, fellowship
rapher tion
beginning may
DISCOVER
INTERVENTIONAL you at a
RADIOLOGIST-Are
year
position
career
is avail-
recognized institution DC area for a board trained angiog-
July
be particularly
1, 1992. attractive
This
posi-
to grad-
uating fellows, individuals considering relocating to this highly desirable geographic local or persons seeking a position for a sabbatical year. Reply in confidence
with
CV
to Box
R-3204.
CHAIRPERSON, RADIOLOGY - The University of Cincinnati seeks applicants for the position of Director (Chair) of the Department of Radiology. Individuals interested in being considered should send their curriculum vitae to: Donald Shumrick, MD, Dept. of Otolaryngology, University of Cincinnati College of Medicine, 231 Bethesda Avenue, Cincinnati, OH 45267-0528. Affirmative Action/Equal Opportunity Employer. We offer a smokefree work environment.
SOUTHERN INDIANA-Radiologist to join seven member group in hospital and office practice. Some interest and experience in interventional studies and/or MRI
desirable
but
all
areas
of
BC
WYOMING-Two
radiologists
seek
HMO’s
package
with
benefits
financial
including
8 weeks
P.O.
and
qualify
of
SER-
Radiology,
for
with population is a 2 year commu-
and
Salary
outdoor
6652.
such
as
skiing,
and Teton Mountains. CV to William R. Sweetwater Radiology,
Drive (307)
203,
Rock
back-
and fishing Gorge RecWind River
Please reply with Compton, M.D., P.C., 1208 Hilltop
Springs,
WY
82901
382-4832.
style. Send
Salary letters
or evening
mammography.
practice
call. Need Great
leading to equal partnership. and CV to: Box R-3201.
RADIOLOGY
exlife
degree,
is based
re-
To
board
certifica-
on academic
benefits
M.D.,
aging,
The
is pro-
along with to: Teresita Divison
University Sciences
an
Univer-
Sciences, Street, (501)
of
is
Opportunity
OPENING
FOR BC/BE GENERAL with experience in
ventional a group hospital
and
Medical
Allentown,
Center,
PA
for
to join a 160-bed PA, about
of Philadelphia.
includes
eral Radiology, Medicine. Please Shohadai, M.D.,
RAInter-
Radiology
radiologists in Allentown,
northwest
practice
for Ac-
Employer.
Vascular
of four located
Slot Little 686-
Arkansas
Affirmative
tion/Equal
DIOLOGIST
a L.
of Im-
of Radiology,
sity of Arkansas for Medical 581, 4301 West Markham Rock, AR 72205. Telephone Medical
rank,
package
Director,
Department
60 miles
private
teaching,
programs. candidate
Address inquiries, Curriculum vitae,
Angtuaco,
interests
M.D.
a generous
nity college and superb outdoor and indoor community recreation facilities. School systems are ranked excellent nationally. Located 3 hours east of Salt Lake City. The surrounding area is ideal for packing, hunting, boating, with accessibility to Flaming reational area and the Uintah,
care
appointment,
have
vided. current
Wyoming There
served.
to direct
clinical
tion in Nuclear Medicine, and the desire to head a medical school section. Teaching and administrative experience are de-
daily
Box
background
southwestern of 50,000
in
MARCH
radiology
Strong
faculty
sirable.
No night
T. Cook, M.D., IN 47716-5249.
MEDICINE
Department
search,
off per year and full partnership at 2 years. The hospital is located in a high mountain desert community of 20,000 in
perience
to partnership. 5249, Evansville,
competing
or PPO’s.
expertise
leading
NUCLEAR
VICE-The
should
No
groups,
group.
years
CHIEF,
procedures.
Competitive
two
recently
Univeristy of Arkansas for Medical Sciences, Little Rock, AR invites applications for Chief, Nuclear Medicine Service. We seek an individual with academic tract
BOSTON-Expanding
for
young
third
trained BC/BE general radiologist to join a growing, independent practice in a modern, 100 bed hospital. 27,000 procedures annually including full service ultrasound, nuclear medicine with SPECT, mammography, CT, and mobile MRI. Limited angiography and interventional
will be considered. All imaging modalities, including MRI available in 400 bed hospital. 90,000 examinations annually. salary
a
all aspects
The of Gen-
CT, US and Nuclear call or send CV to: Asad Allentown Osteopathic 1736
Hamilton
18104.
Tel:
Street,
(215)
770-
8700.
95A
PARTNERSHIP
CLASSIFIED
SERVICES
SUPERB PARTNERSHIP LAS VEGAS-Rapidly member service tal has
group practice imaging centers an immediate
POSITION IN expanding seven covering two full and a small hospiopening. We are
looking for an additional Board radiologist with an uncommon tion to excellence in patient outpatient facilities include: Angio with a 4-bed recovery Mammo, 3 SPECT, plus R & excellent opportunity for a position with a well respected
growing
community.
Please
Dr. Mark Winkier, land Parkway, Las
SDMI, Vegas,
Certified
dedicacare. Our 2 MR. 2 CT, area, 5 US, 5 F. This is an partnership group in a
send
CV to
2950 5. MaryNV 89109.
UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AT CHICAGO has an opening for a Board Certified, Diagnostic Radiologist with interest in abdominal imaging including CT, MRI, Ultrasound, GI and GU Radiology. The position offers a balance of clinical, teaching and research activities. Salary and faculty rank are appropriate to experience. Please send inquiries along with CV to: Steven Pinsky, M.D., Professor and Head of Radi-
ology,
University
of Illinois
at Chicago,
1740 West Taylor Street, Chicago, 60612, (312) 996-0234. UICOMC EO employer offering competitive and benefit package.
Illinois is an AA/ salary
DIAGNOSTIC RADIOLOGIST lLl)i(ilV
Oregon I ‘)-IllCIllhCl’
cXJ)alldiflg
l)Sl)iLtl S(CkS R(’JBL Radiologist for half-tuneposiliollilli
‘dOd clinic-based
O)Uj)
the possihilitof becoming full lime. The l)oSitioIl ould have PriIll:tY reponsihiliLv for I S. (T. Iluoro, films 111(l :Ll)iraliooc1ologies. Opportunities iailahle ill inanuiiogrtph , (lepending 01)00 interest and training: )OSSihlV Mill in the future as OlLIflW increases.
:Lre l)L1I of a successful mttltisl)ecialtv I I%1() I)r.tctiCe, located in the beautiful Ptcific \oiihwesl, which offers sLtte-of4lietrt e(luipnlent and (,
excellent
sahLrv/henefits
l:xlremelv iiients/2 Forward
M.D.,
Kaiser
Medical
Center,
Dept. of Radiology, SOSS N. (;reeley Me., Portland, OR 972 17.4’91.
EOE.
Ce
KAISER Northwest Physicians
rector
of the section
of MRI. The other
po-
agnostic modalities. Ground has just been broken on a new 25,000 sq. ft. radiology wing, which will be furnished with stateof-the-art cancer
equipment. center, and
New rehab
trauma hospital
built. Excellent compensation fits package leading to full Beaches Angeles
and only
sunny
weather.
large-city 2 hours
center, being
and benepartnership.
amenities of Los away. Year-round
Ample
free
time
to enjoy
Southern California and the unparalleled recreational opportunities offered by the resort community of Palm Springs. Direct inquiries to Marvin J. Friedenberg, M.D., Desert Hospital, Department of Radiology, 1150 North Indian Canyon Dr., Palm Springs, CA 92262.
DIAGNOSTIC
RADIOLOGIST
skills in CT, MR. Nuclear Medicine Board Certified practice in Eastern
Interventional, to join group Radiologists. Washington.
a new
multi-modality
center, and two private for long term practice notch school system,
first
rate
universities.
fishing,
boating, Crecelius, M.D., Suite 18B, Spokane, 2385.
with US and of eight Growing 228 bed
imaging
offices. Potential is excellent. Top including three
Excellent
hunting,
skiing. Contact L. E. N. 5901 Lidgerwood, WA 99207. 509-482-
NORTHERN CALIFORNIA-For a radiologist who desires a semi-retirement type of practice in central, northern California in a geographical location equidistant from the San Francisco Bay Area, Carmel-Monterey Peninsula, Yosemite and Sierra ski areas. Full-time radiologist wishes to share practice and provide equal, bountiful time off periods for trayel, leisure and relaxation. Call (209) 6670216 after 6:00 PM (PST).
rM.
PERMANENTE Permanente PC and Surgeons
IMMEDIATE
OPENING
for BC-BE diag-
nostic radiologist for night call and weekend work to join a two member P.C. in a 220 bed community hospital, Birmingham, Alabama area. Home video telemetry provided with few night calls. US, CT, NM, rare angiogram or interventional procedure, general diagnostic radiology. No MRI. Negotiable, competitive salary
with tirement
excellent plan.
benefits, Full
insurance
partnership
Contact Charles Baker, na Road, Birmingham, (205) 481-7193.
96A
PALM
package.
low turnover ( 2 retireresignations in l)1sl 21) ears) C.%. to: Laurie Forrest,
Bess
IN
sition requires a physician with mammography experience to direct imaging in the Breast Health section of a new Comprehensive Cancer Center. The group covers a 350-bed hospital and 2 offices in a desirable, rapidly expanding area of Southern California. MRI facilities indude 1.5 T Picker Vista HPQ with MRA package, ViStar imaging computerand 1.5 I GE Signa. Other equipment includes 3 CT’s, a Cemax image processor, 2 Acuson Color-flow Doppler US, 4 nuclear cameras including 2 SPECT, and all other di-
hospital,
Portland,
POSITION
SPRINGS, CA-Well-established 9member group has openings for 2 board certified radiologists. A physician with a strong background in MRI is sought as di-
RADIOLOGY
and
re-
potential.
M.D., 2650 AltadeAlabama 35243,
ACADEMIC
FACULTY
POSITION
AVAILABLE
as a Diagnostic in Chest,
Radiologist. GI, Ultra-
Subspecialization
sound or Interventional is desired. The Medical University of South Carolina is seeking radiologists for academic positions. Candidates must be Board Certified or Board Eligible. Salary and Academic Rank commensurate with Contact: Kenneth M. Spicer, Interim Chairman, Radiology, University of South Carolina, Avenue, Charleston, S.C.
(803)792-4267.
AAEOA.
DIAGNOSTIC
RADIOLOGIST,
NORTHEAST-Must all aspects of diagnostic
ing MRI and at a 250-bed private
angio. rural
office.
9800
CT,
experience. M.D., Ph.D., Medical 171 Ashley 29425-0720.
be experienced in radiology includ-
To join referral
group of four hospital and
Equipment
1.0 T MR.
includes
biplane
GE
angio
with
DSA, SPECT and color Doppler. Small community in the Catskill Mountains, two hours drive from New York City and 31/2
hours
leading
from
Boston.
Excellent
to partnership.
quiries
to David
Mountain
FULL
Hall,
Road,
TIME
CV
M.D.,
954 Ohayo
Woodstock,
BC/BE
salary
Send
and
NY
in-
12498.
DIAGNOSTIC
RA-
DIOLOGIST-Immediate opening. Outstanding opportunity at well-established private outpatient facility in suburban Philadelphia area. Experience needed in MRI. Full service includes General Radiology, Mammography, CT, NM, US, MRI. No night calls. Competitive salary leading to early partnership. Good Benefits. Contact I. Darocha, M.D., (215) 543-8860.
EMORY UNIVERSITY MEDICINE is seeking sition
as a staff
SCHOOL
applicants neuroradiologist.
OF
for a p0The divi-
sion is staffed by four full-time neuroradiologists and an interventional neuroradiologist. There are also four neuroradiology fellows. We have four 1 .5 TesIa MRI units, one 4.7 Tesla small bore MRI unit,
and
seven
CT scanners.
inquiries
to: James
Director,
Neuroradiology,
Please
C. Hoffman,
Department
Radiology/Neuroradiology, versity School of Medicine, Road,
N.E.,
Atlanta,
4583,
(404)
727-0899
HARTFORD, Board Certified
GA
direct
Jr., M.D., of
Emory Uni1364 Clifton 30322,
(404)
727-
(FAX).
CT-Position
available
Radiologist
to join
for
an es-
tablished group of 8. Practice includes hospital and four private offices, all fully equipped including CT. Mammography experience would be helpful. Competitive starting salary and benefits. Please enclose CV with initial correspondence to: Jeffrey Blau, 40 Hart Street, New Britam, CT 06052; 203-229-2059.
DIAGNOSTIC
RADIOLOGIST-Three
member radiology group seeks fourth radiologist with interventional skills to join them in a suburban community hospital practice in northern Ohio, twenty mm-
utes from the boating sures of Lake Erie and
and fishing pleaits islands. Interest-
ed applicants please call or write to: Dr. Matthew Gutowicz, Jr., 23 Patrician Drive, Norwalk, Ohio 44857. (419) 6688101 Ext. 6205 or 6208.
MARCH
HEAD AND NECK/NEURORADIOLOGIST-The Cleveland Clinic Foundation has a staff position available in the Division of Radiology with special emphasis on head and neck radiology. Candidates must be board certified in Diagnostic Radiology, eligible for Senior Membership in the ASNR as well as licensure in the state of Ohio, and have a clinical background in ENT procedures. This position within neuroradiology will fulfill a complement of five full-time neuroradiolo-
gists
at a 1,200
bed
teaching
hospital
and
large
out-patient facility serving the clinical disciplines of Neurosurgery, Otolaryngology, Neuro-ophthalmology, Adult and Pediatric Neurology. Diagnostic imaging and interventional equipment are
state
of the art and well
staffed
with
VETERANS
cian
board
diology.
eligible/board Subspecialty
CENphysiin Rachest,
GI or interventional radiology is but not essential. This 1,142-bed care Medical Center is affiliated with the Medical College of Georgia. Faculty appointment commensurate with qualification and experience. Augusta en-
joys a moderate
climate,
reasonable
living, numerous recreational and institutions of higher equal opportunity employer. tional information, contact marik, M.D., Chief, Radiology
cost of
facilities learning. An For addiGeorge T. JaService, at
(404) 823-2236.
excel-
GREAT
PEOPLE,
SEE
THE
COUNTRY, WORK WHERE YOU’RE REALLY NEEDED-Join CompHealth, nation’s
largest
locum tenens medical staff. Work when you choose. Teach and learn from colleagues in facilities across the country. Accept or decline any assignment. Enjoy the security of a guaranteed income if you prefer. You’ll earn an excellent income, and your malpractice insurance, travel, housing, local transportation, and licensure will be paid in full. Call today-1-800-328-3084.
IMMEDIATE
OPENING-BC/BE
Diag-
nostic
Radiologist to join eight board certified radiologist incorporated practice covering three hospitals with approx 700 beds and 100+ physician multispecialty clinic. All modalities represented. Must be willing to participate in all aspects of general radiology. Excellent fringe bene-
fit package ing
with
to early
buy-in.
Practice
Valley.
competitive
shareholder
located
Excellent
schools.
Send
Business PA., P.O.
salary status
in Arkansas
public
CV or contact:
Manager, Box 1827,
lead-
at modest and
private
June
Radiology Fort Smith,
River Martin,
Services, AR 72902,
782-5035.
FELLOWSHIPS
FELLOWSHIP IN US/CT/ANGlO-INTERVENTIONAL-A one year fellowship
program
available
POSITIONS
SOUGHT
TRAINED
BOARD
FlED
INTERVENTIONAL GIST-with two years
experience
at
major
seeks
opportunity art patient care. getic and highly
lent
reply
academic
center,
to provide state Bright, personable, motivated, with
references.
Please
CERTI-
RADIOLOpost-fellowship
Geographically to Box
flexible.
R-3207.
JULY 1992 SECOND OLOGY RESIDENCY SOUGHT-Radiology ing first year seeks to transfer search-oriented university-affiliated enced engineer varied research
of the enerexcel-
YEAR RADIPOSITION resident
July,
POSITIONS-The
De-
partment of Radiology of the Brigham and Women’s Hospital-Harvard Medical School has one or two year fellowship positions in the following areas: (1) cardiovascular and interventional, (2) neuroradiology, (3) CT/US/MR. (4) oncoradiology, (5) chest, (6) bone, (7) nuclear medicine, (8) computer science. For more
information tae specifying
please
send
your
curriculum
vi-
of interest to: B. Leonard Holman, Chairman, Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115. Harvard Medical School and Brigham and Women’s Hospital are equal opportunity, affirmative action employers.
area M.D.,
complet-
large private hospital into second year of reacademic university or program. Experiwith strong interest and background in imaging and interventional technologies. Reply via FAX: (602) 982-2391.
EXPERIENCED,
beginning
1992 at Lehigh Valley Hospital Center in Allentown, PA. LVHC is a 492 bed acute care, university affiliated hospital. The fellowship program offers training in CT (head and body), ultrasound, angiography (neuro and visceral), and interventional radiology. MRI experience is also available. For further information contact Robert Kricun, M.D., Department of Radiology, Lehigh Valley Hospital Center, P.O. Box 689, Allentown, PA 18105.
FELLOWSHIP
RECENTLY
(501)
MEDICAL is seeking a certified interest in
444-6653.
MEET
the
GA
skeletal, desirable tertiary
lent ancillary personnel. For further details please contact: Thomas J. Masaryk, M.D., Head, Section of Neuroradiology, Division of Radiology, CCF, 9500 Euclid Avenue, Cleveland, OH 44195. Phone: (216)
AFFAIRS
TER, AUGUSTA,
in
YOUNG,
TERVENTIONALIST
FACULTY
(ABR,
UNIVERSITY
Miami
IN-
SCHOOL
SCVIR)-
seeks
private practice position leading to full partnership. Can perform general radiology, including MRI, Ultrasound, CT. Prefer medium to large hospital in urban or suburban location. Available March 1992. Please respond to Box R-3203.
OF
OF
MEDICINE
Department of Radiology is recruiting faculty for the UM/Jackson Memorial Medical Center, a 1500 bed tertiary care referral center. Positions available to meet expanding clinical and academic programs in:
CT/ULTRASOUND AREA-4 Breast Centers (ACR accredited), general ultrasound (heavy OB/GYN) desires associate leading to partnership. Fellowship or extensive experience in mammography and/or ultrasound desirable. Superb opportunity for ambitious Board Certified radiologist. Reply to Irwin Schiller, DO., Cohn J. Wells, M.D., Breast Diagnostic Centers, 411 Strander Blvd. #303, Seattle, WA 98040,
GENERAL
SEATTLE
(206)
575-9123.
RADIOLOGY
MUSCULOSKELETAL NUCLEAR MEDICINE
CLASSIFICATIONS Positions available Positions sought Fellowships Announcements of courses or symposia
Practices
CENTRAL
MAINE
- PART
TIME-
General Radiologist wanted to supplement dynamic, congenial 5 man group in new hospital department. Work 30 weeks, no weekends. Live in 4 season recreation area close to coast and mountains with time to enjoy them. Competitive salary
and benefits. (207) 786-3571.
MARCH
Contact
Peter
Rutherford
RADIOLOGY
VASCULAR/INTERVENTIONAL
ACCEPTED
postgraduate
for sale
Medical facilities for rent or sale Used radiologic equipment & apparatus for sale Medical employment bureaus Academic posts to be filled Available posts for interns & residents Malpractice insurance
RADIOLOGY
PEDIATRIC EMERGENCY Candidates eligible, equivalent
RADIOLOGY RADIOLOGY
must be Board certified with fellowship training experience. Rank and
ry commensurate Send
CV.
with
C.
A. Poole,
Department
qualifications.
School P.O.
M.D.
and
Chairman
of Radiology
University
(R-308)
of Miami
of Medicine Box
Miami, AN
or or sala-
to:
Professor
EQUAL
IMAGING
016960 33101
Florida
AFFiRMATIVE
OPPORTUNITY
ACTJON/
EMPLOYER
97A
CLASSIFIED
SERVICES
MUSCULOSKELETAL
RADIOLOGY
FELLOWSHIP-Applications are now being accepted for a musculoskeletal fellow position for 1992 at the Cleveland Clinic Foundation (CCF). CCF is a thousand bed tertiary care teaching medical center with a large radiology residency program. Local, national and international patients provide for an interesting and varied mix of bone pathology. Training includes all aspects of musculoskeletal radiology including MR. CT, arthrography, biopsy, bone densitometry, and a large plain film experience. Fellowship includes patient care, teaching, and research. There is a close working relationship with the Orthopedic, Rheumatology, and Endocrinology departments. There are presently four musculoskeletal staff in the section. For further information please contact Bradford J. Richmond, M.D., Head, Section of Musculoskeletal Radiology, Desk A-21, 9500 Euclid Ave., Cleveland, OH 44195 or phone 216444-3931.
ULTRASOUND FELLOWSHIP for physicians
PRECEPTORIAL PROGRAMS-Programs
AND
and technologists in diagnostic ultrasound are offered under the medical direction of Dr. E. A. Lyons. Areas of instruction are offered in abdominal, ob/gyne (endovaginal), small parts, peripheral and abdominal color Doppler. Preceptorship training is available thoughout the year and is adapted to meet individual needs. Fellowships are twelve months and commence in July. The de-
partment clinical
offers exposure,
as visiting
professor
teaching film For additional Clifford
an excellent and teaching file
Health Street, R3A
1R9;
FELLOWSHIP IN OLOGY-UNIVERSITY DA-The in the
Division Department
University
video
wide such tapes,
reference
library.
information contact Section of Diagnostic
S. Levi,
trasound, Sherbrook Canada,
lecture
and
staff, aides
of Florida
Sciences Winnipeg, (204)
Centre, Manitoba,
Dr. Ul820
787-3208.
PEDIATRIC OF
RADIFLORI-
of Pediatric Radiology of Radiology at the
offers
a one-year
fel-
lowship training in Pediatric Radiology, starting July 1993 and July 1994. Three full-time pediatric radiologists provide training in conventional radiology and fluoroscopy, ultrasound, neonatal imaging, CT, MRI, and interventional/angiog-
raphy
techniques.
Supplemental
training
in nuclear medicine is available. Facilities include dedicated standard r/f rooms, 4 color-Doppler ultrasound machines, 2 GE CT units, 3 MR units, ICU electronic image transfer and computed radiography (CR). Opportunity to participate or conduct clinical and basic research is available. Applicants must be eligible for Iicensure in the State of Florida. Contact person is: Jonathan L. Williams, M.D., Director of Pediatric Radiology, Department of Radiology, Box 100374, University of Florida, Gainesville, Florida 32610-0374. Tel (904) 395-0291 . The University of Florida is an equal opportunity/affirmative action employer.
98A
FELLOWSHIP IN MUSCULOSKELETAL RADIOLOGY-UNIVERSITY OF FLORIDA-The Department of Radiolo-
FELLOWSHIP
gy is offering musculoskeletal fellowship positions beginning July 1993 and July 1994. The fellowship currently centers on a 548-bed hospital with wide exposure to skeletal pathology, including more than 200 new musculoskeletal tumors per year. The fellowship experience includes clinical, research, and teaching opportunities in diagnostic skeletal radiology, CT, MRI, MR spectroscopy, metabolic bone disease, TMJ pathology, and image processing.
Swedish
Systems
available
include:
one 1 .5T whole
body spectroscopy/imager, two GE 9800 Advantage CT scanners, and one image processing workstation (DM1) for multiplanar (MPR) and three dimensional (3D) reformation. At the fellow’s discretion, the experience could be expanded to indude aspects of nuclear medicine and the adjacent 473-bed VA Hospital which is equipped with a 1.5T whole body spectroscopy/imager and a Picker 1200 CT scanner. Applicants must be eligible for
licensure CV
in the William
State
of Florida.
Montgomery,
Send
a
Department of Radiology, Box 100374 JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0291. The University of Florida is an equal opportunity/affirmative
action
to
M.D.,
employer.
WAYNE STATE UNIVERSITY BODY MRI FELLOWSHIP-The Department of Radiology, Wayne State University is offering a new Fellowship in Body MRI commencing July 1, 1992. The MR Center includes a 4.7T animal imager and stateof-the-art iT and 1.5T magnets with a 2nd 1ST to be installed in fall 1992; one whole body magnet is dedicated to research. In addition, the physically connected Children’s Hospital has a .35T magnet dedicated to pediatric patients. The Medical Center has 1200 beds and broad referral base leading to a busy dinical service covering all ages and all body systems. There is an active research program in both imaging and spectrosdopy with full time MR physicist, biochemist and graduate students. The Fellowship is a 1 year program with a potential second year for a Fellow with strong research interests. Interested candidates should contact Renate L. Soulen, M.D., MR Center, Harper Hospital, 3990 John R, Detroit, MI 48201, or call 313-745-9542.
FELLOWSHIP OLOGY-The
IN PEDIATRIC RADIDepartment of Radiology,
Bowman Gray School of Medicine, Wake Forest University, offers a one-year fellowship in Pediatric Radiology beginning 1 July 1992. Training will include conventional radiology, neonatal radiology, ultrasound, computed tomography, MRI, and interventional techniques. Facilities include digital fluoroscopy and PACS, ultrasound units with Doppler and color flow Doppler capabilities, 6 CT units and 3 MRI units (l.5T). Opportunities to participate in both clinical and basic research, including PET scanning. Contact Thomas E. Sumner, M.D., Department of Radiology, Bowman Gray School of Medidine, Medical Center Boulevard, WinstonSalem, North Carolina 27157-1088.
RADIOLOGY
1-year Hospital in the
IN
Fellowship Medical
Hospital Pacific
ULTRASOUND-A is available Center,
is the
Northwest.
at Swedish Seattle, WA.
largest The
hospital Ultrasound
Department is responsible for all aspects of ultrasound including abdominal, gynecologic, obstetric (including high risk), pediatric, vascular, and small parts US. Fetal echocardiography and adult echocardiography are also performed within the department. The sonologist performs a wide variety of ultrasound procedures including needle biopsy, abscess drainage, biliary lithotripsy, intraoperative US, and US-guidance for um-
bilical
vein
sampling,
amniocentesis,
chorionic villous sampling, and fetal therapy. State-of-the-art equipment includes color flow imaging, duplex Doppler, transvaginal and transrectal ultra-
sound.
Fellows
sonologists sound and
work
with
one
of four
are dedicated to ultrain teaching. Academic time is granted to promote research and publication. Requirements include satisfactory completion of a 4 year accredited Radiology training program and active interest in ultrasound. Address inquiries and curriculum vitae to: David A. Nyberg, M.D. or Barry S. Mahony, M.D., Department of Ultrasound, Swedish Hospital Medical Center, 1229 Madison Street, Suite 1150, Seattle, WA 98104. Phone: (206) 386-2380, Fax: (206) 386-6312.
SPECIAL
who active
IMAGING
FELLOWSHIP-At
the Johns Hopkins Hospital, Department of Radiology starting July 1, 1993, a unique opportunity for a year of excellence in clinical and/or research in medical imaging. Active body CT service (>16,000 studies per year) on state of the art equipment with special areas of inter-
est including
oncology,
immunocompro-
mised host, inflammatory bowel disease, and 3-dimensional imaging. Research in imaging includes image processing of CT and MRI data using PIXAR Image Computers, Sun Workstations as well as NeXT and Apple Computers. The candidates will be able to devote a significant portion of the year to research and will be a sponsored fellow of the Winthrop Research Fellowship. Interested applicants should write or call Elliot K. Fishman, M.D., Department of Radiology, The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21205, (410) 955-5173.
FELLOWSHIP
IN ULTRASOUND
AND
BODY CT/MRI-One-year fellowships in ultrasound and body CT/MRI beginning July 1, 1992, and July 1, 1993, are being offered by the New York HospitalCornell Medical Center. The department provides state-of-the-art equipment, including Acuson and ATL ultrasound, GE 9800 CT, and GE Signa 1.5 Tesla MR. Wide variety of ultrasound examinations indude abdominal, Ob-Gyn, color doppler, small parts, neonatal head, transvaginal, and transrectal. Applicants should be ABR eligible or certified. Send CV to Elias Kazam, M.D., Department of Radiology, New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, New York 10021.
MARCH
NEURO/ENT VERSITY OF
-
FELLOWSHIP FLORIDA-The
UNI-
Department of Radiology offers several 2-year post-residency fellowship training positions available July 1993 and July 1994. The fellowship offers excellent clinical material, comprehensive and modern equipment subspecialty cal practice include
and experienced four-person faculty. In addition to cliniand training, responsibilities graduate and undergraduate medical instruction in neuroradiology as well as participation in departmental research activities. Minimum requirements include successful completion of an accredited radiology residency. Applicants must be eligible to obtain a medical Iicense in the State of Florida. For additional information contact Ronald Quisling, M.D., Professor, Department of Radiology, Box 100374 JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0291. The University of Florida is an equal opportunity/affirmative action employer.
FELLOWSHIP partment radiology,
Medicine position
POSITIONS-The
of Radiology, Section Emory University is offering a 2 year
beginning
July,
Deof NeuroSchool of fellowship
1992.
A wide
range of clinical and research experience is available including active pediatric, ENT, and interventional neuroradiology. Equipment includes 4 high field MRI units, 7 CT scanners, 2 neuroangiographic suites, and 3 Color Doppler Ultrasound units. Weekly interdepartmental conferences are conducted with the departments of neurology and neurosurgery. Contact James C. Hoffman, Jr., M.D., Director, Neuroradiology, Emory University School of Medicine, Department of Radiology/Neuroradiology, 1364 Clifton Road, N.E., Atlanta, GA 30322; (404) 7274583. Emory University is an equal opportunity/affirmative action employer.
THE NEWLY RENOVATED AND EQUIPPED DEPARTMENT OF RADIOLOGY AT THE ALBANY MEDICAL COLLEGE AND CENTER IN ALBANY, NEW YORK offers the following Fellow-
ACCREDITED FELLOWSHIPS DIATRIC RADIOLOGY AND RIC NEURORADIOLOGY-Depart-
ship positions each year: (1) Abdominal Imaging-The Abdominal Imaging Fellowship encompasses all aspects of MRI, Ultrasound, CT and other advanced techniques in imaging the abdomen. Four state-of-the-art MRI and four CT scanners as well as five color Doppler Ultrasound units are utilized daily. Contact: James C. Peters, M.D. regarding this Program. (2) Neuroradiology-This Fellowship encompasses the full range of advanced neuro imaging including MRI, CT, Angiography and Myelography. Contact: Wilham A. Wagle, M.D. (3) Angiography and Interventional Radiology-Three advanced angiographic suites are utilized daily for a full range of vascular and interventional procedures. Contact: Mohammad S. Sarrafizadeh, M.D. All Program Directors listed above may be contacted at the Department of Radiology A-113, Albany Medical Center, Albany, NY 12208, (518-445-3277) or contact Matthew D. Rifkin, M.D., Chairman, Department of Radiology, A-113, at the above address. Albany Medical Center is an equal opportunity/affirmative action employer.
one- or two-year fellowships radiology beginning July
INTERVENTIONAL MAMMOGRAPHY AND BREAST IMAGING FELLOWSHIP-The University of Arizona is offering a flexible one-year fellowship in interventional mammography and breast imaging for 1992-1993. The section performs more than 12,000 mammograms per year and over 500 breast interventional procedures, including percutaneous, stereotaxic breast needle biopsy, preoperative localizations, and galactography. Equipment includes 6 state of the art mammographic units and 3 stereotaxic devices. The fellowship will include 20% academic/protected research time and up to four months could be spent in other ar-
eas of body FELLOWSHIP OLOGY-The
IN
PEDIATRIC
RADI-
Department of Radiology, Children’s Hospital and Medical Center (CHMC) and University of Washington (UW), Seattle, offers an ACGME accredited fellowship that begins July 1, 1993.
Training
is in the largest
Children’s
Hos-
pital in the Northwest and includes exposure to all aspects of pediatric imaging on state-of-the-art equipment and under the supervision of eight pediatric radiologists. CHMC, a 208-bed medical center
and
UWMC
approximately
neonatal
care
unit
perform
53,000 exams annually. Training encompasses neuroradiology, vascular/interventional, nuclear medicine, oncologic imaging, MRI, ultrasound, computed tomography, neonatal imaging, and radiography and fluoroscopy. There is ample opportunity and time alloted for clinical and basic research projects. Candidates must be board-certified or qualified in diagnostic radiology. CHMC and UW are equal opportunity/ affirmative action employers. A letter of inquiry and curriculum vitae should be sent to Eric L. Effmann, M.D., Director, Department of Radiology, Children’s Hospital and Medical Center, P.O. Box C-5371, Seattle, WA 98105, (206) 526-2166.
MARCH
have
imaging
active
clinical, basic sessment/outcome
(CT, US, or MRI). We
research
program
science
and
as-
reindude: relocation allowance, office space with computer, and funds to attend national meetings. Salary $37,500. Must be BC/BE. For further information please contact: Laurie L. Fajardo, M.D., Director, Mammography and Breast Imaging, University of Arizona, 1501 N. Campbell lated
breast
imaging.
analysis Other
including
technology research benefits
Ave., Tucson, Arizona 85724. Application deadline: April 1, 1992. The University Arizona is an Equal Opportunity/Affirmative Action Employer.
of
POSITION AVAILABLE (July 1992 or sooner)-Neuroradiology Fellowship (one year) for BC/BE radiologist. Section contains 3 neuroradiologists and services neurosurgery, neurology and ENT departments, including extensive skull base surgery. Interventional neuroradiology experience included. Compensation is highly competitive. Equal opportunity/ Affirmative action employer. Send CV to: Dr. B. Azar-Kia, Department of Radiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153.
RADIOLOGY
ment
of
Medical
Radiology,
Center,
year
pediatric
ship
program
IN PEPEDIAT-
Children’s
Cincinnati,
Hospital
Ohio
neuroradiology
is also
offers
in pediatric 1, 1993. A one-
offered
fellow-
and
may
be
taken separately or combined with one year of adult neuroradiology fellowship at the University of Cincinnati Medical Center. Children’s Hospital Medical Center (CHMC) is a 355-bed institution. The Department performs over 105,000 radiological examinations annually in
the largest
children’s
hospital
latory practice in the United Department has 14 full-time diatric radiologists, 6 fellows,
resident
trainees.
Five
pediatric
and ambuStates. The faculty peand many
radiolo-
gy and one pediatric neuroradiology fellowship positions are available annually. Training includes all aspects of pediatric imaging: neonatal radiology; neuroimaging; musculoskeletal radiology; cardiovascular and thoracic imaging; abdominal imaging; oncologic imaging; ultrasonography; nuclear medicine; computed tomography; MRI; and vascular/interventional procedures. The Department has an active clinical service with state-of-the-art equipment as follows: digital fluoroscopy; Acuson, Al, and ATL ultrasound units with Doppler and color-flow Doppler capabilities; planar SPECT gamma cameras; GE 9800 Quick CT scanner, 1ST GE MRI with spectroscopy; and cardiac catheterization/angiographic suite with digital vascular imaging. The fellowship provides a broad clinical experience in pediatric radiology as well as numerous opportunities to participate in both clinical and basic research. Candidates must be Board certified or Board qualified in Diagnostic Radiology and obtain an Ohio Medical License. Salary and fringe benefits are highly competitive. Applications are due prior to January 1992 with interviews scheduled during the fall and winter of 1991-92. There are numerous career opportunities in pediatric radiology in academic and private practice settings. To receive more information about the fellowships at CHMC or careers in pediatric radiology, please contact: Donald R. Kirks, M.D., Director, Department of Radiology, Children’s Hospital Medical Center, Cincinnati, OH 45229-2899. (513) 559-8058. Children’s Hospital Medical Center and the University of Cincinnati College of Medicine are Affirmative Action/Equal Opportunity Employers.
KEEP
YOUR
CLASSIFIED AD an additional $20.00 per insertion, we’ll assign a box number to your ad. Responses will be sent to you as soon as they are received. Send your ad to: Radiology Advertising Production Department 1991 Northampton Street Easton, PA 18042
CONFIDENTIAL-For
99A
ABDOMINAL SHIP-UNIVERSITY
IMAGING OF
The Department versity of Florida
of Radiology is offering
cal fellowships ginning
Minimum
FELLOWFLORIDAat the Uni1-year clini-
in abdominal
in
FELLOWSHIPS AT THOMAS JEFFERSON UNIVERSITY HOSPITAL-The
SERVICES
CLASSIFIED
July
1993
imaging and
requirements
July
include
be1994.
success-
ful completion of an accredited radiology residency. The fellowship includes training in all aspects of abdominal imaging (gastrointestinal and genitourinary radiology, CT, MRI and ultrasound) by a 4person subspecialty faculty. The program offers full clinical experience and research opportunities. Applicants must be eligible to obtain a medical license in the State of Florida. Research Fellowships are also available in abdominal imaging. For additional information contact Pablo R. Ros, M.D., Professor, Department of Radiology, Box J-374 JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0288. The University of Florida is an equal opportunity/affirmative action employer and encourages applications from women
and
minorities.
PEDIATRIC
RADIOLOGY
FELLOW-
SHIP-Egleston Children’s Hospital at Emory University offers a one-year fellowship in Pediatric Radiology beginning July 1, 1992. Training includes conven-
tional
radiography,
ultrasound computerized
cine,
digital
(including tomography,
MRI,
fluoroscopy,
color doppler), nuclear medi-
neuroradiology,
and
interven-
tional techniques. Egleston Children’s Hospital is a 225 bed tertiary care pediatric hospital on the Emory University campus which performed 50,000 imaging studies in 1990. The department is staffed by seven pediatric radiologists and one pediatric neuroradiologist. Two fellowship positions are available eac#{241} year. The application deadline is April 1, 1992. Candidates must be board certified or board eligible in Diagnostic Radiology. For ad-
ditional
information,
please
address
in-
quiries to Dr. Turner Ball, c/o Radiology, Egleston Children’s Hospital, 1405 Clifton Road, N.E., Atlanta, Georgia 303221101. Egleston Children’s Hospital is an Equal Opportunity/Affirmative Action
Employer.
RESEARCH VENTIONAL
FELLOWSHIP IN INTERRADIOLOGY-A two-
year position is General Hospital,
pital
in Pittsburgh,
available a 746-bed
at Allegheny teaching hos-
for a research
fellow
in an innovative program in interventional radiology research beginning July 1992. The fellow will participate in imaging studies directed at ablation of tumors in the liver, prostate, lung and brain. Per-
cutaneous
methods
ed disks also responsibilities
opportunities
are
of removing
being pursued. will be included
to
pursue
herniatClinical as well as
individual
re-
search interests. Candidates must be board certified/board eligible in radiology. Please send CV to Dr. Gary Onik, 320 East North Ave., Pittsburgh, PA 15212.
100A
Department of Radiology at Thomas Jefferson University Hospital in Philadelphia offers the following fellowship programs each year: (1) Ultrasound/CT/ MRI-Jefferson’s ultrasound division is one of the largest in the world and performs all currently available exams, including obstetrical, vascular, lithotripsy, invasive, endoluminal, etc. We also operate four GE 1.5T MRI units and three CT scanners. Contact Barry Goldberg, M.D. regarding this program. (2) Cardiovascular/Interventional-this division is housed in a new suite containing Philips angio units with DSA, and performs the full range of vascular and nonvascular interventional procedures. Contact Geoffrey Gardiner, Jr., M.D. (3) Neuro/ENT radiology-very active clinical services supply a wealth of material to this divi-
sion,
which
is housed
in a Neurosciences
Imaging Center containing all imaging modalities. Contact Carlos Gonzalez, M.D. (4) Breast Imaging-Jefferson’s new breast imaging center performs approximately 85 studies per day, including ultrasound and needle localizations. Contact Stephen Feig, M.D. (5) Chest-includes
biopsies
and
CT. Contact
Robert
being low
Clinic
accepted position
RADIOLOGY are now
for a musculoskeletal felfor 1993 at the Cleveland
Foundation
(CCF).
CCF
is a thou-
sand bed tertiary care teaching medical center with a large radiology residency program. Local, national and international patients provide for an interesting and varied mix of bone pathology. Training includes all aspects of musculoskeletal radiology including MR. CT, arthrography, biopsy, bone densitometry, and a large plain film experience. Fellowship includes patient care, teaching, and research. There is a close working relationship with the Orthopedic, Rheumatology, and Endocrinology departments. There are presently four musculoskeletal staff in
the
section.
For
further
information
please contact Bradford J. Richmond, M.D., Head, Section of Musculoskeletal Radiology, Desk A-21, 9500 Euclid Ave., Cleveland, OH 44195 or phone 216-4443931.
FELLOWSHIP
IN
ULTRASOUND,
BODY CT AND MRI; July 1992, also July 1993. 1 year program featuring ultrasound, body CT, body MRI and noninvasive vascular diagnosis. Send CV, or for information contact: William Zwiebel, MD, Dept. of Radiology, University of Utah Hospital, Salt Lake City, Utah 84132; (801) 581-7553.
RADIOLOGY
Commencing July 1, 1992, position is available for board certified radiologist to receive fellowship training in MR. CT, Ultrasound, and interventional procedures guided by those modalities in the Department of Radiology, University of Southern California. This program offers superb training supervised by academically productive faculty in rich clinical setting. Excellent opportunities exist for supervised hands-on-training in MR, MR angiography, CT, CT-guided procedures, Ultrasound, including color Doppler sonography and ultrasound-guided procedures. The Department of Radiology has state-of-the-art and prototype equipment in all modalities and offers excellent opportunity to achieve expertise in body imaging and related interventional techniques. Interested candidates should contact Philip W. Rails, M.D., Chief of Body Imaging and Interventional Radiology, LAC/USC County Hospital, Box 631, 1200 North State Street, Los Angeles, CA 90033 or (213) 226-7207. USC is an equal opportunity/affirmative action employer.
Steiner,
M.D. (6) MRI-a dedicated body MRI program, including excellent research opportunities in addition to a large clinical case load. Contact Donald Mitchell, M.D. (7) Ultrasound-a dedicated ultrasound program. Contact Barry Goldberg, M.D. (8) Musculoskeletal-includes MRI of the musculoskeletal system. Contact David Karasick, M.D. All program directors listed above can be contacted at the Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107. Jefferson is an equal opportunity/ affirmative action employer.
MUSCULOSKELETAL FELLOWSHIP-Applications
FELLOWSHIP IN BODY IMAGING AND INTERVENTIONAL RADIOLOGY, USC SCHOOL OF MEDICINE-
INTERVENTIONAL
RADIOLOGY
-
The Montreal General Hospital, Department of Radiology, seeks one clinical fellow in intervention and related abdominal imaging techniques to begin July 1992. The Montreal General Hospital is one of the major McGill University teaching hospitals. The department has a volume of over 130,000 examinations per year. The fellow will perform vascular and non-vascular interventional procedures as well as diagnostic Ultrasound, CT and MRI. Training facilities include state of the art equipment in ultrasound, computed tomography, angiography, and Magnetic Resonance Imaging. The fellow will be involved in clinical work and will have research and teaching responsibil-
ities. Requirements
include
completion
of
an accredited diagnostic radiology training program. Send inquiries including CV and 3 references to: Patrice M. Bret, M.D., Radiologist-in-Chief, The Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada. Telephone (514) 934-8003.
FELLOWSHIP TERVENTIONAL
IN VASCULAR AND RADIOLOGY-The
IN-
University of Arizona is sponsoring oneyear fellowships in vascular and interventional radiology beginning July 1, 1992 and July 1, 1993. In depth clinical experience and training in all aspects of interventional radiology will be offered. Facilities at the University Hospital (300 bed) and Tucson Veteran’s Hospital (300 bed) include state-of-the-art angiographic, CT, and MR units. Opportunities for research and teaching also provided. Interested applicants should submit a current CV and three letters of recommendation (including one from the program chairman) to Gerald D. Pond, M.D., Head, Section of Vascular and Interventional Radiology, University of Arizona Health Sciences Center, Tucson, AZ 85724. For further information please contact Linda Fowler at (602) 694-7136.
MARCH
FELLOWSHIP IN ANGIO/INTERVENTIONAL RADIOLOGY-The Department of Radiology Florida is offering residency clinical beginning in July giographic suites
Philips
C-arms
at the University of several one-year postfellowship positions 1993 and July 1994. Anare available, two have
with
1024
ADAC
digital,
and a new Toshiba Vascular Lab. The Department has intravascular ultrasound color-flow Doppler and angioscopy equipment. Training includes all interventional procedures-vascular, biliary, urology, etc. as well as experience with investigational devices such as CO2. angioscopy, atherectomy, and holmium lasers. An animal laboratory, a full-time veterinarian, and an instrument shop are available. Applicants must be eligible for Iicensure in the State of Florida. For further information contact Irvin F. Hawkins, M.D., Professor, Department of Radiology, Box 100374JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0291. The University of Florida is an equal opportunity/affirmative action employer.
2 YEAR LOWSHIP RIC/ADULT
NEURORADIOLOGY IN A COMBINED PROGRAM-The
FELPEDIATfirst
CARDIOVASCULAR TIONAL RADIOLOGY THE JOHNS HOPKINS
/ INTER VENFELLOWSHIPS, HOSPITAL-
TheJohns Hopkins Hospital has one position open for its 1 year CVIR training program beginning July 1992. The program has been redesigned to provide strong clinical experience in a wide variety of vascular and nonvascular interventional procedures including: angiography; angioplasty; percutaneous atherectomy; intravascular ultrasound; thrombolytic therapy; varicocele, tumor, and AVM embolization, caval filters; percutaneous central venous catheter placement; percutaneous abscess drainage; and complex urologic and biliary intervention including percutaneous biliary endoscopy and biliary atherectomy for biopsy. In addition, daily morning conferences, a private CVIR patient admitting service, and a weekly vascular clinic strengthen the total patient care concept of this program. Superb interaction with both the vascular surgery and general surgery services help to facilitate an understanding of the evaluation, care, and treatment of CVIR patients outside the department. Research time for both clinical and laboratory sciences is available. The candidate will also
year is full-time pediatric neuroradiology at the Children’s Memorial Hospital in Chicago. Children’s is a 265 bed pediatric
participate
hospital
planned upgrades including a new room with a Siemens Angiostar, giving us three dedicated CVIR rooms and two shared rooms. Our division includes six full-time staff, 19 dedicated technologists and five full-time RNs performing over 12,000 exams per year. Interested candidates should contact Floyd A. Osterman, Jr.,
with
3 full-time
pediatric
neuro-
radiologists, rologists. imaging
4 neurosurgeons and 3 neuWithin the Division of Neuro(neuroradiology) are 2 CT scanners (GE 9800 Quick and Philips LX), one 1.5T Signa MR. 4 Acuson (1 color dopper) ultrasound scanners and a new Siemens digital and conventional angiographic and myelographic unit (functioning Jan uary 1992). Training will be in all modalities of diagnostic neuroimaging of the head, neck and spine (MR. CT, ultrasound, myelography and angiography) and interventional neuroradiology in children. The second year will be adult neuroradiology at Northwestern University Medical School/Northwestern Memorial Hospital (750 bed private hospital) with complete training in MR. CT, US, myelography, angiography, head and neck radiology and interventional neuroradiology. The next opening is July 1, 1992. Address inquiries and curriculum vitae to: Sharon E. Byrd, M.D. Head, Divi-
sion
of Neuroimaging,
diology, Children’s 2300 Children’s Plaza, Tel. (312) 880-3565/FAX Eric J. Russell, M.D. diology, Department 3420, Northwestern 710 N. Fairbanks/Olson go, IL 60611, Tel. (312) 908-9029.
Please
Department
of Ra-
Memorial Hospital, Chicago, IL 60614, (312) 880-3572 or Director of Neuroraof Radiology, Suite Memorial Hospital, Pavilion, Chica(312) 908-2462/FAX
support
the
dent
V ‘
MARCH
CANCER
SOCIETY#{174}
Our
ly undergoing
M.D.,
Chief,
and
with
of CVIR, The Johns 600 N. Wolfe St., Phone Number
IN VASCULAR AND RADIOLOGY-The
Balti(301)
IN-
University of Arizona is sponsoring oneyear fellowships in vascular and interventional radiology beginning July 1, 1992 and July 1, 1993. In depth clinical experience and training in all aspects of interventional radiology will be offered. Facilities at the University Hospital (300 bed) and Tucson Veteran’s Hospital (300 bed) include state-of-the-art angiographic, CT, and MR units. Opportunities for research and teaching also provided. Interested applicants should submit a current CV and three letters of recommendation (including one from the program director) to Gerald D. Pond, M.D., Head, Section of Vascular and Interventional Radiology, University of Arizona Health Sciences Center, Tucson, AZ 85724. For further information please contact Linda Fowler at (602) 694-7136.
A CLINICAL
FELLOWSHIP
with
time
research
A wide
and
numerous
breadth
POSITION
ING CLINIC DIOLOGY
FOR
SALE
RADIOLOGY AND
SALE
- FREE STANDDIAGNOSTIC
HOSPITAL PRACTICE
BASED RAIN SOUTHWESTERN SUNBELT. Annual collected fees-Clinic $700,000, Hospital practice $960,000. Only Radiologists in City of 45,000 with drawing area population of 100,000. Sale price based on real estate and equipment values only with attractive owner financing to qualified parties. Real estate approximately $280,000 and equipment including conventional XRay, Fluoroscopy, Ultrasound and ACR Accredited Mammography $400,000. Three retiring Radiologists available for transition period as employees or on Loaim tenens basis as required. Reply to Box R-3205. All replies will be acknowledged.
MISCELLANEOUS
MRI VISITING FELLOWSHIPS IN SAN FRANCISCO AREA-Intensive, highly structured one to six week courses in Clinical Magnetic Resonance with emphasis on head, spine and musculoskeletal imaging. Live instruction with over 25 hours of dual projection slide presentations and overhead case presentations in week one. Extensive teaching file and updated videotape library. Course has been running for over six years. More than four hundred visiting fellows have been trained. References from former visiting fellows available. Certificate awarded on completion. For further information, please contact Murray A. Solomon, M.D., MRI Learning Center, 1633 Bayshore Drive-Suite 320, Burlingame, CA 94010. Phone (408) 925-8328. NORTH BAY MRI TUTORIALS-A comprehensive one-week course of instruction features over 30 hours of dual slide projection. Orientation lectures coyer basic principles, protocol issues and fundamentals of image interpretation. Heavy emphasis is applied to current dinical applications, including craniospinal, musculoskeletal and abdomino pelvic examinations. Extensive videotape library and up-to-date teaching file is supplemented with case reviews and readout sessions. Rotating faculty includes Kelly, Bell, Brant-Zawadzki, Clark, Crues, Kucharczyk and Morgan. Well-equipped conference room/imaging center is located in Fairfield, CA adjacent to the Napa Valley between SF and Sacramento. For course dates, contact Mary Kelly, course coordinator, (916) 753-2337.
projects
of interven-
tional radiology procedures is done in a busy practice covering two hospitals. For more information contact: Eric VanSonnenberg, M.D., Professor of Radiology and Medicine, Chief of Interventional Radiology, UCSD Medical Center, 225 Dickinson Street, San Diego, CA 92103.
RADIOLOGY
PRACTICE
FOR
stu-
is current-
renovations,
Division
FELLOWSHIP TERVENTIONAL
medical
department
major
Hopkins Hospital, more, MD 21205, 955-5687.
is available.
AMERICAN
in resident
teaching.
PRACTICE
CLASSIFIED AD DEADLINES 20th of the 2nd preceding month issue. Payment must accompany ad.
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AMERICAN
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CANCER
SOCIETY#{174}
MARCH
The MISSOURI Counselors:
Board
Contudfrom
TEXAS
G. David Dixon, MD Robert R. MacDonald, Fong V. Tsai, MD, Kansas City
NEW YORK Counselors:
Bulletin
David Cheris, MD Theodore Robinson,
Counselors: Jr, MD
WASHINGTON MD
Arthur Sega!, MD Jeffrey A. Cooper, MD, Albany Brian K. McCandless,
Gordon Calderwood, MD W. P. Evans Ill, MD Harvey M. Goldstein, MD Loma L. Laird, MD, Nacogdoches
Counselor: John N. Roehr, MD Elizabeth J.M. Carter, MD, Tacoma
WISCONSIN
Counselor: John C. McDermott, George H. Beihobek, MD Thomas A. Tomsick, MD Peter P. Hindel, MD, Beavercreek Kedarnath B. Joshi, MD, Toledo
Jae M. Koh, MD, Steubenville
OREGON Counselor: Gerald Warnock, MD Christopher J. Morgan, MD, Portland
MD David E. Enerson, MD, Stevens Point Richard J. Jochem, MD, West Allis
CANADA BRITISH COLUMBIA Counselor: Ron Campbell, MD Sidney S. Joss, MD, Victoria Kenneth 5.5. Kaan, MD, New Westminster
Joel I. Cossrow, MD, Pittsburgh Hugh H. Hoke, MD, Lancaster Mitchell 0. Schnall, MD, Landsdowne
Johann H. Bonow, MD, Germany
Matthias Brado, MD, Germany James CS. Chan, MD, Hong Kong Robert P. J. Fabiny, MD, Australia Young-Mm Han, MD, Korea
Warwick W. Herbert, MD, Australia Knstian
0. Herrlin,
MD, Sweden
Johnson, MD, Australia
Shinichi Kan, MD, Japan Yves M. Menu, Sr, MD, France Isamu Narabayashi, MD, Japan Ron 0. Norman, MD, Australia Antonio Orlacchio, MD, Italy Ethna M. Phelan, MD, Australia Margaret S. Phelan, MD, England Norbert Rilinger, MD, Germany Regenfledis Schoemaker, MD, Germany Annie Sibert, MD, France L. Yvonne Eliza Ticket, MD, Belgium Harry S.L. Tjiong, MD, The Netherlands Stamos J. Trakadas, MD, Greece
Keil Volker, MD, Germany MANITOBA
PENNSYLVANIA Counselors: William L. Campbell, MD Beverly G. Coleman, MD Anne P. Dunne, MD
page
CORRESPONDING Hameed H. Al-Taleb, Sr, MD, Kuwait Helge Baum, MD, Germany
Sylvia
MD, Albany
OHIO Counselors:
kst
Counselor: CliffordS. Levi MD Susan C. Holt, MD, Winnipeg
MEXICO Counselors:
Francisco Quiroz, MD Patricia Silva, MD Gaspar Cantu, MD, Mexico City Jose L. Criales, MD, Iztapalapa
Paula T. Messina, MD, Mexico City Jaime A. Saavedra, MD, Colonis del Valle
Eberhard A. Walter, MD, Germany
The
Bulletin
Board
of the Radiological of North America RSNA
Oak
Dues
New
Trustees
R&E
.
to
1 992
Applicants
organizers
which lowing
to
Meet
The
Review
took the
Stauffer, and tant
RSNA
dia,
consult
Office with training
the
Sod-
the
Information about medical practices, produced Its first new and asked each memthe integrity of the col-
Society Invoice to verify
dues ber
members provide the
Dr
Ernest
Ferris,
RSNA
guests
wishes as a member.
proofreading.
and data
good entry
scale of the project at its precluded traditional Our regret is that the
only foolproof” proofreading the first time the member asked to review the data. Dr Ferris went on to say,
aware
that
errors
that members nienced. Our bear with us
Corrections taken over the your questions
Membership (708)
must
humor errors.
have
have hope through
to the data telephone; will
be
We
and
cannot however,
addressed staff
by
by
deadline
meet
Trustees of the RSNA Reand Education Fund will in Chicago on April 10. Mem-
bers of the Scholar Review PanelDr Helen Redman, Dr William Hendee, Dr Robert Parker, Mr Wffliam Edwards, and Mr Harvey Pickerwill travel to Chicago earlier and will interview
the
selected
didates on April 9. Decisions on all awards will be made and applicants should know review by late
K. of
Scholar
can-
of the 1992 on April 10,
and nominees the results of the April.
of address
letter
and MD,
SecretarySociety
it
of
202 1 SprIng Road, Brook, Illinois
Counselor:
of-
are
struments,
not
FLORIDA Counselor: Walter P. Scott, MD Roberto J. Calderon, Jr, MD, Miami
submission
Counselors:
persons,
of
Brian 0. Mulligan, MD, Lisle
Radiol-
to
any
may physics,
KENTUCKY
events,
subspecialties,
may dard or current concepts They should be identified cal and will be reviewed chairman of the Program tee, Dr William A. Murphy, Louis, Missouri.
. The following is for RSNA membership,
a list
as-
include, in-
places,
Papers
and
or-
Counselor: J. Matthew Schwab, MD Fang-Kum Loh, MD, Lexington Allan Paris, Jr, DO, Louisville
MASSACHUSE1TS Counselor: Herbert F. Gramm, MD Peter 0. Clarke, MD, Brookline
be stanlength. as historiby the
MICHIGAN
Commit-
Counselors:
Jr,
Rodolphe E. Langevin, MD, Milton
of St
within of this
as
30 list,
Burton Ellis, MD Henrj Van Der Kolk, MD Meketa M. Schlega, MD, Grosse Pointe
MINNESOTA
of applicants published
provided by the bylaws of the Society. Society members are asked to review these names. Should a member have a question concerning the eligibility of an applicant, days of the publication
Vlastimil Capek, MD David Lewis, MD
forms
related
Topics limited to,
Martin Leborgne, Sr, MD, Miami
ILLINOIS
of ScienScienpresenta-
the Program Comsoliciting papers of
interest
MD
materials
applicant 1992 meeting
of Imaging.
Lawrence N. Rappaport,
Zachary Rattner, MD, New Haven
Society
to the
for
Oaks
CONNECTICUT
Society. potential
for 1992 RSNA Current Concept,
historical
publications,
571-7873.
signed
Thomas R. Cain, MD Clime A. Handy, MD Guy Juillard, MD Hideyo Minagi, MD Sheila Moore, MD James Moorefleld, MD Robert M. Agulnek, MD, Sherman
J.
Remember, mittee is also
at
the
withheld and reconsidof Censors.
CALIFORNIA
were
Paper, tific Exhibit, and infoRAD tions is May 1 . Application are In the January issue
pect but
that be
In-
ogj.
be
Oak
request
60521.
organlz-
completed
1 if the to attend the
ganizations.
S The search
Delhi,
of the reminds
June
tific
inconveyou will last step.”
Ferris, Radiological
600,
meeting
submitted
applications
are
occurred
been is that this
Department
is
J.
Suite
department staff re1 ,500 membership were distributed during
that be
U The
occurs actually
mark your “Confidential”
protest
RSNA assisfor scientific
secretary-general
199 1 meeting Ernest Ferris
their
graciousness in helping correct
Please
America,
Congress.
applicants fice
eration
North
of Dr Sudarshan the
applications
secre-
should
membership investigation by the Board
Counselors:
tary-treasurer, speaking on behalf of the Board, expressed his appreciation to all of the members for
The sheer inception
Delmar
representatives
U Membership port that over the Dr
member
applicant’s pending
to Ernest Treasurer,
and
lected data.
600
director;
to New
with
RSNA
Aggarwal,
RSNA
1992 Suite
the
ers. the
their
Mr
Hedland, director
traveled
to
Asian
Parker,
executive
Mr Merle executive
The
ety
place RSNA
meetings,
*._
to
6th
of Radiology inof RSNA reprethe Congress, immediately folmeeting, December
14-18, 1991. Dr Robert 1992 RSNA president;
Dr Parker Attends Asian Oceanian Congress
. One year after were fIrst asked
of the
Oceanlan Congress vited a contingent sentatives to attend
Invoice
March
-
Executive Offices, 202 1 Spring Road, Brook, Illinois 60521 #{149} (708) 571-2670
.
Receive
Members
Society
Counselor: William Thompson, MD James S. Erwin, MD, Winona
(continued
on preceding
page)
‘91
77th
Assembly Meeting Notes
Scientific Annual
and Part2 Table 910
917
of Contents Neuroradiology Hervey D. Segall, MD, Chairman William S. Ball, Jr. MD David L. Daniels, MD Sylvie Destian, MD Charles R. Fitz, MD Norman E. Leeds, MD Robert M. Quencer, MD Arthur E. Rosenbaum, MD Eric J. Russell, MD Gordon K. Sze, MD Michael S. Tenner, MD William T. C. Yuh, MD Robert D. Zimmerman, MD Magnetic Richard
Resonance L. Ehman,
Warren Robert Theresa Mathias
B. Gefter, MD G. Levitt, MD C. McLoud, MD Prokop, MD Cornelia M. Schaefer, MD Paul Stark, MD
927
922
923
MD, 929
Applications Imaging L. Arenson, MD,
932
Pediatric Radiology Beverly P. Wood, MD, Chairman Charles R. Fitz, MD William H. McAlister, MD John H. Miller, MD Sheila G. Moore, MD Janet L. Strife, MD Richard B. Towbin, MD
935
Official
936
1991 RSNA Replacement
and
Chairman
Thoracic
Radiology
Reginald
Greene,
Dixie
J. Anderson,
MD,
MD
Cardiovascular/Interventional David W. Hunter, MD, Chairman Sandra Althaus, MD Michael D. Darcy, MD Steve Falconer, BA Xiaoping Hu, MD Deborah G. Longley, MD Louis G. Martin, MD Terence Matabon, MD Arthur Stillman, MD Robert L. Vogelzang, MD E. Kent Yucel, MD
Samuel J. Dwyer III, PhD H. K. Huang, DSc 925
PhD
Radiology
Technical Exhibits Joel E. Gray, PhD, Chairman Gary T. Barnes, PhD Joel P. Felmlee, PhD Cynthia H. McCollough, PhD Richard L. Morin, PhD Computer Digital Ronald
Radiology G. Baron,
MD, Chairman Melvin E. Cbouse, MD Antoinette Gomes, MD Robert J. Herfkens, MD Harold Mitty, MD Roderic I. Pettigrew, MD, Renate L. Soulen, MD Mark H. Wholey, MD Jack Ziffer, MD, PhD Murray
Chairman
R. Nick Bryan, MD, PhD John V. Crues, MD Robert J. Herfkens, MD Hedvig Hricak, MD Herbert Y. Kressel, MD Robert E. Lenkinski, PhD Donald G. Mitchell, MD Stephen J. Riederer, PhD Jeffrey R. Ross, MD Mitchell D. Schnall, MD
Cardiac
Chairman
Registration Program Abstracts
Figures
L
RSNA
‘9 1 Meeting
Notes
Neuroradiology Segall, MD, University of Medicine, Los Angeles S. Ball, Jr. MD, Children
Hervey
of Southern
D.
School William
‘s Hospital
California of Cincinnati,
Cincinnati
David
L. Daniels, MD, Medical College of Wisconsin, Milwaukee Sylvie Destian, MD, University of Soutlwrn California School of Medicine, Los Angeles Charles R. Fitz, MD, Children’s Hospital of Pittsburgh, Pittsburgh Norman E. Leeds, MD, University ofTexas M.D. Anderson Cancer
Center,
Houston MD,
M. Quencer,
Robert
University
ofMiaini
Miami Arthur E. Rosenbaum, MD, State University Health Science Center, Syracuse Eric J. Russell, MD, Northwestern University Chicago Gordon K. Sze, MD, Yale University School
School
of
of New
York
Medicine,
Neu’ Haven, Michael
Hospitals,
of Medicine,
Connecticut
S. Tenner,
MD,
New York
Medical
College,
T. C. Yuh,
MD,
University
of iowa
Hospitals,
Valhalla William
Iowa
City
Robert D. Zimmerman, Center, New York
MD,
Cornell
Llnivt’rsity
Medical
Index terms: Brain, MR, 10.1214 #{149} Brain neoplasms, diagnosis, 10.3 #{149} Cerebrat blood vessels, disease, 17.12 #{149} Radiological Society of North America, 77th scientific assembly and annual meeting #{149} Spinal canal, 3.12 Radiology , RSNA,
1992;
182:910-917
1992
The annual meeting of the RSNA continues to grow at an incredible rate, and activity in neuroradiobogy maintains pace accordingly. This neuroradiobogy committee reviewed all or part of 31 different scientific sessions and close to 100 exhibits at RSNA ‘91. Two special symposia were of great interest to neuroradiobogists, one on bumbar disk disease and the other focusing on fast magnetic resonance (MR) imaging. Stephen A. Kieffer completed his tenure as chairman of the neuroradiobogy program committee this year, and we salute him at this time for his superb contributions. The considerable amount of new information presented at the meeting is reflected in this review. It is hoped that this report will provide our readers with a useful memento of happenings in neuroradiobogy at our 77th annual meeting of the RSNA.
Cerebrovascular It was
Disease
evident
at RSNA ‘91 that morphologic and dynamic studies that contribute to the evaluation of ccrebrovascular diseases continue to be intensively evaluated by neuroradiobogists and others. Likewise, treatment of various vascular lesions by transluminab methods and by other techniques remains an active area of endeavor. Many advances in the diagnosis ment of cerebrovascular disease displayed ber meeting are reviewed in this section.
910
#{149} Radiology
and treatat the Decem-
.
.
MR angiography: technical considerations-A number of different technical refinements of MR angiography were demonstrated and discussed. Time-of-flight (TOF) MR angiography techniques based on inflow enhancement and phase-contrast MR angiography are now being used and studied at many sites. However, limited seetion resolution and insufficient flow-stationary-tissue contrast have stifled the development of two-dimensional (2D) and three-dimensional (3D) black-blood MR angiography. Nevertheless, Listerud and Atlas (149) continue to investigate a new 3D Fourier transform multisbab fast spin-echo (FSE) method of obtaining blackblood images, but artifacts in addition to other problems have thus far prevented them from perfecting the technique. Workers who introduced at RSNA ‘90 the multiple overlapping thin-slab acquisition (MOTSA) MR angiography technique compared it in 35 cases with the more conventional 3D TOF MR angiography. Davis and cobleagues (170) demonstrated that MOTSA provided supenor large and small vessel visualization and improved imaging of pathologic anatomy. Conventional angiography was available in 15 of the 25 abnormal cases studied with MR angiography. Some facilities are now using finer matrices to obtain higher-resolution MR angiography studies. Images of great clarity have been obtained, and the techniques employed have proved to be practical in the clinical setting (165, 996C). Hausmann and associates (166) introduced a new elongated transmit/receive coil that enables MR imaging from the circle of Willis down to the aortic arch without changing coils. Both 2D sequential acquisitions with traveling presaturation and 3D slabs can be obtained; there is a small sacrifice of signal-to-noise ratio (S/N) due to the larger field of view compared with that of studies with a conventional head coil. A new method of postprocessing of MR angiographic data was introduced by Atlas and Listerud (952). TRAP (traced ray by array processor) can be used to reconstruct sharply delineated projection images in which a sense of depth is created with vessel shadowing. The authors now prefer this method over conventional MIP (maximum intensity projection) for studies in the region of the circle of Willis. New work was presented in which gadolinium injection was used to improve the visualization of small-caliber vessels at 3D TOF MR angiography. Kanal et al (169C) initiate very short repetition time (TR)/echo time (TE) acquisitions through the circle of Willis during or shortly after a fast bolus injection of contrast material (delivered within 20 seconds). This method enables preferential enhancement of blood over adjacent tissue; if the acquisitions are delayed too bong, undesirable enhancement of stationary tissues results. Zimmerman et ab (1186) also used gadolinium-enhanced 3D TOF MR angiography to depict cerebral cortical vessels in infants, but imaging was impaired when there was damaged contrast-enhancing tissue. Stressing the importance of compensating for an infant’s normally slower cerebral blood flow, they showed that 2D TOF and velocity compensated-uncompensated TOF studies can also be sue-
March
1992
cessfully employed in newborns.
in evaluating
cerebrovascular
insults
associates (847C) demonstrated of intracranial vessels obtained angiography by using an eddy-current-free
Nishimura
imwith 3D
and
pressive
images
TOF
MR
0.3-T permanent-magnet were much better field-strength unit.
than
one
imaging would
system. anticipate
The
results from a low-
Investigators are now employing phase-contrast MR angiography methods to quantitate flow velocities within intracranial and extracranial vessels and in phantoms (994, 998C, 1124). Some of these are done with cine MR pulse sequences, and they are being correlated with Doppler ultrasound (US) results. Extracranial carotid stcnosis and occlusion-Two studies compared 2D TOF MR angiography with conventional angiography in evaluating the carotid bifurcation (164; exhibit 152). Data reported by Laster et al supported vascular MR imaging as a primary diagnostic screening technique (exhibit 152). Using selective common carotid arteriography, they graded 202 vessels as normal to mildly stenotic (0%-29%), moderately stenotic (30%69%), severely stenotic (70%-99%), or occluded. The accuracy of 1.5-T MR angiography was 95.8% for normal to mild stenosis, 71.4% for moderate stenosis, 91.1% for severe stenosis, and 100% for occlusions. Huston and colleagues (164) noted a consistent tendency for MR angiography to cause overestimation of the degree of stenosis and also observed poorer correlation with angiography in the moderate stenosis group. Ulcerations were noted with MR angiography in only one of 16 instances appreciated at conventional angiography. Smith and associates (165) obtained better lumen definition and improved delineation of carotid stenosis by using 512 (read) x256 (phase) matrix 3D TOF MR angiography, compared with a 256 x 256 matrix. The highresolution technique demonstrated less tendency to overestimate mild to moderate stenosis. The acquisition time was 10 minutes, and it required only a slightly longer postprocessing time (around 5 minutes) than their lower-resolution method. Moran and co-workers (420) reported on the use of spiral
computed
tomography
(CT)
with
intravenous
contrast extracranial
material and 3D reconstruction in imaging the carotid arteries in 10 patients. Atherosclerotic plaques could be readily distinguished, and correlations with conventional angiograms have been encouraging. However, adjacent structures that are dense (eg,
calcified
plaques
or
opacified
jugular
vein)
create
difficulties when superimposed on the contrast-enhanced carotids. Further work with additional technical modifications (such as subtraction) should be of interest. Polak and colleagues (251) compared color-assisted Doppler sonography with angiography in 96 patients to determine velocity parameters that best enable detection of 70% diameter stenosis of the internal carotid artery (the current threshold at which carotid endarterectomy has been found to be beneficial). The internal carotid artery-peak systolic velocity was found to be the most useful parameter. Fleiter et al (254C) introduced a new technique of color-coded duplex sonographic vascular
Volume
182
#{149} Number
3
reconstruction that enables a function-related 3D display. Peterman and associates (423C) described a method of identifying patients who clinically tolerate an internal carotid artery balloon test occlusion but who, nevertheless, will suffer a cerebral infarction following permanent occlusion. Patients who were asymptomatic with the balloon test occlusion were then given intravenous Tc-99m HMPAO during balloon inflation and single photon emission CT (SPECT) of the brain was then performed. Patients who display ipsilateral hypoperfusion are still at risk for stroke from carotid ligation, whereas the outlook appears to be better in patients with symmetric perfusion. Rosenkranz and colleagues (421) demonstrated that there is much potential for the use of an acetazolamide stimulation test to evaluate the cerebral vascular reserve capacity of patients with symptomatic extracranial internal carotid stenoses and occlusions. Transcranial pulsed Doppler and Tc-99m HMPAO SPECT measurements were made before and after acetazolamide injection in such patients. Cerebral circulation-The incredible versatility of MR and its various methods has provided numerous ayenues for investigation of the cerebral circulation. Many interesting studies in this area were reported at RSNA ‘91. Enzmann et al (1124) have been using phase-contrast cine MR as a new method of measuring blood flow in major cerebral arteries. This technique appears to have considerable promise for assessing blood velocities within cerebral vessels in the clinical setting. Gado and co-investigators (1125C) have been performing cerebral blood flow and transit time studies, acquiring rapid Serial MR images of both the internal carotid artery and brain tissue during the hand injection of Gd-DTPA. Cincinnati researchers (905) have been able to implement fast T2*weighted MR imaging to assess cerebral perfusion in children following injection of a Gd-DTPA bolus. This technique requires a software update but no hardware modifications. Thulborn et al (1122) demonstrated that the quantitative in vivo measurement of oxygen consumption within the brain and other tissues can be done in humans by employing echo-planar MR imaging. This was shown to be feasible by obtaining in vivo T2 measurements as an index of blood oxygenation, determining arteriovenous blood oxygenation differences by obtaining blood samples, and calculating global oxygen consumption with the Fick principle. Cerebral infarction-There have been numerous ongoing animal studies employing MR in the evaluation of cerebral ischemia (422, 425C, 426, 427). Finelli et al found dynamic gadolinium-enhanced magnetic-susceptibilityweighted imaging to be a superior method of imaging early acute cerebral ischemia (422). Experimental work continues at other centers that are employing contrast agents and echo-planar imaging to demonstrate perfusion deficits in stroke (863, 864). Serial MR imaging and ies were used to compare and incomplete ischemia
proton MR spectroscopic studanimal models of complete by Mathews and co-investiga-
Radiology
911
#{149}
RSNA tors
‘9 1 Meeting
Notes
(427).
Signal changes appeared earlier in incomplete and involved a larger area, possibly due to greater pathologic water influx. Aneurysms-In studying 15 patients with 18 circle of Willis aneurysms proved at angiography, Atlas and assoischemia
ciates
(171)
found
3D
phase-contrast
MR
angiography
superior to 3D TOF MR angiography. Images obtained with both techniques were reconstructed with TRAP and maximum intensity projection (MIP). TRAP improves luminal definition by eliminating signal variations; TRAP also provides depth cueing. TRAP images were judged superior to those generated with MIP. TRAP of 3D Fourier transform phase-contrast data enabled clearer delineation of aneurysms, their necks, and adjacent vessels compared to 3D Fourier transform TOF. With 3D Fourier transform TOF, false-positive interpretation
of spasm
rors
were
was
made
with
made
in five
cases,
phase-contrast
but
no
images.
such
er-
Further-
more, hematomas adjacent to vessels are not seen with phase-contrast MR angiography; therefore, they do not confuse interpretation as they might with 3D TOF MR angiography. Presentations by Levrier and colleagues (167C) and Lee et al (172) dealt with flow patterns observed with phase-contrast MR angiography in intracranial aneurysms. Peripheral slow flow may not be appreciated within larger aneurysms, so that their lumina appear smaller than they actually are. The use of lower velocity encodings can show this flow close to aneurysm walls. Atlas observed, however, that further work is required to determine the optimum velocity encodings that should be used when studying aneurysm patients. Detailed postmortem studies by Moody and co-workers
(exhibit
127)
established
microaneurysms
are
that
extremely
Charcot-Bouchard rare.
In
2,798
autopsy
such anfound, and none was associated with hemorrhage. It is believed that the numerous arteriolar coils and twists seen with conventional high-resolution microradiography were mistaken in many instances as microaneurysms on earlier vascular injection studies in investigations
over
eurysms
a 10-year
period,
only
five
were
hypertensive
sd walls rupture
specimens.
Also,
changes
weakening
yes-
circumstances can result in arteriobar when injected after death. Exhibit 127 was one of four Magna Cum Laude award winners; Moody is to be congratulated for his remarkable back-toback achievement, having also won the same award at RSNA
in such artifacts
‘90.
A rteriovt’nous
malformations-Marks
evaluated MR with cerebral
(956)
tients (AVMs)
to
identify
images and arteriovenous characteristics
a nd colleagues angiograms in 60 pamalformations that
highly
correlate
It was concluded that the findings of an intranidus aneurysm or central venous drainage enable excellent predictive ability for hemorrhages. On the other hand, the observation of angiomatous change is negatively predictive. AVMs with such changes bleed infrequently; they may have a bower perfusion pressure. Lunsford and collaborators (957) considered conventional cerebral angiography to be the most definitive diagnostic test to determine AVM obliteration by radiosurgery. High-signal changes on T2-weighted MR imwith
912
hemorrhage.
#{149} Radiology
.
.
,
. ... .
‘:
:-
.
-
..
ages seen during the course of radiosurgery resolve within 19 months in at least 80% of patients, but permanent changes persist in around 4% of patients. Radiosurgery is capable of obliterating over 75% of AVMs, but chances of success are much less with AVMs greater than 4 cm in diameter. Further critical assessment of radiosurgery is warranted; however, the technique appears to play a potent adjuvant role in the treatment of cerebral AVMs. Interventional neuroradiology.-Peters and colleagues (179) described their use of radiolabeled polyvinyl alcohob sponge particulate matter in staged embobization of cerebral AVMs. Gamma camera imaging of head and chest radioactivity determines the percentage of embobic material crossing the AVM nidus. This technique enabbes assessment of nidus vasculature and whether or not larger particles should be used for subsequent embolizations. Gugliebmi and co-workers (exhibit 176) were able to completely occlude anterior choroidal artery feeders to cerebral AVMs by using a small detachable platinum coil soldered to a stainless steel delivery wire. Detachment by electrolysis took 4-12 minutes and enabled blocking of feeders distal to the artery’s cisternal segment. Since presenting their experience in 16 cases at RSNA ‘89, Higashida et ab (964) have performed transluminab balloon angioplasty for symptomatic intracranial arterial vasospasm in an additional 12 patients. Clinical improvement is provided in over 60% of cases. However, balloon overdistention resulted in vessel rupture in two cases. In another, hemorrhage from reperfusion of a previously infarcted territory occurred because of treatment. These complications led to the deaths of the three patients. These authors also use balloon angioplasty for symptomatic stenosis of the posterior circulation refractory to medical therapy (967). The vascubopathies were mainly atherosclerosis and fibromuscubar dysplasia. Suecessful results were obtained in all but 10 of 156 angioplastics (112 subclavian, 41 vertebral, and three basilar arteries). Access to the area of stenosis could not be obtamed in two patients. A few complications occurred, including transient ischemia during the procedure, stroke, and vessel rupture. Vazquez et al (965) did follow-up angiography in 60 patients who earlier underwent carotid balloon occlusion for carotid-cavernous fistulas and carotid aneurysms. In six patients these studies showed progressive revascularization of the carotid siphon via collaterals but without recrudescence of the original lesion or symptoms. Several presentations described the use of animal models to test new devices and to assess the results of interventional treatment. Mehta and co-investigators (178) evaluated the intravascular use of small tubular hydrogel stents, which might be of value in occluding lesions such as carotid-cavernous fistulas and aneurysms. These hydrophilic stents swell with water absorption. Gonzalez et ab (175) have shown that MR appears to be a useful modality for studying aneurysm treatment with helical platinum coils; MR shows the location of the coils, amount of thrombosis within the aneurysm, and patency of the parent artery.
March
1992
.
Other
Brain
and
Skull
.
.
Conditions
Neoplasms.-Workers from Kumamoto, Japan, who introduced their method of dynamic MR imaging of the sellar region at RSNA ‘90 presented further observations at this meeting (16). They found that dynamic MR was useful for delineating recurrent macroadenomas; these tumors enhance with Gd-DTPA later than the anterior lobe of the pituitary (which, in turn, enhances 30 seeonds later than the posterior lobe, infundibubum, and cavernous sinus). On the other hand, surgical filling materials displayed an enhancement peak that was even more delayed than that for tumors. Bromocriptinetreated tumors behaved similar to surgical filling matenab at dynamic scanning. Pituitary imaging with dynamic and 3D TurboFLASH was also discussed (15C, 17). Carlier et al (15C), however, cautioned that hypointense-appearing areas are seen within the gland very frequently on noncontrast studies with this fast gradient-echo method. Elster pointed out that susceptibility artifacts projecting upward from the sphenoid septum account for some of these false-positive images. Baker and colleagues (18) attempted to categorize the various germ-cell tumors based on their imaging features. Enhancement patterns were not helpful in differentiation. CT studies demonstrating fat and calcium within teratomas were useful in confirming the nature of highand bow-signal areas seen within these heterogeneous tumors on Ti-weighted MR images. Hemorrhage was reasonably common in teratomas and also in choriocarcinomas. Yuh and associates (exhibit 164) updated their results in studies determining the efficacy of higher doses (0.3 mmol/kg) of gadoteridob in demonstrating central ncrvous system metastasis. Higher doses improved lesion detection (46 new lesions in 19 of 27 patients) and lesion conspicuity (in 80 of 81 lesions). The additional informalion resulted in a modification of treatment in 10 of 27 patients. Haustein et al (143C) and Maravilla and colleagues (435) also found that a triple dose of gadoteridol was well tolerated by patients. Using standard doses of this agent in children, Ball et al (83) and Darling et al (exhibit 138) observed no serious reactions. Several tumorlike lesions that were sharply marginated and homogeneously enhancing (as seen on axial MR images) were shown by Kioumehr et al (exhibit 177); these proved, however, to be infarctions in the subacute phase. These lesions were observed in areas where there were transverse sulci and deeply infobded cortices (occipitab lobes and cerebelbar hemispheres). Other features were observed that eventually made correct diagnosis easy. The patients presented acutely. The lesions had no mass effect in the subacute phase, and images in other planes occasionally showed a more wedge-shaped configuration. They occurred in a vascular distribution. On follow-up studies, enhancement was no longer diffuse, and encephabomabacic changes eventually appeared. Tumor spectra are remarkably different from those of normal brain tissue according to Jassoy et al (ii). Their work with proton spectroscopy showed increased inositol signals in two-thirds of gliomas and elevated saturated fatty acids and cholesterol peaks in all metastases.
Volume
182
#{149} Number
3
.
.
RSNA
‘.
1 Meeting
Notes
However, no characteristic patterns were seen with meningiomas. Kamman et ab concluded that MR spectroscopic imaging may be useful in assessment of brain tumor grading and response to radiation therapy (861). Ogawa and colleagues observed that methionine positron emission tomography (PET) was limited in the grading of gliomas (10; exhibit 018). Kim et al found that PET with F-18 fluorodeoxyglucose (F-18 FDG PET) missed recurrent microscopic and low-grade astrocytomas (12). On the other hand, false-positive uptake was seen with this agent due to nontumoral postoperative tissue response and within inflammatory changes. Workers at Johns Hopkins University (1 139) described the use of a multidimensional imaging workstation that can be used in real time at surgery to interactively implement previously acquired cross-sectional head scans. This system has been useful in determining craniotomy sites and has been used in roughly 100 operations (ineluding surgery for skull base and other intracranial tumor). CT and MR images to be used interactively are obtained prior to surgery. It is helpful to apply markers at various sites on the patient’s head prior to imaging and to keep them in place through surgery. These markers and other anatomic sites and prominences on the head are registered with a sensor in the operating room so they correspond to those of the original images (the data set of which has been loaded onto the workstation). The tip of this six-jointed mechanical sensor transfers the reconstructed radiobogic data to the surgical site. Thus, the tip of a probe at surgery can be viewed on a television monitor relative to pertinent imaging anatomy. Thus far, the use of this “surgical bocalizer” has enabled more accurate placement of incisions (with respect to underlying tumors) and the use of smaller craniotomies. Two other interesting presentations incorporated 3D reconstruction of MR imaging data in surgical and radiosurgical brain and skull base tumor planfling (1139C, 1140). Multiple sclerosis-Shah et al (696) used heavily Tiweighted 3D MP RAGE to identify multiple sclerosis plaques and concluded that the sequence was equally sensitive compared to axial T2-weighted spin-echo studies. Many lesions were better seen with MP RAGE. Positiorting is not critical with this volume technique; this should prove useful when doing longitudinal studies of plaque size. Ordinary Ti-weighted spin echo can be deleted in evaluation of patients with multiple sclerosis when using MP RAGE. Frank and colleagues (700) did monthly gadoliniumenhanced MR studies and neurologic examinations in 10 patients with relapsing remitting multiple sclerosis, some being followed up as long as 21 months. Sixty percent of patients exhibited cyclical variation in the number of enhancing lesions. Around 50% of new contrastenhancing lesions appear without new clinical signs and symptoms. Enhancement usually lasts for less than a month, but in a very small percentage it may persist for up to 11 months. Bydder et al (699C) found in patients with multiple sclerosis that heavy diffusion weighting causes most Icsions to display a decrease in MR signal intensity whereas others showed an increase compared to unsen-
Radiology
#{149} 913
RSNA
‘9 1 Meeting
Notes
sitized images. This new approach appears to merit further investigation, since it may show changes not seen on conventional T2-weighted spin-echo images. Workers from Vancouver (697) and Philadelphia (698) have found new and abnormal resonances on localized proton MR spectroscopic studies that appear to be mdicators of myelin breakdown in patients with multiple sclerosis.
Koopmans
et
ab (697)
also
observed
instances
where diminished N-acetyl aspartate (NAA) later returned to normal, suggesting that NAA may be a marker of neuronab dysfunction and not necessarily neuronal loss. Hiehle et al (698) also found that there was a correbation between increased amino acid bevels and abnormalities on magnetization transfer imaging (MTI) studies. MTI is being used to enhance contrast between pathologic and normal tissues not only in multiple sclerosis (698) but in other conditions as well (i127C, 1128). Head trauma.-Heier and Zimmerman (601) found that MR was more accurate than CT in documenting the nature and extent of intracranial injury in birth trauma. Another advantage of MR is that it may show unsuspected changes in the upper cervical cord on sagittab head images. With MR, undisplaced skull fractures are routinely missed, but by themselves these have little clinical significance. Sivit et al (81) showed that intracraniab abnormalities may be found on CT studies (albeit infrequently) in children with low clinical risk or high Glasgow Coma Scale (GCS) scores. Studies by Lenkinski and co-investigators (145) provided evidence that coma in head-injured patients is associated with a metabolic state in which energy demand is markedly reduced. Decreased glucose utilization rates on F-18 FDG PET studies and high PCr/Pi ratios at localized P-31 MR spectroscopy were found. Fetal, neonatal, and pediatric ncuroimaging.-The recipients of a Magna Cum Laude award, Hansen et al (cxhibit 140), presented what is believed to be the first in vitro sequential MR imaging study of human developmental anatomy. Normal central nervous system appearances were emphasized by using formalin-preserved embryos and fetuses with gestationab ages of 8-38 weeks. Newer techniques currently being evaluated in older individuals are being applied to studies in neonates as well. Bydder et al showed that diffusion-weighted imaging is possible in the neonate with good gating and immobilization (i188C). It may prove highly sensitive to myelination, showing suggestive diffusion patterns in four of 33 cases despite the apparent back of myelination on conventional Ti-weighted images. Philadelphia investigators (906, 907) reported the implementation of MR spectroscopic studies in preterm and term infants. Certain spectra suggesting abnormalities in term infants may not be necessarily abnormal in preterm infants (907). Taylor (903) demonstrated that most major venous sinuses and deep veins were seen consistently on transfontanelle color Doppler US studies in full-term newborns. This technique can be useful in detecting and monitoring abnormalities of venous drainage, as well as characterizing arterial flow in infants (903, 1i92C). Using neurosonography, Dovgan et al (il9OC) showed that surfactant, used in treatment of respiratory
914
#{149} Radiology
distress syndrome, decreased the incidence of intraventricular hemorrhage, particularly in low-birth-weight infants. The presence of a fibrovascular mass, representing caudally displaced fourth ventricular choroid plexus tissue in the Chiari II malformation, is well known to neurosurgeons and neuropathobogists. This tissue, found dorsal to the cervical cord in the upper cervical canal, may enhance intensely with Gd-DTPA. Stark et al (1185) observed this finding in three patients with Chiari II and cautioned that this tissue should not be confused with a tumor mass or inflammatory lesion. In a review of 124 male patients with severe hemophilia, Wilson et ab (86) found high-signal white matter foci (single or multiple) on T2-weighted MR images in 11%. The cause of these unexpected lesions has not yet been proved. White matter MR changes in hyperphenylalaninemia may represent toxic edema caused by high phenylalanine levels. These changes may regress markedly after 3 months of strict dietary control, according to Bick et al (1189C). Propofol, a new ultra-short-acting alkylphenol sedative, has been used primarily as an anesthesia induction agent. Goske et al compared intravenous propofol to intravenous Nembutal as sedative agents for pediatric imaging. A significant advantage of the new agent is its extremely rapid recovery time (85). Fast MR imaging-Acceleration of interest in faster imaging techniques in neuroradiobogy was evident at RSNA ‘91. Even ultrafast techniques have been empboyed. The main clinical applications have been dynamic imaging of the pituitary region (17) and sequential cerebral perfusion studies (905). Rosen (RSNA/ AAPM Symposium) showed wondrous echo-planar brain images obtained in a fraction of a second. Functional images of regional cerebral blood volume can be obtained by exploiting the alteration of paramagnetic properties of hemoglobin, rebated to its oxygenation state. These MR images are not unlike functional PET studies. An exciting example of visual cortical activity was shown manifesting as a sudden increase in occipital signal intensity following photic stimulation. Considerable attention was paid to FSE imaging (432C,
433,
434).
A number
of
experts
seem
to
be
nearby
convinced that conventional spin-echo imaging of the central nervous system will ultimately be replaced by other methods. The marked reduction of examination time made possible with an FSE sequence is a product of its ability to encode separately up to 16 echoes per TR. Atlas et al (434) challenged the effectiveness of long TR FSE by comparing it with conventional long TR spin echo in detection of focal brain lesions. All patients who had focal intraparenchymab lesions on spin-echo images also had focal lesions on FSE images. Cerebral contrast characteristics were deemed nearby identical. However, the lesser sensitivity of FSE to iron may be of some importance; it was noted that normal brain iron accumulation appeared less hypointense on the rapid examination. However, the brighter appearance of fat compared with intensities on conventional TR images seems to be less significant. Kalina et al (432C) displayed that higherresolution 2D and 3D T2-weighted FSE is capable of cx-
March
1992
;:
-,
cellent
resolution,
showing
anatomy and small and petrous bone. specific Elster
comparisons and Provost
details However,
fine
vascular
intracranial
within the cavernous sinus Kalina did not make many
in his general overview. described their experience
with
large-tip-angle spin-echo (LTASE) imaging (429). Examination time can be shortened by 30%-50% by reducing TR. These images appeared somewhat noisy; the availability of FSE may make LTASE imaging less important. Wehrli (RSNA/AAPM Symposium) presented an excelbent discussion of the theory and methods of fast MR imaging techniques in reviewing gradient-echo, half Fourier, and FSE pulse sequences. The speed of each of these was analyzed in terms of how data acquisition was obtained in k-space. Gradient-echo or spin-echo imaging requires a full set of phase-encoding pulses; thus imaging time is limited by TR. Half-Fourier imaging relies on symmetry of the echoes; it requires approximately half of a phase-encoding set, and, therefore, approximately half of the acquisition time is needed. As mentioned above, much effort has been expended recently in the acquisition of images very similar to T2weighted spin-echo images with greatly reduced imaging times. In accomplishing this, additional gradient pulses have been used to acquire multiple phase-encoded echoes from a single 90#{176}-180#{176} radio-frequency pulse pair. Other considerations.-Hudgins et al (430) found that 3D Ti contrast images generated with a spoiled gradient recall sequence are at least comparable to (or, perhaps, preferable to) conventional 2D Ti-weighted spin-echo studies. The 3D studies have superior S/N and graywhite demarcation, but they are more sensitive to patient motion. Others have shown, however, that routine Ti-weighted spin-echo sequences are superior to fast gradient-echo Ti-weighted sequences in detection of contrast-enhancing lesions (1129). Dabbey et ab (436) showed that fat-saturation, gadolinium-enhanced sequences may demonstrate slowly flowing blood within many venous structures at the skull base. These channels may result in symmetric ring, target, or tubular enhancement within optic, hypogbossal, carotid, and facial canals, foramina ovale, lacerum and rotundum, and other basilar structures. Mark and colleagues (1133) showed that enhancement of the third nerve on gadolinium-enhanced MR images is always abnormal, usually resulting from an inflammatory or neoplastic process. Ischemia may also be a cause. A third nerve palsy may or may not be present when enhancement is seen. In three cases both enhancement and symptoms resolved together. Hansman-Whiteman et al (702) reviewed MR findings in 47 patients positive for human immunodeficiency virus (HIV) with progressive multifocab leukoencephabopathy (PML). Posterior fossa white matter involvement was not rare (that may be the only site). The basal ganglia, corpus callosum, and temporal lobe may also be involved. Gd-DTPA enhancement in PML lesions is uncommon, but contrast material is needed in HIV patients for evaluation 30%). Mirowitz
and
Volume
#{149} Number
182
of concomitant colleagues
3
infection (139)
showed
(which significant
occurs
in hy-
RSTA
‘91
Meeting
Notes
perintensity (on Ti-weighted images) of the globus pallidus (especially the medial segment) in nine patients treated with long-term total parenteral nutrition. There was variable involvement of adjacent structures. This finding may be due to deposition of parenteralby administered manganese and/or other trace metals. Several papers described observations associated with radiation-induced injury to the brain. Gaensler et al (958) described single (five cases) or multiple (12 cases) lesions, punctate or up to 2.5 cm in diameter and within radiation portals in patients treated for central nervous system neoplasms. High and low MR signals corresponded to hematoma with hemosiderin in five cases with pathologic correlation (no tumor was present). Findings volvement
of normal-appearing (on pretreatment
brain imaging
in the area of instudies) and
records of high dose levels supported radiation treatment as the cause. Yousem et al found low NAA/creatine-phosphocreatine (NAA/CR) ratios in radiationinjured brain; this ratio separated radiation-injured from normal brain within the framework of their project. A number of interesting presentations dealt with findings in patients with seizures. Hugg et ab (146), in 10 patients with medically refractory epilepsy (studied interictally and blinded to the abnormal side) were abbe to lateralize correctly the ictal focus in each case by using P-3i MR spectroscopic imaging. Studies by Glicklich et al indicated that MR readings alone can be misleading in patients with temporal lobe seizures; qualitative MR has low sensitivity in the evaluation of mesial temporal sclerosis (147). Exhibit 109 (by Tampieri et ab) showed the value of MR in two patients with temporal lobe epilepsy by nicely demonstrating temporal lobe meningoencephaboceles. Orrison et al (exhibit 145) have successfully localized neuronal activity within somatosensory and auditory cortex by using a 37-channel biomagnetometer in eight volunteers. A display of electrical activity can be superimposed on MR images, thus creating a functional map.
Spine Disk disease-A
Special Focus Session entitled “Controversy, Communication, and Diagnosis in Lumbar Disk Disease” was one of the meeting highlights. The panel, chaired by Kricheff, also included Bryan, Haughton, Miller, and Modic. Terminology, diagnostic approach, relative value of the various imaging methods, anatomic-pathobogic considerations, and clinical considerations in diagnosis and treatment were actively discussed with vigorous audience participation. As expected, many differences of opinion emerged. It seems that this multifaceted subject is a complicated one for neuroradiobogists, and there are many variables that make scientific analysis difficult. At present, technology is changing rapidly. Disk disease may be a self-limited disorder. As Haughton observed, surgeons have difficulty separating bulging disk from true herniation at operation. Bryan’s comments reminded us that this is not strictly a radiobogic problem; the imaging approach should take into account the clinical picture, and, furthermore, patient outcome should be included in studies evaluating diagnostic accuracy of imaging methods.
Radiology
#{149} 915
RSNA Nevertheless, ganizing
‘9 1 Meeting
there a national
ogy as well problems.
Notes
seems to be much sentiment consensus conference on
as other
aspects
of imaging
for
for orterminol-
lower
back
of MR as a substitute for myelographic the evaluation of lumbar and cervical disk disease is increasing, and thorough data presented support this (596, 600). However, conservative clinicians and neuroradiologists at several outstanding institutions still continue to use myelography somewhat extensively. Several presentations documented that some of the newer MR techniques offer good images in patients with degenerative disk disease with decreased imaging times Acceptance
studies
in
(328, 598, 599). Deutsch et ab (868) both before and after ful lumbar diskectomy was
there
nucleus the disk
complete pulposus;
space
virtually
no
reviewed MR studies obtained (mean, 1.6 years) clinically successin 15 patients. In only a few cases imaging
resolution
of
the
herniated
extradural defects in continuity with persisted in most. In three cases there was
change
compared
with
preoperative
stud-
ies. Intense enhancement was noted in each extradural lesion when gadolinium was used, indicating fibrosis. A George Washington University team (869) showed an orderly progression of imaging changes (with a tendency toward stabilization by 6 months) on sequential postoperative MR images following successful diskectomy.
Contrast
enhancement
of
decompressed
nerve
roots gradually subsides. Correlation of gadolinium-enhanced MR findings with symptoms appears to be limited in postoperative patients; 13% of their asymptomatic patients showed persistent mass effect with rim enhancement at 3 months. Milwaukee investigators (871) showed that immature postlaminectomy scar has less enhancement than mature scar. Enhancement becomes more homogeneous with time in mature scar tissue. Thus, in an early postoperative patient an area thought to represent recurrent disk might possibly be immature scar tissue. These workers also showed that greater contrast enhancement in scar was appreciated when MR images were obtained at 2-15 minutes after injection (compared to later) and when higher doses were used. Vascular ina!formations.-Rolland and co-workers (i68C) reported on the use of phase-contrast MR angiography
in
the
follow-up
of
patients
undergoing
em-
bolization correlations draining treatment.
of spinal cord vascular malformations. With with conventional spinal angiography, veins were seen in their entire length before The disappearance or diminution of these
veins
postembolization
on
MR
studies
is a useful
nonin-
vasive criterion of the efficiency of embobization. Latchaw and colleagues (872) pointed out that cord congestion resulting from slow venous drainage of spinal AVMs may result in appearances suggesting hyperintense cord tumor on MR studies. This appearance, in conjunction with low-intensity structures (particularly those that are serpentine), makes further evaluation for cord vascular malformation necessary. Trauma-Several presentations dealt with the value of MR imaging in prognosticating outcome in cases of spinal cord injury (476, 477; exhibit 110). Takahashi et ab
916
#{149} Radiology
showed changes
that the extent on T2-weighted
compression initial study,
and duration images and
on the initial study were high-signal cord changes
of high-signal the severity significant. extending
cord of cord On over
the
two vertebral bodies indicate that improvement will be infrequent and that there is only a 5% chance of cornplete recovery (20 cases studied). When such changes over two segments persisted on subsequent studies, however, there was no improvement in any of five cases studied. Results are better when there are small areas of hyperintensity and when such abnormalities clear (476; exhibit iiO). Flanders et al (477) showed that the percentage of motor recovery was only 9% when a single MR study obtained within 14 days of injury demonstrated an intramedublary hematoma. Heier and Zimmerman (601) showed that MR demonstrated unsuspected cervical cord contusion and complete cord transection on sagittal head MR images in a series of neonates studied because of documented traumatic dclivcry. Pediatric spine-Byrd and associates (604) revealed that high-resolution, gadolinium-enhanced MR is very sensitive in detecting spinal canal spread of central ncrvous system neoplasms. In studying 55 children, there was very close correlation with findings at water-soluble myebography and cerebrospinal fluid cytology; in one case, however, cytologic results were positive, but both imaging studies were negative. Schumacher and Kroll (ll9iC) showed with US that the caudal spinal cord always moves both ventrodorsally and craniocaudally in normal children. A tense thick fibum or postoperative scar with tethering may hinder these undulatory movements. Meningomycbocele patients with cord motion fare better than those who do not exhibit cord motion. Technical advances..-Sze et al (478) observed that T2weighted FSE sequences are capable of producing images of spinal cord pathologic conditions diagnostically comparable to standard spin-echo studies. Yet, FSE may reduce imaging time in the spine by 70%-80%. Adjustment of several parameters (echo train length and echo spacing) is required to obtain optimum images. Optimization for extradural disease, on the other hand, involves use of a separate set of parameters at present (327). Osseous lesions (such as metastases) may be missed on ordinary T2-weighted FSE studies (433); this needs to be more fully addressed. Nevertheless, Modic (RSNA/AAPM Symposium) reminded us that the reduction of motion artifact related to relatively short acquisition time is an important factor giving FSE great potential for spine imaging. Miller et al (exhibit 175) demonstrated the advantage of a six-coil system for spine imaging. Once in place, the MR operator chooses which four coils will be active, depending on the site(s) to be imaged. Thus, multiple coil placements are not required. This multicoil system gencrates high-quality images of the spine in less time than conventional coils. Felmlee and colleagues (852) showed that patient motion during spine imaging can be compensated for by using an imaging pulse sequence with interleaved projection (non-phase-encoded) echoes located cranial and
March
1992
t
:
caudal to the axial image stack. Movement was evabuated with motion-detection algorithms, and weighted corrections were applied to the image echoes with a special reconstruction program. Other preventive measures were incorporated to deal with physiologic motion. By incorporating such corrections, excellent high-resolution Ti-weighted spine images can be obtained despite motion. Other considcrations.-Yu and Rosenbaum (330) emphasized that the thin posterior longitudinal ligament can be seen only as a discrete entity on midsagittal MR images below the L4-5 level because of fat in front and behind. Cryomicrotome studies showed that this ligament is intimately related to bow-intensity normal structures at higher levels. Phase-contrast studies to evaluate normal and abnormab cerebrospinal fluid motion in the spine continue (472, 473, 474). Bradley and colleagues (473) showed that phase-contrast studies with the patient in the prone position may be useful in excluding posterior tethering of the spinal cord. His group (473, 1126C) also showed that velocity images can help outline spinal arachnoid cysts by delineating their sharp margins; meanwhile cyst motion is easily appreciated since it is not in phase with surrounding cerebrospinal fluid (“rebound sign”).
Magnetic
Resonance
______________
Richard L. Ehman, MD, Mayo Clinic, Rochester, Minnesota R. Nick Bryan, MD, PhD, The Johns Hopkins Hospital, Baltimore John V. Crues, MD, Santa Barbara Cottage Hospital, Santa Barbara, California Robert J. Herfkens, MD, Stanford University School of Medicine, Stanford, California Hedvig Hricak, MD, University of California Medical School,
San
Herbert
Francisco
Y. Kressel,
Pennsylvania,
Robert
E. Lenkinski,
Pennsylvania,
Donald
MD,
Hospital
of the University
of
Philadelphia
PhD,
Hospital
ofthe
University
of
Philadelphia
G. Mitchell,
MD,
Thomas
PhD,
Mayo
Jefferson
Hospital,
Philadelphia
J.
Stephen
Riederer,
Clinic,
Rochester,
Minnesota
Jeffrey
R. Ross,
Mitchell
MD,
D. Schnall,
Pennsylvania,
Cleveland Clinic, Cleveland MD, Hospital of the University
of
Philadelphia
Index terms: Magnetic resonance (MR), contrast enhancement #{149} Magnetic resonance (MR), physics #{149} Magnetic resonance (MR), spectroscopy #{149} Magnetic resonance (MR), vascular studies #{149} Radiological Society of North America, 77th scientific assembly and annual meeting Radiology ‘ RSNA,
1992;
182:917-922
1992
Clinical magnetic resonance (MR) imaging years old, yet the growing impact of this most areas of diagnostic medical imaging apparent at RSNA ‘91. More than one-third
is less than 10 modality on was readily of the 1,272
RSNA refereed modality.
Neurologic
182
#{149} Number
3
abstracts
MR
in the
scientific
Notes program
involved
this
Imaging
The rapid pace of development of MR angiographic technology and techniques of the past few years is leveling off as the field matures. Comparison of different MR angiography techniques and comparison of MR angiography to more conventional modalities continues to drive the field. Two-dimensional (2D) time-of-flight (TOF) MR angiography was shown to be equivalent to ultrasound for evaluation of the carotid bifurcation (164), and three-dimensional (3D) phase-contrast imaging was considered superior to 3D TOF studies for intracraniab pathology (171). Multiple overlapping thinvolume acquisition (170, 582) was shown to be superior to a single-volume 3D TOF technique for intracranial pathology. Technical innovations for MR angiography included a higher resolution 512 x 256 matrix providing improved lumen definition (165); a new barge-field-ofview head coil allowing imaging of both head, neck, and arch vasculature (166); and the use of a timed injection of Gd-DTPA to correspond to the bow-order phase encoding to increase conspicuity of small vessels (169). MR angiography has also shown increased use at lower field strengths, both at 0.5 T (3D and 2D TOF) (410) and with a permanent magnet at 0.3 T (2D TOF) (847). New methods of postprocessing continue to improve MR angiography quality, such as TRAP (traced-ray with array processor), which was shown superior to conventional maximum intensity projection (MIP) (952). Simulated flow streamlines were created by using phase-contrast MR angiography in both aneurysms (172) and the cxtracranial carotid vessels (577), a subject that previously could be studied only intraoperatively or in vitro. Magnetic susceptibility contrast-enhanced MR imaging enables early visualization of cerebral perfusion deficits during temporary ischemia in the cat middle cercbra! artery model (425C). This approach is promising for clinical application. Studies evaluating the safety and efficacy of tripledose-O.3 mmol/kg-Gd-DTPA injection for MR contrast enhancement reported this dose to be clinically safe and produce greater conspicuity of enhancing lesions (143, 435). Localization of focal epilepsy foci remains a clinical challenge. P-31 MR spectroscopic imaging with a 3D technique found statistically significant differences in spectra from electrically abnormal temporal lobes versus electrically normal temporal lobes during the inner ectal period. pH was increased as was inorganic phosphate, while phosphomonoestcrs were decreased in the abnorma! temporal lobe (146). Standard MR imaging was found to be relatively insensitive to medial temporal sclerosis, in contrast to previous reports (147). Spine MR imaging also continues to be an active area of interest. Fast spin-echo (FSE) (RARE) imaging showed good results in the evaluation of spine degenerative disease and intramedullary disease (328, 433, 598, 478), compared to conventional T2-weighted spin-echo technique. Optimization is necessary to minimize artifacts and
Volume
‘9 1 Meeting
blurring
(327).
Focal
brain
lesions
are
detected
Radiology
with
#{149} 917
RSNA
‘9 1 Meeting
FSE imaging with an accuracy that matches the range intraobserver variation present in the routine T2weighted spin-echo images (434). Fat-suppressed T2weighted spin-echo imaging allowed an improved
of
cerebrospinal fluid myebogram effect compared to conventional T2-weighted imaging (326). The diagnosis of cord and caudal brain stem tethering or compression (as in Chiari malformation) and arachnoid cysts all benefited from cine phase-contrast imaging (473, 474). A 1-minute modified spin-echo acquisition allowed display of the cord motion without cine techniques (475). The role of MR versus computed tomography (CT) in the evaluation of spine degenerative disk disease was evaluated in two papers. MR was shown to be equivalent to CT myebography and plain CT for lumbar disk disease. It was suggested that in patients with a high probability of disease, MR should be used; in patients with a low probability of disease, plain CT is the test of choice (596). A bow-flip-angle volume gradient echo MR technique was demonstrated to be equivalent to CT myebography for cervical degenerative disease (600). Longitudinal studies of disk disease in the previously unoperated and operated lumbar spine were presented. Sequential studies in the unoperated spine showed decreasing size of herniations with time in 63% of cases (597). In the operated spine, persistent extradural defects were seen in patients with a mean of 1.6 years since successful
also, after
surgery,
an orderly diskectomy
mass
effect
representing
progression was seen
at
the
surgical
epidural
fibrosus
of postoperative (869), with 38% site
which
resolved
(868);
changes showing with
time.
Fat-suppressed MR after Gd-DTPA administration was shown to increase the depiction of epidural scar (870), and higher doses of contrast agent (0.3 mmob/kg gadoteridol) improved visualization of scar in a dog model (871).
MR
imaging
injuries
can
performed acutely after cervical spine predict ultimate neurobogic recovery. intermedulbary hematomas have a signifiprognosis than those with intermedullary
help
Patients with cantly worse edema (477). Spinal cord metastases in children were found to be equally well detected with gadolinium-enhanced MR as with CT myebography (604). 3D TurboFLASH of the pituitary was shown to have a high sensitivity but poor specificity and poor positive predictive value for adenomas. This was ascribed to the various hypointensities seen in the pituitary with this sequence (15). Dynamic TurboFLASH imaging with contrast material allows for detection of cavernous sinus invasion by adenomas (17). Head and neck MR imaging appeared to be dominated by the use of techniques with contrast material and fat suppression and those achieving improved resolution. Normal facial nerves can show enhancement,
even
if they
around brynthine riety of ment is foramina cause of
918
the
are right-left
symmetric,
and
particularly
geniculate ganglia (191). In comparison, baenhancement is abnormal and is seen in a vaconditions (20), and endolymphatic sac enhanceassociated with M#{233}ni#{232}re (21). Most skull are seen to enhance with fat saturation bethe skull base venous plexus (436). T2-weighted
#{149} Radiology
appear
studies cochlcar
useful
implant
obliteration
in the
.
.
by
of the cochlea
(26).
evaluation
showing
the
of
fibrous
MR appears
extension of adenoid overcall of bone disease
extension (712). correction with and Ti-weighted
.
preoperative
candidates
show intracranial but may cause
conspicuity
“
‘
.
useful
to
cystic carcinoma and perincural
Tumor margin and signal showed no the grade of parotid neoplasms (7i3), unenhanced images showed the best
of parotid
lesions
in 81 % of cases
Cardiothoracic MR Imaging Evaluation of MR contrast media
(714).
for cardiac
imaging
continues to be an active area of research (56, 59, 629, 746, 999). Fast MR imaging techniques were shown for first-pass contrast enhancement studies of cardiac shunts (742) and rapid measurement of cardiac ejection
fraction
(630)
ages of the (53). A variety
tion
and
have
proximal
of quantitative
were
reported
progress
provided
in the
of pulmonary
the
coronary MR
most
detailed
anatomy
reported
studies
of cardiac
(54, 58, 627, 740, 743, 744), use
of MR
artery
flow
volumetry
(626).
myocardial motion with contrast techniques were (628, 745). 3D myocardiab tamed with phase-contrast
for
Methods
the
imto date func-
including assessment
for measuring
saturation tagging and phasethe subject of further reports motion measurements obmethods correlated well with
radiographic measurements of motion obtained with tantalum markers attached to canine hearts (57). In a session on MR imaging of the vascular anatomy of the lungs, detailed images were presented that were remarkable for the wide variety of techniques used (386-388, 390). These included contrast-enhanced multisection gradient-echo images, electrocardiogram-triggered single-section spoiled gradient-echo images, and thick-section 2D gradient-echo images, all with echo times less than 3 msec. With all techniques, fifth-order branches of pulmonary arteries were depicted. While the optimum technique remains unestablished, it appears that high-quality pulmonary MR angiography is rapidly becoming a reality. With some of these techniques, thrombus may have similar signal intensity to
flowing
blood,
establish the bobus (388).
however,
so further
sensitivity
for
work
detection
is needed
to
of pulmonary
em-
Overall, the combination of more thorough examination of existing technologies and the continued development of more rapid and improved imaging techniques has
shown
significant
for evaluation RSNA
‘91 has
shown
which
suggest
that
the
chest
reached
in major
ent-echo
and
an exciting
the
rapid
vascular
capabilities
thoracic
progression
growth
of MR
diseases. of studies,
of applications
structures
has
not
in
yet
of the Breast
of fat-suppressed,
imaging
of the
contrast-enhanced,
of the breast
interest (260). The vious investigators than normal breast
evidence
in the
its peak.
MR Imaging A study
advances
of cardiovascular
generated
results supported that breast cancer tissue, and they
value
of MR imaging
3D
gradi-
considerable
observations of preenhances more provide preliminary
as an adjunct
March
to
1992
rt’::
conventional ported
mammography.
in a larger
echo
techniques
Abdominal Clinical uation sented
of patients
(263).
tiate between (709). Current methods for breast lesions
Similar
series
results
MR imaging
radiation research MR-guided (707).
MR Imaging experience with
gastrointestinal
agents
continue
re-
with
appears
MR contrasts
tract, (28-31,
The
lesions. of
in the
eval-
abdomen reprethe identification
investigations
33, 35).
oral
role
of
of distribution of the contrast material was emphasized (29), particularly the effect of viscosity and particle distribution as a function of the magnitude of the susceptibility-related artifacts, which can be identifled with some agent formulations. Particularly promising results were demonstrated with a new agent (consisting of ferric iron with inositol hexaphosphate) (33). This agent appeared to distribute uniformly and demonstrated minimal related artifacts. Thus, bowel lumen and the entirety of the bowel wall could reliably be visual-
ized
in a series
of animal
to weigh
administration
studies
the
benefits
against
the
that
were
or oral
financial
presented.
contrast
costs,
It
agent
logistic
the
metastases, Promising coborectal
homogeneity
is difficult
Limited investigation of pancreatic MR imaging continues. In one study, 52 patients from several institutions were studied with dynamic CT and MR imaging including Ti- and T2-weighted spin-echo, gradient-echo, and short-tau inversion-recovery techniques. There was no significant difference between CT and MR imaging for demonstrating
regarding
important
Notes
liver tumors. The signal-to-noise ratio was highest with T2-wcighted fat-suppressed images. Enhanced gradient-echo images helped characterize
to differen-
agents
1 Meeting
characterizing
spin-
fibrosis and tumor recurrence is also directed at developing percutaneous baser ablation
of the gastrointestinal tract and a major theme at RSNA ‘91. For
of the
were
imaged
RSNA”9
carcinoma,
tumor
or nodal
or hepatic
either
with
balloon
staging
of
insuffiation
or
surface coil imaging (686, 687, 690). The initial report of the Radiology Diagnostic Oncology Group in comparing MR and CT with body coil techniques in staging coborectal carcinoma showed that the two techniques were comparable at the present state of development (686). Additional experience in the usc of MR for evaluation of recurrent rectal carcinomas was presented (688, 689). Dynamic imaging with Gd-DTPA appears to offer improved ability to depict recurrent carcinoma and to differentiate it from scar and inflammatory conditions. Few new MR imaging.
diffi-
primary
or vascular invasion (968). results were presented in local
results were presented in the area of renal Further studies confirmed last year’s pre-
cubties, and impact on patient tolerance. Another major thrust in the application of contrast agents to MR imaging of the abdomen was a series of studies reviewing clinical experience with Mn-DPDP (181-183, 185, 971). This agent causes enhancement of normal liver parenchyma, thereby improving lesion de-
sentations on the value of contrast-enhanced images in the diagnosis and characterization of renal masses (197). Potential technical pitfalls in interpretation of contrastenhanced renal MR imaging studies were described (199).
tection
Pelvic
in Ti-weighted
pears facial
spin-echo
to be safe, although minor flushing are not uncommon.
images.
The
agent
adverse effects As the agent
ap-
such as is a di-
rect hepatocebbular contrast material, it may provide cvidence of hepatocelbular function and may be useful in distinguishing primary liver lesions, both benign and
MR Imaging
In evaluating
the
attention was with Gd-DTPA Once again,
paid to the role of contrast enhancement and similar agents (44-46). the technology of prostate MR imaging
was
a focus
bladder
of major
interest.
with
MR
imaging,
A number
significant
of presentations
malignant, from secondary liver neoplasms (185, 183, 6i8). Promising results with Mn-DPDP as a pancreatic contrast agent were also reported (971). Apparently, this agent improves pancreatic delineation and lesion detec-
dealt with various combinations of FSE (RARE) sequencing, closely coupled external radio-frequency (RF) coils or arrays, and endorectal RF coils (285, 286, 984, 985, 990). These papers showed excellent morphologic detail.
tion.
Mixed
Also
notable
at RSNA
‘91 was
some
increased
activity
in MR of the biliary tract and gastrointestinal tract. tiab results of 3D MR cholangiography with gradientecho techniques were reported (614, 615). Abnormal ducts could be delineated, likely with improvement to be an important MR (32) reported morphologic
tion
of the
different
to differentiate neoplasm.
Two phy with
papers
acute
mibile
as well as obstruction. It is in technique this might prove application. An interesting paper patterns based on observa-
layers and
reported
in the chronic
high
for displaying portal portal hypertension
wall
accuracy
venous (1142,
of the
cholecystitis,
gallbladder as well
of MR angiogra-
anatomy in patients 1143). Ultrafast T2-
weighted images acquired with echo-planar technique were highly effective for detecting liver tumors (1145). In paper 1i48, various MR techniques were compared with dynamic contrast-enhanced CT for detecting and
Volume
182
#{149} Number
3
as
reports
were
presented
on
the
use
of gadolinium
contrast enhancement of the prostate anatomy and pathology. While paper 988 demonstrated the usefulness of contrast enhancement in selective cases, paper 989 showed little benefit of contrast enhancement over noncontrast T2-weighted images. Contrast-enhanced MR imaging was also reported in the evaluation of testicular tumors (49) and penile physiology (347). In a single paper investigating the use of endorectal surface coil imaging in patients after radical prostatectomy (986), MR imaging
it was demonstrated that was valuable in attempting
high-resolution to detect
recurrence after radical prostatectomy. MR important role in studying the evolution of tatic hyperplasia (987). Gynecobogic MR imaging continues to be major interest, with considerable activity in technology. The FSE technique was shown tageous for imaging the female pelvis (454,
a local
may have an benign prosa focus of the area of to be advan456). Excel-
Radiology
#{149} 919
RSNA lent anatomic array RF coils
‘9 1 Meeting detail (454)
was shown and endorectal
with
Notes
the use of phasedcoils (458). Fat
.
ation of the arthritides. proper MR technique
suppression was shown to be helpful for characterizing ovarian masses, by distinguishing between hemorrhage and fatty tissue (458). Considerable improvement in the assessment of the depth of myometriab invasion of endometrial carcinoma was provided by administration of intravenous Gd-DTPA (455). The use of MR imaging in gynecobogic radiation oncology as a predictor of patient outcome (462) and the ability of MR imaging to distin-
postcontrast
guish
ation
of muscle
ising
clinical
ing
radiation a new
changes
field
from
of gynecologic
recurrent
tumor
are
open-
imaging.
tion
MR Imaging
of MR imaging in muscubowane at the RSNA ‘91. Joint imtopic of great interest, and wrist of particular interest. Refineof instability and ligament inju106). Motion studies may imof instabilities (99, 102). the clinical accuracy of MR of carpal tunnel syndrome was discussed with emphasis on the role of MR imaging in the setting of equivocal clinical and electrophysiobogicab findings (104, 105). New high-resolution techniques appear accurate in determining causes of operative failures (i03). Shoulder imaging was also a major topic of discussion. Data were presented in support of the accuracy of MR imaging for evaluating shoulder instability, in cases of superior babrab, anterior, and posterior (SLAP) tears (376), anterior and posterior labrab tears (377), and after acute dislocation (380). Morphologic criteria appear more useful than signal intensity in detection of labrab tears (377). The potential advantages of intraarticular (378, 379) and intravenous (1214) contrast agents were reviewed. MR arthrographic techniques are particularly useful in young athletes suspected of suffering from dynamic instabilities when the routine MR imaging study does not reveal an injury to the labrum or glenohumeral ligaments. Techniques for evaluation of rotator cuff disease (913-915), the coracoacromial ligament (916), and suprascapular nerve entrapment (917) were presented. Progress in MR imaging of the knee emphasized the evaluation of anterior cruciate ligament tears (515, 1226) and follow-up evaluation of anterior cruciate ligament surgical repairs (5i6, 518, i222-1224, i225C). Knowledge of the normal progression of intraligament signal changes after reparative surgery is necessary for proper interpretation. The patelbofemoral joint and tracking studies stated important robes for MR in studying the physiology and functional pathology of this articulation (514, 5i7, 519, 520). Dynamic imaging with muscular contraction is more sensitive to early tracking abnormalities than passive kinematic studies. Intraarticular (1228) and intravenous (1229) contrast agents show promise as adjuvants to standard MR knee imaging. The use of 3D techniques for meniscal tears was addressed (521), as was the significance of signal patterns in aging menisci (1227).
MR
920
imaging
#{149} Radiology
has
been
used
sparingly
in clinical
evalu-
is useful
in rheumatoid
in the
arthritis
with and
detailed
depic-
(1214-1217,
1219-
and the role was emphasized
of MR and
is essential in evaluation
clarified.
Imaging
cisc were imaging
detailed in multiple reports (107-ill, 113). MR has become an important modality in the evalu-
for locomotion, of this tissue
and
spectroscopic
physiology roles
for
to sports
treatment
Enthusiasm for applications skeletal diseases did not aging continued to be a MR imaging was a focus ments in the evaluation ries were presented (98, prove accuracy in detection Additional data confirming imaging in the evaluation
imaging
can be evaluated 1218). Routine
1221). Muscle imaging
athletes Muscuboskeletab
MR
of lesions
Cartilage (101, 1213,
and
the
use
injury
of MR
activities
after
are
actively
modalities
changes
(1i2,
after
114).
in timing
injury
and
under
exer-
Prom-
return
of
selection
of
investigation.
“Magic-angle” effects on normal signal from tendons were clarified (919). Patellar (920), sinus tarsi (921), and lateral collateral ankle ligament (922) injuries were reviewed.
The well-documented importance of MR imaging in evaluation of marrow disorders was further documented in scientific sessions. Refinement in the MR imaging assessment of ischemic disease was presented (268, 273-275). osteoporosis necrosis was
neoplasm cially
The possible close association and early, possibly reversible, suggested (269). Differentiation
and
in the
fracture
spine.
can be difficult
The
role
of MR
of transient avascular between
clinically,
imaging
espe-
in this
clinical
dilemma was addressed in multiple MR imaging criteria in the evaluation
papers (656-659). of primary and
recurrent neoplasia 948). Techniques
(792-794, 795C, 797, MR imaging of the
skeletal use
system
of MR
for
for metastases
imaging
eboma (944-946), transplantation Muscuboskeletal as well.
were addressed screening with in the
were
evaluated
evaluation
(943).
of multiple
bymphoma (949), beukemias (947, 95i) was addressed. soft-tissue masses received
Imaging
findings
in Morton
The
my-
(950),
and
attention,
neuroma
(1044),
extraskeletal osteosarcoma and chondrosarcoma (1047, 1048), and giant cell tumors (1049, 1050) were presented. The possible roles of P-31 spectroscopy in monitoring response
provide
to therapy
limited
were
specificity
shown
(1046).
MR
in differentiating
findings
benign
from
malignant solid soft-tissue masses (794). Techniques with MR in the evaluation of bone mmera! were presented with both T2* and spin-echo sequences as well as spectroscopy (800, 804, 808). The clinicab role of MR among other modalities in the evaluation of osteoporosis requires further clarification.
MR The rum and were
Spectroscopy annual meeting of the RSNA continues to be a fofor the presentation of new and exciting technical clinical studies involving MR spectroscopy. There a number of both technical and clinical developments reported at this year’s meeting that provide mdications
that
spectroscopy
is continuing
portant role in radiology departments Overall, there was an increasing
to pbay
across emphasis
an
im-
the world. on proton
spectroscopy in the brain in many of the clinical studies. Studies of brain tumors suggest that the concentration
of lactate the level
correlates of lactate
with the grade appears to stay
of tumor, and high in tumors
that that
March
1992
.
do not respond to therapy (861). A mathematical model for estimating the lactate concentration under a variety of conditions was presented (853). The role of proton spectroscopy
in studying
attention. (MS)
Studies
have
white
correct cases.
tion
baterabization Another study
of the
than system
that
proton
disease
to study
focal epilepsy phosphorus
of the seizure that received
demonstrated
sitive vous
provide
spectroscopy
refractory proton and
received
pathophysiobogy
may
patients
demonstrated spectra permitted
focus in all of the considerable atten-
spectroscopy
is more senof central ncr-
MR imaging in the detection human immunodeficiency
virus
infection
papers
for cardiac
presented the in model systems.
rejection
(856),
results These
fructose
of spectroscopic included models
loading
(862),
proton The
and phosphorus spectroscopy emergence of controlled and
studies
that
show
clinical
is an
important
trend.
MR
Imaging
Physics
applications
during
meeting,
oped imaging
spectroscopy
Thursday
to clinical
and
flow
and
period
brings gists. those based
of the
the
imaging,
area
182
per
in the
past
RSNA
of newer is that
it
as well as clinical radioboattended sessions were were presented that were that have been developed
1 or 2 years.
pulmonary,
of cardiac
meeting
imaging,
and
These
#{149} Number
3
unit
included
Images
in which as refined
were
magnitude about
flow
patterns
1
brain techof the
imaging.
However,
bevel. detail
this
The
field
cere-
into
number
so that
time
by
work
within
an FSE
spatial
sequence
standard
a breath
(308, 310). echoes an
measurements
hardware
is to provide
itself
resolution
to provide
of phase-encoding
using
contin-
FSE sequence
effects can be better understood were presented in which gradient
of this
images
in
(386-390).
in areas imaging,
to assess
in more
goal
high-quality
(685).
One
T2-weighted
hold.
Other interesting presentations that will likely lead to future developments included discussion of a miniature endoluminab detection coil (60), studies of magnetization transfer (683, 684), studies of the effects of susceptibility (304), the use of recursively determined RF pulses to provide excitation of saturation of arbitrary regions and
the
use
of MR
imaging
for
stereobogic
analysis
of bone (851). In summary, the clinical and physics MR presentations at RSNA ‘91 demonstrated the short delay time between development of new techniques and their clinical use. Additionally, there continue to be many areas in which future refinements are expected.
neuroradiologic
presentations
included
very recent work in the imaging of human coronary arterics (53), myocardial tagging with SPAMM or phasecontrast techniques (55, 57), and assessment of the passage of contrast agent with echo-planar imaging (59). Many of these talks made use of various fast imaging methods that are less than 3 years old. An entire session was devoted to the imaging of pub-
Volume
studied
the
in fast
used
at a technical
incorporated
imaginto deveb-
MR
to have an impact in routine Additionally, phase-contrast
in clinical
to grow
greater
advances
advances
development
of the
cardiac, cardiovascular, applications.
In the
being
even
(682),
strengths
only
are
were
MR
using
flow patterns equivocal. FSE
of the was
afternoon
assessment,
together basic scientists Some of the most highly in which clinical results on physics techniques
refined
assess are
is being
during
by
brospinab fluid (i4i, 472, 473). Vascular and flow imaging with MR continues to be an area of very active physics research. Specific areas of study include a fundamental understanding of the accuracy and precision of phase difference measurements of velocity (578), the determination of streamlines as based on phase difference methods (577, 584), and the suitabibity of FSE techniques for black-blood angiography (149). A number of fast imaging concepts are being used ues
techniques.
One
ously images
routinely
was devoted to fast talks can be categorized application of recently
techniques
techniques,
physics
time
the
Symposium the physics areas: the
imaging
as
valid
to be a major part MR physics session
available
additionally
physics
vascular
and
every
and
RSNA/AAPM ing. Overall, several major
for
flow
and contrast Also, results
MR imaging physics continued RSNA program. In general an offered
(907). statistically
blood
Notes
presented with short repetition time [“turbo”l 2D and 3D Fourier transform techniques. Imaging times ranged from several seconds per section for 2D acquisition to up to 9 minutes for the 3D case. In a number of examples from more than one presenter, fourthand even fifthorder branches could be visualized. Again, 2 years ago these techniques had not yet been attempted. Now they book very promising for assessment of pulmonary vasculature. High-speed phase-contrast imaging techniques are now being applied in a number of clinical cardiovascular imaging tasks (888, 993, 1000). As the acquisition time and data reduction times decrease, these techniques are being used more and more to quickly and unambigu-
niques
and
hyperthermia (857). Evaluations of the effects of proton decoupling on phosphorus spectra demonstrated improved sensitivity and spectral resolution in studies of brain (401), heart (402), and calf muscle (405). New RF coil designs for spectroscopy were also presented (855, 906). Such improved designs showed promise for applications such monitoring brain development in neonates by using
‘9 1 Meeting
.
year ago, is starting imaging (433, 434).
(701).
Several investigations
...
monary
multiple
alterations
that
standing the underlying (697, 698). A study that employed
medically localized
with
disease
sclerosis in the proton speca means of under-
demonstrated
tra of MS plaques
with that
matter
of patients
;
Industrial A number ent
at the
MR Imaging Research of trends in the MR marketplace scientific
sessions.
In the
past
were several
apparyears
it
has appeared that MR engineering and scientific dominance was becoming concentrated in the hands of only two or three major vendors. This year, the scientific program and the technical exhibits appeared to show increased engineering and scientific activity among other MR vendors, particularly the Japanese companies.
Radiology
#{149} 921
RSNA
‘91
Meeting
Notes
The research and development staffs of the MR equipment vendors have been very prompt in incorporating new techniques in their products. MR angiography was introduced only a few years ago and is still rapidly evolving, but most vendors now have a product offering in this area. The refinements of the RARE technique known as FSE, which were so new at RSNA ‘90 that they did not appear in the scientific program, were on display in prototype form by every major vendor of MR equipment only a year later.
Technical Joel
Exhibits
E. Gray,
PhD,
Barnes, Birmingham,
Gary
T.
Mayo
Clinic,
Rochester, ofAlabama
Minnesota at
Joel P. Felmlee, PhD, Mayo Clinic, Rochester, Cynthia H. McCollough, PhD, Mayo Clinic, Miii
L. Morin,
Index terms: cnmmunication 77th scientific Radiology RSNA,
(
Images, system assembly 1992;
PhD,
Mayo
Clinic,
critical
care
Florida archiving America,
and
system.
In bedside radiography, scatter is a problem. To address this issue, Eastman Kodak introduced the Flex Grid, which is similar in concept to a bow-aspect-ratio parallel-hole collimator used in nuclear medicine and has a scatter clean-up that is equivalent to that of a 6:1 linear grid. The advantage of the grid is that it is flexible and therefore difficult to damage. It is also less sensitive to misalignment than a 6:1 grid. The grid is produced by using lithographic (etching) techniques, as opposed to mechanical stacking of lead strips and interspace material. The technology of very large scale integrated chips continues to improve, and a number of manufacturers showed television cameras based on charge coupled de-
922
#{149} Radiology
Lorad camera
and
and
Fischer
stereotaxic
devices
had a number and indicated
employed
in their
as an
of images that they
1,023-line system. Fischer ing a 1,023-line system.
were aid
from were
Imaging
by
prone
mam-
to localization.
a 525-line CCD going to develop is currently
heart
catheter
laboratories
have
a
evaluat-
been
bulky
AOT
cut
film
changers,
roll
film
even more dated cassette changers. Although progress in digital technology hard- rather than soft-copy images continue
182:922-923
Imagelmnk
mography
Scientific
Systems
in exist-
the
1992
Ektascan
Sierra
Minnesota
A number of advances were introduced in the RSNA ‘91 technical exhibits. Fuji Medical Systems USA showed an interface for their low-cost AC-i computerized radiography (CR) system that allows digital images to be output to a workstation or network. An AC-i system with the interface is referred to as the AC-i Plus. At present, the AC-i acquires a digital image employing stimulabbe storage phosphor plates but has only a film hard-copy output. The interface was announced last year, but has yet to be delivered in the field. Previously purchased interfaces are scheduled to be delivered starting in the first quarter of 1992. Philips showed an interface similar to that for the AC-i, with the output coupled to a Unix workstation, and Du Pont announced plans to integrate the Fuji AC-i CR system into its existing local area digitab network, which previously was able to acquire images only by digitizing conventional radiographs. Eastman Kodak announced its CR system (referred to as KESPR, or Kodak Ektascan Storage Phosphor Reader)
and
by
Medical
Rochester,
Picture of North
#{149}
shown
Lorad
that were
ence for several years, and it is anticipated that Puck film changers will become a dinosaur among specialprocedure suite equipment in the near future, as have
Jacksonville,
display #{149} Images, processing (PACS) #{149} Radiological Society and annual meeting
also
camera
Siemens showed a new C-arm fluoroscope a CCD television camera. CCD cameras
Filmless
nesota
Richard
camera. employed
of a CCD television than a conventional
Digital fluorographic systems continue to be improved. Siemens introduced a totally digital biplane neuroangiography suite referred to as the Neuro Star.
_________________
PhD, University Birmingham
vices (CCDs). The advantage is that it is much more compact
mainstay
of the
medical
imaging
changers,
and
continues, to be the
community.
With
digi-
tab devices, state-of-the-art hard copies are obtained with laser multiformat cameras that employ conventional silver halide film and wet chemistry. A novel and competitive hard-copy technology was introduced by Polaroid that uses no wet chemistry: the Helios 810 dry laser imaging system. lios imaging system particles embedded
The process employed utilizes 50-100-A (5-10-nm) in a polymeric matrix.
in the Hecarbon
High-frequency duced only a few than the exception.
x-ray generators, which were introyears ago, have become the rube rather They were exhibited in essentially
every
x-ray
integral
booth
of an
part
of the
new
equipment
vendor
generation
of compact,
and
are
an
moder-
ately priced computed tomographic (CT) scanner designs that were introduced at this and previous RSNA meetings. As in the past several years, a large number
different
mammography
high-frequency x-ray tures and specifications.
units
were
generators. Most An exception
shown. had was
of
All utilized similar feathe OptiScan
AEC on the Transworld X-Ray mammography unit, which employs an array of 32 sensors to determine the location of breast features and optimize the density of glandular tissue. More than 50 technical exhibitors presented offerings in picture archiving and communication systems (PACS), teleradiology, and associated equipment. A!! major medical imaging companies currently market PACS products. The offerings at this year’s meeting demonstrated steady progress in the development and availability of PACS and teleradiobogy systems. Within most
vendors,
a variety
of computing
platforms,
ranging
from economical image display stations to sophisticated imaging manipulation workstations, were available. In general, PACS components and subsystems are capable of communicating with different modalities within the products
of a particular
either demonstrated the long-awaited gration through
vendor.
While
most
vendors
or offered an ACR-NEMA interface, ubiquitous presence of seamless intethe ACR-NEMA interface has not yet
March
1992
.
occurred.
.
.
Teleradiobogy
crocomputer mary
systems
platforms
difference
interface
were
among
(software
..
.
based
widely
vendors
on
primarily
offered.
continues
friendliness)
and
mi-
The
pri-
to be the
component
user
pricing.
fast scanning, breathing),
heat
mat
reconstruction
units
[MHU]),
CT
and
couches.
use
low-voltage
scanners
the
coach (about
potential
and
Most
multiforand
slip-ring
technology,
problems
incorporates
slip-ring
and
dynamic-focus
scanning to cover 60 cm in 30 materials claim tube hearing is somewhat misleading. Their
tube
other
with
industry
offerings
scanning, scanners
Siemens will in their product
by
announced
a thinner
ware
its entry
(1.5-mm)
into
section
improvements
helical
collimator
as part
and
as well
several
soft-
of its accelera-
tor
package due in the third quarter of 1992. The magnetic resonance (MR) imaging technical cxhibits can be summarized into two categories: innova-
tion
and
optimization.
The
innovation
includes
the
in-
troduction of new imaging techniques, as well as new manufacturers in the high-field-strength MR imaging market. Optimization includes refinement of imaging techniques that have been available for a number of years at high and bow field strengths. Otsuka Electronics (USA) (Fort Collins, Cob), a new
vendor
in the
introduced
imaging and
their
182
MR imaging
high-field-strength
system.
extremity
Volume
high-field-strength This
system
imaging
Number
#{149}
and
3
(1.5-T)
design includes
focuses
and
and
magnetic
times
were
could
field
also
pulses
followed
by
optimization workstations
be com-
shielding
introduced.
As in the
strated
useful
past,
the
(in-
A number
gradient-echo
RSNA
evolutionary,
changes.
changes reduction
fast
of data acquisition and software were
of
Most
readout.
‘91 technical
important,
Further
and manipulation shown.
as opposed
with
exhibits
demon-
to revolutionary,
however,
one
sees
continuous
resulting in the improvement of image quality, in the cost of some equipment, and new and applications of presently available equipment.
market, clinical
on head
application-specific
Ronald
Applications
L. Arenson,
MR
San Dwyer
MD,
and
University
Digital
of California
at San
Francisco
Samuel J. III, PhD, Angeles, Los Angeles H. K. Huang, DSc, University
be offering line as part
scanning
of an upgrade
Administration
storage,
Francisco,
University
ofCalifornia
of California
at Los
at Los Angeles,
Los Angeles
of a Siemens-Imatron joint marketing venture. Potential improvements in electron beam scanners as part of this collaboration can only be speculated at this point. Ima-
tron
optical
Computer Imaging
in the
5-MHU range; they simply multiply their heat rating two, as they arc imaging two sections with one exposure. Systems will not be available until bate 1992.
In electron-beam the Imatron C-iOO
Drug
technol-
ogy with helical volume seconds. Their promotion limits of 10 MHU, which
is competitive
and
acquisition schemes decrease the total imaging time and include fast spin-echo, variable repetition and echo time methods, as well as the use of contrast preparation
and down time. GE Medical Systems, Picker, and Sicmens introduced low-cost, compact (the complete CT system will fit in a conventional fluoroscopic room), slipring CT scanners. Elscint provided the only novel CT development with the introduction of their CT Twin system. Using a dualdetector ring design reminiscent of first-generation CT, they effectively doubled the system performance parameters by obtaining two simultaneous sections. Their sys-
tem
Food
reconstruction
continuous-rota-
for equipment
Notes
eluding the use of active shielding of the static magnetic field) was shown by a number of companies, including GE Medical Systems, Siemens, Toshiba, Philips, and Hitachi. Finer acquisition matrix size (5i2 x 512) and faster
patient 5 mil-
lower-profile
‘9 1 Meeting
gradient coils. This results in a smaller system with a larger clear area in the bore of the magnet and in a reduced price. The system is subject to approval by the
coils,
to allow
three-dimensional
patient
reduces
design
auto-voice (to heat capacity
software,
higher-weight tion
slip-ring
auto-filming, increased anode
lion
which
include
RSNA
mercially available in 1992. GE Medical Systems showed contrast material-enhanced, fat-suppressed, three-dimensional breast imaging, a new area of considerable interest in MR imaging. Hitachi Medical unveiled a new high-field-strength (i.5-T) system that uses an actively shielded magnet. Refinement of the fast spin-echo technique of rapid acquisition with relaxation enhancement was shown by a number of the vendors. Optimization of two- and three-dimensional angiography sequences, receiver
ume scanning. All major CT vendors offered helical scanning, although only Siemens and Toshiba have an installed base (Picker International has two beta test sites in operation). Other vendors are quoting availability in late 1992. Additional features found industrywide
models
.
U.S.
This year was most reasonably characterized as a progression in the evolution of both PACS and teleradiology into clinical practice, with continued evolution being likely in the future. Product development in the field of CT focused on fast acquisition times (1 second or less) and helical vol-
on high-end
..
Index terms:
as
Computers,
diagnostic
archiving and communication North America, 77th scientific Radiology ‘ RSNA,
1992; 1992
RSNA
‘91 continued
Picture of
#{149}
182:923-925
of even more and exhibits. greatly
aid #{149}Images, enhancement system (PACS) ‘ Radiological Society assembly and annual meeting
the
trend
computer-related The infoRAD
of the
past
scientific exhibits have
several
years
presentations expanded
as well.
Several papers were presented on the use of computers to help in the detection of microcalcifications in mammography. Scheck et a! showed computed radiography
for
screen-film dual-contrast presented images
mammography
to approach
high-resolution
systems for detecting microcalcifications images were presented. Newstead similar results obtained with magnified
compared
with
magnified
film
technique.
Radiology
if et al digital How-
923
#{149}
RSNA ever,
‘9 1 Meeting
problems
with
false-positive
Notes
findings
‘.
remain
largely unresolved. In addition to mammography, computer-aided diagnosis was used for chest and bone images. Lo et a! discussed the advantages of fractal analysis to enhance edges in chest radiography for the detection of pneumothoraces. They presented how fractal Brownian motion was used to model pixel-to-pixel intensity differences as an estimate of the fractal dimension. This fractal transformation of digital chest radiographs was shown to enhance the edges in the image without increasing the noise (areas of uniform tissue had large fractal dimensions, while areas with nonuniformities or edges had smaller dimensions). In chest radiographs from patients with pneumothoraces, visualization of the abnormal border of lung parenchyma and the peripheral pleural space was enhanced. A paper by Majumdar and Prasad used the fractal dimension to extract structural features of trabecubar bone in computed tomographic (CT) images with potential uses in assessing the severity of osteoporotic changes in patients. Fractal analysis may be a useful preprocessing tool for image segmentation and/or feature description. Katsuragawa et al demonstrated their success in using a gradient histogram analysis technique for the computer-aided detection of septab lines in digital chest radiographs. The earlier enthusiasm for large-scale picture archiving and communication system (PACS) implementations has now settled into a more realistic approach to the appropriate use of smaller systems for selected seetions of a department. Several papers discussed experiences with PACS dedicated for specific purposes. Terotzky et al presented their successful experience with remote monitoring of CT and magnetic resonance (MR) studies.
Teleradiology
systems
were
presented
and Telepak et a!, showing the utility especially for CT. Lear et ab presented periences with a Macintosh system for and presentation in nuclear medicine. described their continuing development for medical imaging applications. The scribed in this paper is a three-dimensional ing procedure in which specific regions be uncovered by “ erasing” or removing tures. A nice feature of their “paintbrush” is sensitive
ent the
across edge,
to
edges
gray
thus
within
levels)
allowing
the
data
(it
by
Shile
of these systems, their positive cximage processing Ney and Fishman of display tools new tool devolume-editof interest can obscuring structool is that it calculates
and will erase only very fine control
a gradi-
on one side of the editing
of
graphic
findings.
Although
not
neural networks of investigators for detection of radioready
yet
for
routine
use
in clinical
radiology, we should expect much more in the years ahead. Cheng et al discussed their use of a neural network to detect osteopenic changes in phalangeab trabecular bone. Wu et al used an artificial neural network for detecting breast cancer. Nelson et ab have simulated the use of a neural network localization of myocardiab activation sequences. Garg and Floyd presented their work with the Perception neural network model for the detection
924
of
#{149} Radiology
pulmonary
nodules.
Christy
et
al used
a
j
.
‘
neural network for analysis of avascular necrosis of the femorab head. Fujita et a! attempted to detect coronary artery disease in single photon emission CT with a neural network. At RSNA ‘91, over 500 scientific exhibits were presented. Many of these exhibits were based on computers and their utilization. There were 1 1 exhibits on the display of three-dimensional (3D) images. Oftomo et a! presented a rotary stereo-radiographic device for displaying stereoscopic angiograms. Joyce et al presented 3D real-time angiographic imaging at 30 frames per second for
intracranial lesions. Miki et a! presented
nique
for cerebral
sented images sented (0.50-T)
phy rate
MR
system
et al demonstrated in preoperative
ment
than
a 3D
stereoscopic
MR angiography.
a method for of the temporal a 3D method
display
Janioka
tech-
et al pre-
generating 3D reconstructed MR bone region. Nida et al prethat uses a bow-field-strength to display cerebral aneurysms. Murthat 3D images are more accuassessment and surgical manage-
conventional
imaging
of congenital
heart
disease and vascular ning CT to generate and concluded that ing coronary artery
rings. Anno et al used helical-scan3D coronary angiographic images this method was useful in evabuatcalcification and patency of coronary bypass. Stephensen et al presented 3D visualization of joint surfaces and soft tissue from CT data. Soyer et a! presented a study that used CT imaging to conclude that 3D images of hepatic metastases improves the information presented to the surgeon. Murakami et al presented 3D images of the abdominal organs and blood vessels obtained by using MR images. Moriyasu et a! presented a 3D color Doppler ultrasound technique for imaging of hepatic blood flow. Eleven scientific exhibits used a personal computer
(PC)
as the
tool
for processing
data.
Smith
et ab pre-
sented a PC radiology database and teaching package. Fishman et a! presented a teaching file consisting of over 1,000 body CT studies. Becker et ab presented a bevel III interactive videodisc program to enhance the understanding of imaging modalities used to image the urinary tract. Wehrbi developed a supercard-based teaching
module
for vascular
imaging
with
MR.
Hawkins
et al
demonstrated a PC system for the generation of graphics and a clinical-educational interface. Halimi et a! presented a computer atlas of head and neck anatomy. Mon et a! demonstrated a system for computer-aided
detection
process.
A number of presentations on showed the increasing enthusiasm this new technique for automated
z
of nodules
on chest
radiographs.
Arenson
et a!
presented a digital radiology image learning library for mammography on an imaging workstation for radiologic education. Doi et a! presented their intelligent workstation for computer-aided diagnosis for analysis of chest findings, microcalcifications in mammograms, and blood flow in angiography. MacMahon et a! presented a study of digi-
tized
film
and
laser
film
printed
images
that
were
dem-
onstrated to be comparable or superior to storage phosphor radiography. Kandoh compared conventional screen-film examinations with high-resolution (4K x 5K x 12 bits) storage phosphor images and found that storage phosphor images were not as good as the conventionab screen-film images for subtle interstitial changes.
March
1992
RSNA suspected
The infoRAD exhibits were excellent, presenting 73 exhibits. These exhibits were divided into the following areas: literature searches, networks, videodiscs, cornputer-aided instruction, practice management, and education. An infoRAD theater was introduced where exhibitors
could
present
their
that
Greene,
Barnes
M. Schaefer,
Hannover,
Paul
Stark,
General
School
of
West
County
MD,
Medizinische
‘s Hospital,
growing resolution parenchyma,
presentations
on
Boston
computed
‘91 show
tomography
(CT),
and
in-
technology. Notable clinical of diffuse lung diseases, airway lung, tuberculosis, chest dishost, lung cancer and and intensive care.
HRCT HRCT
Structure parenchyma
and
Function was the central
focus of this meeting. In addition to being the Annual Oration in Diagnostic Radiology cia! Focus Session, HRCT was the technique in a large number of papers and exhibits. Primary
interest
Volume
182
#{149} Number
centered
around
the
subject of and a Speemployed
HRCT
correlating
function. Controversial of specificity of HRCT
3
and
dependent
opacities
involved the specificity of at HRCT. Papers now report that can be produced by a wide vari-
topics findings
exhibit
415).
From
a pathologic
view-
honeycomb
acquired (exhibit
cystic lung 422), phrenic
adjust
lung
ILO-based reporting
spaces nerve
pneumonia fixed inflated
(International form was
of integrating HRCT reporting (157). note, it was reported window
not
(exhibit pathology
settings
(exhibit lung spcci-
Labour suggested
findings that increased
improve diagnostic displays in evaluating
Ofas a
with the
stan-
ability
to
interpreta-
performance diffuse lung
(163).
Spiral and Ultrafast CT Continuous fast scanning during a single breath hold with spiral CT is an emerging technical development. In the mediastinum, central pulmonary artery emboli are
and digital topics included imaging diseases, the transplanted ease in the immunosuppressed lymphoma, intervention,
with structure and eluded the question
found
a
imaging. High(HRCT) of the lung
magnetic resonance (MR) imaging of the pulmonary vasculature dominated the technical themes. Trends eluded increased interest in functional-pathologic-imaging correlation, quantitation of image data, computer
Correlation with of the pulmonary
sensitive
study
such as bronchiectasis, inter!obular thickening.
(1057C). An pneurnoconiosis
helpful method dard radiographic On a technical
60.1211 Society of #{149} Thorax, CT,
at RSNA
cross-sectional tomography
applications,
moderately larger
428), localized organizing methods of preparing
and
tion time but did over fixed window
chest
spiral
923;
findings, and
(exhibit 440), mens flee)
182:925-927
emphasis computed
(160,
ulomatosis (1060), 409), emphysema
Hochschule
Hannover, Germany MD, Brigham and Women
the
of 19 found
Several HRCT pathologic correlative studies were presented (exhibit 419), including lower-lobe bronchiectasis in immunodeficiency disorders (159C), progressive systemic sclerosis (158), sarcoidosis (i056C), Wegener gran-
Hospital,
disease
again,
opacities,
controversy opacities opacities
associated abnormality,
freely
Once
and
a much
a study
asbestosis
point ground-glass opacities can be found with alveolar wall thickening, partial alveolar filling, and granubomas in the alveolar walls (160). The differential diagnosis of ground-glass opacities relies on the detection of other
of
terms: Computed tomography (CT), high-resolution, abnormalities #{149} Lung, transplantation #{149} Radiological North America, 77th scientific assembly and annual meeting 60.1211 #{149} Thorax, MR, 60.1214 1992; 1992
specific
hand,
curvilinear
A similar ground-glass ground-glass
Hospital,
Index Lung,
Radiology ‘ RSNA,
highly
other
hand,
(161).
Theresa C. McLoud, MD, Massachusetts General Hospital, Boston Mathias Prokop, MD, Medizinische Hochschule Hannover, Hannover, Germany
Cornelia
the
smoking
Massachusetts
MD,
one proven
a large proportion of non-asbestos-exposed subjects findings that have previously been considered spefor asbestosis, namely, septal lines, parenchymal
cific bands,
Philadelphia
Robert G. Levitt, St Louis
the
pathologically
was
On
On
Notes
ety of diffuse lung conditions associated with chronic interstitial pneumonia, pneumocystic pneumonia, lymphangitic carcinomatosis, sarcoidosis, and cigarette
Dixie J. Anderson, MD, Washington University Medicine, St Louis Warren B. Gefter, MD, Hospital of the University
Pennsylvania,
HRCT
that had
material.
MD,
with
(156).
Radiology
Reginald Boston
asbestosis.
subjects
RSNA ‘91 continued to demonstrate the growing importance of computer applications in radiology. PACS, teleradiobogy, computed radiography, 3D displays, and PCs for education continue to dominate the presentations. Neural networks show increasing promise for the future.
Thoracic
‘9 1 Meeting
inin
easily
identified
appears
to allow
creased
volume
with
spiral
useful of contrast
CT
(1051).
vascular
The
opacification
medium
(1052;
technique
with exhibit
de420).
Because of diminished respiratory misregistration, spiral CT can produce less distorted two-dimensional (2D) and three-dimensional (3D) volumetrically rendered images, providing advantages over conventional CT in the identification of small pulmonary nodules, chest wall lesions, pleural disease, and the major airways (1053). Spiral CT with 2D and 3D rendering are most useful for anatomy aligned along the axis of table movement, such narrowing
of the
trachea
produced
by
cancer
and
benign
steno-
sis (1054C).
The advantages of iOO-msec, ultrafast acquisition of CT sections in functional assessment continues to be explored. In evaluating diffuse lung conditions for cvidence of airway obstruction (i055C), ultrafast CT identifled air trapping-that is, lung regions not demonstrat-
Radiology
#{149} 925
RSNA
‘9 1 Meeting
ing a normal expiration-in boma, chronic genie
increase tuberous interstitial
organizing
in attenuation sclerosis, pneumonia
pneumonia,
following forced cosinophilic granuand fibrosis, crypto-
cystic
mode
practical
of conventional of increasing
means
uncooperative quality
MR
point, CT the
patients
the
was speed
and
dynamic
thereby
On
as a convenient acquisition in
improving
image
(1059).
in Lung
Cancer
Staging
In lung cancer staging, MR papers continue to confirm the results of the recently published Radiobogic Diagnostic Oncology Group cooperative multicenter investigation. A prospective study of 202 consecutive lung cancers
found
that
MR
was
marginally
more
sensitive
than
CT for both T and N staging (58%-68%), but both were still relatively insensitive (119). Although discrimination of T2 versus T3 or T4 tumor extension was better with MR, the difference had little impact on treatment. The main application of MR appears to be in evaluating chest wall tumor invasion and as a supplementary method of problem solving after CT. An interesting paper found that Ti-weighted MR imaging appeared to be more sensitive than iliac crest biopsy and radionuclide bone scanning in identifying marrow metastases in small-cell lung cancer (120). MR appears to have an advantage over CT in staging malignant mesothelioma for apical, diaphragmatic, subdiaphragmatic, and pericardial involvement (121). Although the potential practical impact of MR in the staging of lymphoma is yet to be fully
demonstrated,
tage
over
CT
in
a few
in determining
patients
MR
radiation
has
port
visualized
neoplasms,
an
size
advan-
(uS).
parenchyma.
Pulmonary
Angiography
Great strides have been made in imaging the pulmonary vasculature with MR. Several new rapid imaging approaches show promise in visualizing normal and abnormal vessels down to the fifth and sixth branching generations, including (a) a breath-hold spoiled gradient-echo sequence with intravenous gadopentetate dimeglumine (386), (b) an electrocardiogram-gated ultrafast acquisition with phased-array coils for imaging of the entire lung in a single breath hold (387), (c) a highresolu tion syncopated three-dimensional fast low-angle shot (FLASH) sequence with a variable delay time between in-plane phase-encoding steps (388), and (d) a rapid
acquisition
method
arteries with aerosolized macromobecubar agent
showed
embolism
promise
evaluation
time-of-flight
found central
of
selectively
visualizing
pub-
and veins (390). An experimental study Gd-DTPA as a ventilation agent and polylysmne-(Gd-DTPA) as a perfusion
monary
and
(890). maximum
a technique
MR
for
pulmonary
venography
intensity
with projections
2D was
for showing normal and occluded Velocity-encoded cine sequence (VINNIE) was reported to be useful in identifying vascular malformations of relatively large size (389). These papers confirm that proximal-order vessels can be
926
to be useful veins (889).
as
#{149} Radiology
MR for evaluation and
of emboli,
hypertension.
Parenchyma
Lung
gadolinium in evaluating
cancer
greater enhancement 443). Other preliminary
nodules
appears to pulmonary
demonstrated
than tubercubomas work suggested
(122; exhibit that neoplasms
could be differentiated from granubomas and postoperative changes by using dynamic contrast-enhanced TurboFLASH (1230). Gadolinium-enhanced images (including FLASH with breath hold) demonstrated that contrast enhancement was increased (a) in proportion the severity of interstitial lung disease, (b) in malignant versus benign pulmonary nodules (1234C), and (c) in active sarcoidosis of the lung and mediastinum (1236).
Gadolinium
contrast
enhancement
was
also
found
to
to
produce superior visualization of pleural and chest wall lesions as compared to CT (1238). A number of other papers investigated various means of improving lung sig-
nab and 403). variety
hibits
reducing
artifacts
(1231,
1232,
1233C;
exhibit
Several presentations described MR findings in a of conditions, including pleural disease (121; cx427, 407) and mediastinal disorders (116, 117,
118C; exhibits 405, 430). A combination of low-density barium paste and gadopentetate dimcglumine was ported to improve MR visualization of the esophageal lumen
Lung Lung
re-
(1235C).
Transplantation transplantation
has
now
become
common enough CT is re-
to attract several imaging papers. Ultrafast ported to be useful compared to transbronchial
and
pulmonary
tive
bronchiolitis
plantation MR
with
malformations,
Contrast enhancement with show increasing application
half-scan
reported of image
readily
MR of Pulmonary
fibrosis/Swyer
James syndrome, and bymphangitic carcinoma (162). One wonders whether some of these same observations also might not be possible with more rapid spiral CT.
an everyday
I
Notes
function that
(535C).
tests frequently
Early
biopsy
in detecting
the oblitera-
complicates
CT findings
after
lung
trans-
transplanta-
tion include bronchial dehiscence, segmental airway dilatation, patchy ground-glass opacities, ARDS-like conditions, basilar lung opacities, pleural effusions, ischemia, infection, and rejection (1058C; exhibits 401, 421).
Later ture,
findings decreased
include hyperinflation, bronchial stricblood or air flow to the lung, and infecdevelopment of ground-glass opacities
tion. The bate may indicate rejection or other complications cytomegabovirus infection or pulmonary
of the protecting is reported
after
Radionuclide
mechanism
with
lymphadenopathy which is better
radiography,
has
the
opacity over the
of the bronchial
studies
show
an
lung versus complica-
transplantations are manialveolar opacities, and (811; exhibit 435). This detected with CT than
a favorable
munosuppression is reduced. detecting bronchial dehiscence entiating cardiac enlargement, hilar lymphadenopathy and from placed
vasoconstriction
in the transplanted Lymphopro!iferative of lung patchy
as Failure
(402).
ventilation-perfusion
increased V/Q mismatch that in the native lung. tions that occur in 2% fested by lung nodules,
mediastinal complication,
of hypoxic
transplantation
such fibrosis.
prognosis
when
im-
CT is especially useful in and for correctly differmediastinal mass lesion, retrocardiac consolidation
omental flap anastomosis
that
is normally (536C).
March
1992
.
.
.;
,
Emphysema and Abnormal Air Spaces Several presentations focused on quantification and imaging of emphysema, diagnosis of other abnormal air spaces of the lung, airway reactivity, and air trapping. A rapid automatic quantitation technique with conventionab CT calculates emphysema defined by a subrange filter for lung values with attenuation -900 HU (423; exhibit 530). HRCT is superior to standard CT in depicting panacinar emphysema, but it is unsuccessful in detecting mild or “early” emphysema (533C). Differentiation between the imaging characteristics of centrilobubar, panbobubar, perifocal, localized emphysema (exhibit 422) and acquired cystic spaces in the lung, such as blebs, bullac, cavities, pneumatoce!es and dilated bronchi (exhibit 409), continues to be discussed. Impaired ventilation in bulbous lung disease was studied with 3D images from helical CT by using 30% nonradioactive xenon (exhibit 412). In addition to demonstrating nondependent ground-glass opacities, HRCT more than conventional CT depicts the higher proportion of subpleural nodules, parenchymal micronodules, and upper lobe emphysema found in smokers (923). The extensive upper lobe lung emphysema that may be found at HRCT is often associated with little evidence of functional impairment (924). It appears that this upper lung pathology tends to be more functionally occult than lower lung emphysema (924). Compared with healthy subjects, asthmatics show a greater number of bronchi of larger diameter than the accompanying artery, suggesting that mild bronchial dilatation in asthmatics should not to be confused with cylindrical bronchiectasis (925). Intervention Topics on intervention concluded (a) that most intrathoracic air and fluid collections can be drained with smallbore catheters (667), (b) that self-expandable endoluminab prostheses are reasonable alternatives to surgery for tracheobronchial stenoses (668), (c) that advances in cytomorphology and immunophenotyping can compensate for some of the previous limitations in percutaneous biopsy diagnosis of malignant lymphoma (666), (d) that a spring-activated biopsy needle is a safe and reliable means of obtaining histologic specimens from various organs (670), and (e) that an extrapleural route is a safe method of approaching mediastinal lesions under CT control (669).
Digital
Radiography
and
Intensive
Care
physics sessions actually contained more on digital chest radiography than the per se, there were many interesting presentations on (a) the value of digital film duplication in correcting exposure errors (276; exhibit 432), (b) the potential of an experimental high-resolution storage phosphor system with 4K x 5K and 12-bit resolution (exhibit 439), (c) the utility of a scatter compensation technique to improve underexposed areas in digital images (278), and (d) an interactive display technique based on histogram analysis to improve selected tissue densities in dig-
Volume
182
#{149} Number
3
‘9 1 Meeting ,.
AMBER of (28iC).
Notes
-
.
No adverse effect on performance is reported as a result of reduced hard-copy size of unprocessed digital storage phosphor images of subtle lung disease (279C). Electronic displays of digitized radiographs on 1,024 by 840 pixel monitors are reported to be adequate for bocalization of chest tubes and lines (281C), but data were not presented to show that the soft display was adequate for other primary diagnoses. Barotrauma was confirmed to be a frequent complication of severe ARDS and most sensitively detected with CT (283). Observations continue to show very limited univariate correlations between cardiac status and radiographic findings in criticalby ill patients (284).
Other
Topics
Other topics of interest indicate (a) that 50% of patients who undergo median sternotomy without mediastinitis have enlarged mediastinal lymph nodes up to i.5 cm in diameter at CT (531); (b) that round atelectasis, unlike lung cancer, shows characteristic dense enhancement with a minimum of a 200% increase in attenuation at dynamic CT (534); and (c) that the positive predictive value of mediastinal invasion in lung cancer staging is only 67%, compared to a negative predictive value of 96% (538). Thus, CT evidence of mediastinab invasion may not preclude resectability. Other presentations of interest include (a) a detailed multimodality description of the venous anatomy of the chest (exhibit 437), (b) unusual appearances of tuberculosis in the diabetic and immune-compromised hosts (exhibit 442), (c) the anatomy of the intersublobar septum of the lung and inferior pulmonary ligament (539), and (d) the successful attempt to differentiate tubercubomas from cancer nodules with Gd-DTPA-enhanced MR (exhibit 443).
Cardiac
Radiology
G. Baron, Medicine, Atlanta Melvin E. Clouse, Boston Murray
Antoinette
Gomes,
Medicine, Robert
J.
Roderic
MD,
Emory
MD,
New England
MD,
University
University
School Deaconess
of California
of Hospital, School
of
Los Angeles Herfkens,
Medicine, Stanford, Harold Mitty, MD,
Although the presentations chest sessions
ital radiography (282). Beam equalization with technology is reported to improve visualization phrenic sulci superimposed on the diaphragm
RSNA
I. Pettigrew,
MD, Stanford University School of California Mount Sinai Hospital, New York MD, PhD, Emory University School
ofMedicine, Atlanta Renate L. Soulen, MD, Wayne State University School Medicine, Detroit Mark H. Wholey, MD, Pittsburgh Vascular Institute, Pittsburgh Jack Ziffer, MD, PhD, Baptist Hospital, Miami
of
Index terms:
Coronary vessels, disease #{149} Heart, CT, 51.1211 #{149} Heart, Heart, MR. 51.1214 #{149} Magnetic resonance (MR), rapid imaging arteries, abnormalities #{149} Pulmonary veins, abnormalities #{149} RaSociety of North America, 77th scientific assembly and annual
diseases Pulmonary diological meeting
#{149}
Radiology C RSNA,
1992; 1992
182:927-929
Radiology
#{149} 927
RSNA
‘9 1 Meeting
Notes
The advances in magnetic resonance (MR) imaging and ultrafast computed tomography (CT) for imaging of the heart and pulmonary circulation and for evaluation of cardiac function were substantial and further narrowed the disparity in information content available by means of cardiac catheterization and angiocardiography. In some areas, such as the study of myocardial motion, pertinent data can be provided with MR imaging that is not available by other means. A marked improvement was also noted in MR angiography, particularly in the delincation of the pulmonary vascular tree and, to a lesser extent, the coronary circulation. The rapidity with which new MR imaging techniques and their capabilities are being developed created the impression that within the next few years, MR imaging will likely emerge as the primary imaging modality for cardiac disease. Arteriosclerotic coronary artery disease is the most common cardiac disease and one of the most common of all diseases in the United States. Existing diagnostic techniques are not completely satisfactory as screening methods. The usefulness of ultrafast CT for the detection of coronary artery calcification has been previously demonstrated. A quantitative study (352) showed a correlation between the volume of calcium as determined with ultrafast CT and the presence or absence of significant coronary stenoses. A peculiar finding was that the calcific deposits did not always occur at the sites of greatest arterial narrowing and plaque formation. The most direct way to demonstrate coronary artery disease is to visualize the vessels themselves. At present, this requires selective coronary arteriography. With a fast gradient-echo MR sequence, the proximal portions of the coronary arteries could be imaged during breath holding (53). Despite the limited area of visualization of the vessels, the authors believe that their results warrant further development of the technique. Ultrafast CT with a bolus injection of iodinated contrast material can show the coronary vessels for a brief period, which is determined by the rate of clearing of the contrast agent from the blood and obscuration of the vessels by the contrast material-enhanced myocardium. A blood pool CT contrast agent, demonstrated in dogs (351), overcame these problems as it remained localized within the intravascular space for a protracted period. Another approach to coronary visualization involved three-dimensional reconstruction of the vessels from helical CT scans. None of the techniques could reliably show enough of the coronary arteries to be of the routine clinical use. Contrastenhanced spiral CT and three-dimensional reconstruetion was used effectively to evaluate patency of bypass grafts (355). Although angiography can demonstrate the patency of the coronary vessels, it may be difficult to gauge the effect of a stenosis, or series of stenoses, on the function of the dependent myocardium. One approach is to evaluate the adequacy of myocardiab perfusion, a perfusion defect indicating occlusion or stenosis of the supplying vessel. First-pass MR imaging, after intravenous bolus administration of gadopentetate dimeglumine with dipyridamole-induced stress, was reported to reliably depict hypoperfused myocardium in dogs and in 10
928
#{149} Radiology
human patients (56C). Other papers demonstrated increased contrast between injured and normal myocardium in rats by using gadolinium benzyboxypropionictetraacetate, as compared with gadopentetate dimeglumine (59, 746). The heart functions by orderly contraction and expansion of the myocardium. Thus, a more direct evaluation of the functional state of the myocardium can be gained by determining the magnitude and pattern of its motion during the cardiac cycle. Two different MR imaging techniques are used for this purpose. Presaturation tagging of the myocardium (SPAMM) can produce a grid of lines on the myocardium that move with the muscle as it contracts. The pattern of deformity of the grid, indicating directions of regional wall motion, was consistent in normal volunteers (628). A method to compensate for heart motion during SPAMM imaging was believed to increase its accuracy (942). Exhibit 515, using cine imaging with myocardial tagging, demonstrated abnormal patterns of contractility in cardiomyopathic muscle but not in hypertrophied cardiac muscle secondary to arterial hypertension. In the batter case, the alignment of the myocardial muscle fibers is normal, in contrast to that found in cardiomyopathy. The same method of myocardial tagging was also found to improve the distinction between the endocardial surface and the ventricular cavity, making measurement of ventricular volumes more accurate (55). The second method of quantifying myocardial motion involves measurement of phase shift in three dimensions. Phase contrast cine MR imaging was validated in animal models, by comparing the results against those obtained by tracking tantalum markers implanted on the heart (57). This technique was also used to successfully measure myocardiab motion and strain in cardiac patients (745). Experience with this technique is insufficient to judge its eventual clinical usefulness. A problem commonly encountered when dealing with areas of myocardiab ischemia is the differentiation of “stunned” myocardium from an acute infarct. Both may appear the same with echocardiography or on nuclear medicine studies or static MR images. Stunned myocardium is salvageable, however, and can regain function after reperfusion. In a study of dogs (58), a marked increase in systolic wall thickening was demonstrated with cine MR imaging in “stunned” myocardium when the heart was stressed with an infusion of isoproteronol. Another attempt to evaluate reperfused myocardium after thrombolysis (999C) utilized first-pass time-intensity curves after a bolus injection of gadobinium in 10 patients with acute myocardial infarctions. The effectiveness of the reperfusion could be demonstrated, but no conclusions were drawn regarding the viability of the perfused myocardium. The potential feasibility of direct imaging of infarcted myocardium was shown in rats by using a special iron oxide compound attached to a monocbonal antimyosin antibody (629). MR images show a decrease the areas of infarction. Substantial progress when compared with to image the pulmonary
in signal
intensity
localized
to
was demonstrated, especially last year’s meeting, in the ability arterial tree. Several different
March
1992
T eting
Notes
gradient-echo schemes were presented (386, 387, 388, 390) that were abbe to show opacified pulmonary arteries down to the subsegmental level. In one study (386), the visualization of the pulmonary vessels was improved by enhancing the images with intravenous gadopentate dimeglummne. Good-quality pulmonary angiograms can also be obtained by using cardiac-gated phase contrast imaging. This method was used effectively to demonstrate pulmonary vascular malformations (389). Contrast-enhanced ultrafast CT is also a viable means for detecting pulmonary emboli (exhibit 524), as a study can be completed within one breath hold, thus doing away with the motion artifacts that interfere with routine CT studies of the pulmonary vessels.
(1157) suggested that they were due to the ionic content of the contrast agent rather than its hyperosmolarity. The negative effect could be countered by adding cabcium ions to the contrast agent. Finally, there were several good review exhibits on obstruction of the inferior vena cava (exhibits 509, 538), radiographic appearances of implantabbe cardioverters and defibrillators (exhibit 535), and total anomalous pubmonary venous drainage (310).
The role of MR imaging in the study of congenital heart disease has yet to be determined. There is no doubt that MR imaging is effective in visualizing abnormalities of the great vessels and the pulmonary circulation (74iC; exhibit 328). It is also of use in the postoperative evaluation of patients after a Mustard procedure (627) for evaluating the patency of shunts and anastomoses, identifying areas of stenosis, and so on. Often the MR study will obviate repeated catheterizations. Nevertheless, for most intracardiac lesions, MR imaging alone is still not sufficient as a preoperative study. This may change in the near future. Two papers were presented on the quantification of intracardiac left-toright shunts. One (626) determined shunt volume by comparing aortic and main pulmonary artery blood flow, derived from velocity-encoded cine MR images, while the other (742C) measured the shunt by imaging a bolus of gadopentetate dimeglumine as it passed through the heart. MR imaging was also shown to be considerably more accurate than echocardiography for sizing the aortic anulus before surgery for valve replacement (743C). The standard method for evaluating a stenosis is to measure the pressure gradient across it. Another means to the same end involves measuring flow velocities on either side of the narrowing. This technique was suecessfu!by used in a comparison of 10 patients with coarctation of the aorta and 10 healthy volunteers (1000). The problem is more difficult with tighter stenoses because of marked poststcnotic flow turbulence. Laboratory studies involving phase contrast cinc MR imaging, however, validated the measurement of poststenotic flow velocities over a considerable velocity range (998C) and held some promise for estimating the grade of the stenosis (353). Two studies were concerned with the use of nonionic contrast agents. In one (1158), 92 patients, 13 of whom had documented pulmonary arterial hypertension, underwent pulmonary arteriography with full-strength nonionic contrast media. None showed a rise in pulmonary artery pressures or other complications. The other (1159) reported the results of a double-blind, randomized controlled trial from 23 centers. The effects of diatrizoate and iohexob were compared in 1,194 adult patients undergoing cardiac catheterization. lohexol proved to be significantly less renotoxic, especially in high-risk patients with an elevated creatinine level. A study of the negative inotropic effects of gadopentetate dimeglumine
David W. Hunter, MD, University ofMinnesota Hospital and Clinic, Minneapolis Sandra Althaus, MD, University of Washington Hospital, Seattle Michael D. Darcy, MD, Mallinckrodt Institute of Radiology, St Louis Steve Falconer, BA, University of Minnesota Hospital and Clinic, Minneapolis Xiaoping Hu, MD, University ofMinnesota Hospital and Clinic, Minneapolis Deborah G. Longley, MD, University of Minnesota Hospital and Clinic, Minneapolis Louis G. Martin, MD, Emory University, Atlanta Terence Matalon, MD, Rush-Presbyterian-St Luke’s Medical Center, Chicago Arthur Stiliman, MD, University ofMinnesota Hospital
Volume
182
#{149} Number
3
Cardiovascular/Interventional Radiology
and Robert
Clinic, Minneapolis L. Vogelzang,
Hospital, Chicago E. Kent Yucel, MD,
MD,
Northwestern
Massachusetts
General
Memorial Hospital,
Boston
Index terms:
Arteries, chemotherapeutic embolization, 9.1299 #{149} Arteries, stenosis or occlusion, 9.7214 #{149}Contrast media, comparative studies ‘ Magnetic resonance (MR), angiography #{149} Radiological Society of North America, 77th scientific assembly and annual meeting #{149}Thrombosis, venous, 9.751 Varicocele #{149} Veins, US, 9.1298 Radiology C RSNA,
1992; 1992
182:929-932
As members of the Cardiovascular and Interventional Radiology Meeting Notes Committee, we kept musing to ourselves throughout the meeting that there was “nothing happening, nothing new.” A review of the papers would suggest that there were fewer basic science papers and those dealing with new techniques or new devices. We speculated that this might be due to a decrease in the amount of scientific effort, a decrease in acceptance of that effort by RSNA ‘91 reviewers, or maybe a move of this type of paper to the subspeciabty meetings, which are yearly assuming a greater importance in our increasingly subspecialized field of radiobogy. When the papers presented at RSNA ‘91 are looked at carefully, however, one notices a steadily increasing quality of clinical evaluation and, most important, a healthy tendency to critically review previous work and attempt to substantiate and put it on a firmer footing scientifically or, in some cases, to refute it. The feeling
Radiology
#{149} 929
RSNA
‘9 1 Meeting
Notes
that there was “not much happening,” I think, is therefore just a small trend or cycle in a year of consolidation and what, on final review, appears to be ever-improving scientific efforts on the part of vascular radiologists around the world. The format of including works in progress with longer papers appeared to work well for the vascular section, although the difference in content between the two types of papers was usually not noticeable and te distinction between the two may be irrebevant. As in previous years, magnetic resonance (MR) angiography had more papers than any other vascular imaging modality. The faster and improved-resolution black-blood techniques (149, 1001) and the relatively new multiple overlapping thin-slab acquisition technique (582C) show promise in increasing blood-tissue contrast. MR angiography still appears to have a general problem with overcalling stenosis (154) but maintains its sensitivity for severe lesions. Four papers showed exeeptionalby promising results for MR pulmonary angiography (386, 387, 388, 390), with one technique not even requiring breath holding. The measurement of velocity in vessels is revealing itself to be not such a simple maneuver, and several papers dealt with methods for increasing accuracy by means of specific sequence adjustments (578, 580C, 992, 994, 998C). An exciting new method of velocity mapping was discussed as well (579). Peripheral duplex ultrasound (US) made the biggest leap forward and promises to be an extremely important component of peripheral vascular imaging for many years to come. Of the 24 total papers on this subject, 20 of them were excellent clinical investigations of the technique, many of which will have immediate effects on the way we practice. Color duplex imaging appears to be more sensitive than descending venography in assessing venous incompetence (206), although a standard for the accuracy is backing. Duplex imaging once again appeared to be proving itself equal to venography for lower-extremity deep venous thrombosis above the knee (213), although the two techniques appear to be complementary rather than competitive, and duplex images definitely benefit from rereading if results are questionable. Once again, as in 1990, duplex imaging showed itself insensitive for detecting calf deep venous thrombosis in asymptomatic postopera tive patients
(258). ing
Duplex papers
imaging of the
appears, meeting
in one of the more (470), to be predictive
interestof an-
gioplasty results at 2 years on the basis of the presence or absence of a greater than 50% stenosis at the angioplasty site within I week of the angioplasty. It also appears to be sensitive for the detection of renal artery stenosis or other intrarenal pathologic conditions on the basis of waveform changes in the native kidney (908, 909, 910). Its role in the evaluation of arteriogenie impotence is becoming clarified, in that peak systolic vebocities are being shown to have a gray zone between 25 and 35 cm/sec (1028) and some false-positive duplex studies may actually have disease involving the hebicine or smaller vessels (1029). Duplex imaging is clearly also becoming an important tool for the imaging of varicocebes (1033, 1034); color and
930
#{149} Radiology
gray scale were shown to be complementary, with color being the most important part of the examination. One exciting exhibit (exhibit 218) appeared to suggest that duplex US was predictive of mortality in intensive care units on the basis of renal pulsatility indexes. MR angiography and duplex US together accounted for 60 of i64 papers in the peripheral vascular field at the meeting. The largest other single category was stents, with 23 papers. There was a marked improvement in the clinical quality of these papers, with 18 of them showing careful clinical comparisons or evaluations of new techniques or devices. One of the most exciting things to emerge from the meeting was a clear movement toward the use of stents in aortoiliae occlusive disease as the primary treatment without adjunetive use of thrombolysis or angioplasty. Several groups showed excellent 2-year patency results of greater than 60%, with i-year patency results of 90% or better and technical successes of 90% as well (66C replacement, 68C, 70, 412, 419, 893). Femoral-popliteal stents are still plagued with poor long-term results (69, 412), although the proximal superficial femoral artery appears to be a more favorable site (413). In a repeat performance from last year, the one outstanding randomized prospective trial of stent placement versus angioplasty in the iliac area (411) showed progressive widening of the differences between stents and angioplasty. One very exciting paper (896) revealed an attempt to decrease myointimal hyperplasia by using intracavitary radiation therapy. Animal work in this field appears clearly indicated. In two outstanding exhibits that appeared to be overlooked in their quality and potential implications (exhibits 504, 506), the effects of angioplasty and stent placement on the vasa vasorum were explored in an experimental model; the underlying potential for control of myointimal hyperplasia by understanding its physiologic basis was clearly evident. Filters continue to be a subject of debate. The titanium Greenfleld filter came under some fire at this meeting with reports of asymmetric or crossed legs (208C) and the fact that such asymmetry can significantly reduce the efficiency of clot trapping (209C). One in vivo study (632) and one improved in vitro study (exhibit 503) further challenged the ability of the titanium and regular Greenfleld filters to trap small clots. It is surprising that the bird’s-nest-shaped filter appeared to trap clots with equal efficiency whether the wires were extended or compressed (2uiC). Another study demonstrating high rates of occlusive or nonoeclusive thrombus at insertion sites, even with the smaller filters (631), suggested that in patients with thrombus or occluding lesions in the pelvic system, an internal jugular approach or, as cxpbored in one paper, an antecubital approach (634) with the bow-profile Simon Nitinob filter might be a better option. The studies exploring various reactions to high-osmolality and low-osmobality contrast material were of high quality this year, with two outstanding studies by one group (90, lil8C) demonstrating that high-osmolality contrast media depress ereatinine clearance more than low-osmolality media, especially at 48 hours in patients
March
1992
‘Notes
L with previously decreased renal function, even when there is no difference in the serum creatinine level. They suggested that this difference may be related to the difference in adenosine production between the two media. Two other excellent randomized and double-blind studies clearly demonstrated that high-osmolality media have a worse effect on renal function than low-osmolality media in patients with previously decreased renal function (1119, 1159). In contrast to this, a third study that also appeared to have excellent methodology, being randomized and double-blind, showed no difference in serum creatinine level between high-osmolality and low-osmobality media (95). The differences between these studies appear to lie in their analysis of subgroups of patients, since two of the three studies showed no difference between high-osmo!ality and bow-osmolality media in evaluating serum ereatinine levels of all their patients, but showed distinct differences in those patients with previously depressed renal function. Large studies of the relative safety of nonionic media in pulmonary angiography are needed to counteract the older literature on the subject; one of these showed up at the meeting this year (1159), showing clearly that nonionic media are safe, even in patients with pulmonary hypertension. It appears from one study (92C) that patients receiving high-osmolality media may be able to receive a single dose of hydroxyzine 12 hours before the study and have a decrease in the severity and number of allergic-type reactions. Angioplasty, athereetomy, and lasers were subjects of very few papers at this meeting (a total of 13), but severa! of these papers had interesting results. Low-pressure heated balloons appeared, in one of the first reports on this technology, to have a restenosis rate similar to that of standard angioplasty, with an increase in the rate of myointimal hyperplasia with increasing heat (1003). Two studies of atherectomy in the femoral-popliteal region showed that atherectomy plus angioplasty improved overall results (1166, 1167), and both studies suggested that diabetes was the primary factor concerning the angioplasty site or clinical variables. An interesting study of athereetomy (1168) suggested that the Dotter effect of the athereetomy catheter and the inflation of the balloon accounted for 57% of the result in concentric lesions but only 12% of the result in eccentric lesions. A baser study with results similar to those obtained with the heated balloons showed that increasing thermal laser injury (1005C) increases the amount of myointimal hyperplasia. Several studies have reconfirmed that lasers are no better than advanced guide-wire techniques for recanalizing obstructed lesions (1006, 1007, 1008). Thrombolysis catheters are coming under some scrutiny, with two good studies showing a wide variation in the method of dispersing agents, especially in the drip mode (750C, 7SiC), with no correlation between price and quality of dispersion. Most of the catheters, except the Bookstein and EDM catheters, drip most of the solution out of the proximal holes. Thrombolysis continues to extend its usefulness in patients for limb salvage (753), with the only factor governing the adequacy of the result remarkably being the presence of a correctable
Volume
182
#{149} Number
3
lesion and not diabetes or adequate runoff. The reason for the discrepancy between this study and previous studies was unexplained. Although hepatic chemoembolization is still something that is simply reported as being performed but not carefully compared with other treatment modalities in terms of its effect on longevity, two interesting papers showed that these techniques can be performed through collaterals when the hepatic artery is occluded (221C), and that midgut carcinoid syndrome is treatable with the same technique (224). A fascinating study of military recruits with varicoceles (349) showed that the treated group had normal growth of the affected testicle and no decrease in sperm count as they aged, whereas the nontreated group had a decrease in both the size of the testicle and the sperm count with age. Although these results were not statistically significant, they are the first to suggest that the process of varicocebe-related subfertility is one that occurs slowly and that an early approach to this problem is definitely warranted. One group reported good results in closing patent ductus arteriosus with a cone-shaped plastic device (ii69C). An interesting exhibit (exhibit 536) suggested that gastrointestinal bleeding sites in the small bowel and colon coubd be treated with !vabon (polyvinyl alcohol) particles 100-500 m in size without significant bowel infarction. Angioscopy, a fascinating toy, was discussed occasionally but no papers on it were presented. Intravascular US seems to show more information after vascular interventions than angiography does (463, 791), but its actual effect on long-term outcome is still in doubt. Its use in other areas, including the evaluation of tumor invasion into vessels (464), may be more important in the bong run. Several groups reported on large series of patients who underwent placement of venous access devices entirely in the radiology department (219C, 220C, 417); the movement to perform this type of implantation with radiologic control seems firmly established. Two interesting papers (356, 358) came up with exactly opposite conclusions as to whether angiography should be performed in trauma patients without clinical evidence of vascular injury. Another interesting general angiography study showed that the only variable that is predictive of whether a patient will have a hematoma after angiography (35%) is the platelet count, which correbates with the clinical bleeding history. There also appeared to be a small correlation between catheter size and hematomas, which conflicts with a previous study on this subject. Spiral and fast CT techniques showed some outstanding promise in the evaluation of large vascular structures (ii6lC, ii62C, 1163) and even pubmonary embolism (exhibit 524). Computer-assisted learning technologies (infoRAD) were much more impressive this year. The switch to Macintosh or Macintosh-like menu and mouse systems in the IBM exhibits has made everything much more intuitive and user-friendly. This is particularly true of the Macintosh Supercard or Hypercard programming, which allows people to make programs that are booklike in feeling. Users understand better where they are
Radiology
#{149} 931
RSNA
‘9 1 Meeting
Notes
within the program and feel much more secure in controlling their motion within the program. This was particubarly true for a very impressive MR angiography instruetor (exhibit 004), which has all the best parts of a book combined with the good parts of moving video displays. The combination of videodisc and computer indeed appeared to be the winning one in terms of user friendliness and the amount of high-quality image information that was available in any format you can imaginc. Particularly good in this respect were the Society of Cardiovascular and Interventionab Radiology videodisc guide to peripheral vascular disease (exhibit 9319) and a superb early effort on the teaching of radiographic anatomy (exhibit 9310). This technology has finally reached maturity and will be an important learning tool for all of us in the years to come. When all is said and done, RSNA ‘91 cardiovascular and interventional papers appeared to be carefully cbsing some loopholes in previous understanding, rounding the rough edges of previous haphazard studies, and challenging some of the results of previous years, which may have been incomplete. To continue to have highquality scientific presentations at this meeting, the RSNA organizers should encourage rather than discourage resubmission of papers from subspeciality meetings so that they can be heard by this larger audience.
#{149}
The radiographic feature of primary tuberculosis in childhood noted most commonly was adenopathy, present in 92% of cases; parenchymal abnormalities were identified in 70%, occurring more commonly in the right lung. Children aged 0-3 years had a higher prevalence of adenopathy and lower preva!ence of parenchyma! consolidation. Twenty-six survivors of stage IV bronchopulmonary dysplasia were evaluated at ages 14-25 years for late outcome. Thirty-one percent (n = 8) of the subjects showed significant radiographic abnormabities, and 76% (n = 20) of the patients had pulmonary dysfunction. The respiratory complications of varicebla in immunocompetent children were compared with those in immune-suppressed children and were found to be present more often in immunodeficient patients. Bacterial infection accounted for the bronchopneumonic or bobar pneumonia in children who were not compromised, while the varicella virus itself produced the abnormality in children with compromise. Invasive aspergilbosis in immunocompromised children is a potentially lethal complication of prolonged neutropenia. Multiple rounded parenchymal nodules and larger confluent masslike infiltration is characteristic of Aspergillus infection; peripheral pleural-based nodules are also commonly identified.
Cardiovascular
Pediatric
Radiology
Beverly P. Wood, MD, Children ‘s Hospital of Los Angeles, Los Angeles Charles R. Fitz, MD, Children ‘s Hospital National Medical Center, Washington, DC William H. McAlister, MD, Washington University School ofMcdicinc, St Louis John H. Miller, MD, Children ‘s Hospital of Los Angeles, Los Aigek’s Sheila
G. Moore,
California Janet L. Strife,
MD,
MD,
Stanford
University, ‘s Hospital
Children
Stanford,
of Cincinnati,
Cincinnati
Richard
B. Towbin,
Index terms: Magnetic logical Society of North meeting . Radionuclide in infants and children Radiology :
RSNA,
A large
1992;
MD,
Children
‘s Hospital,
resonance (MR), in infants and America, 77th scientific assembly imaging, in infants and children
Pittsburgh children #{149} Radioand annual #{149} Ultrasound (US),
182:932-935
1992
number
of scientific
papers
and
exhibits
on
im-
.
Radiology
Pediatric cardiovascular papers included a review of 70 arteriograms obtained in children aged 0.3-18.3 years. The coronary arteries were accurately demonstrated in all, and complications occurred in 7% (n = 5), 3% (n = 2) of whom had major complications. Radiographic evaluation of transvenous atrial septab defect occlusion devices was undertaken in 13 patients. Chest radiographs are helpful in the evaluation of these devices, and knowledge of the radiographic appearance is important in identification of partial disbodgment or entanglement. MR imaging plays an increasing robe in the evaluation of congenital heart disease and has obviated angiography in the evaluation of disorders of the great vessels, anomalies of the aortic arch, aortic coaretation, and bilatera! pulmonary branch stenosis. Three-dimensional dinicab MR imaging of congenital heart disease and vascular rings with color-coded, rotatable, and sectional threedimensional images is helpful in the evaluation of cardiovascubar anomalies and the airway. Reconstructions are obtained from a single set of 3-S-mm sections. MR imaging is increasingly used in the evaluation of functionab abnormalities, with velocity-encoded dine MR imaging being an accurate, reproducible, and noninvasive method for measurement of Qp/Qs in patients with in-
aging in infants and children dealt with applications of ultrasound (US), magnetic resonance (MR) imaging, and nuclear scintigraphy for accurate and sensitive diagnosis of diseases that are specifically pediatric in nature.
creased pulmonary-to-systemic flow ratios. U!trafast MR cardiac imaging is used after a bobus injection of gadopentetate dimeglumine to evaluate intracardiac shunts. MR imaging evaluation of Mustard repair for D-transposition of the great vessels provides insight into
Pediatric Chest Radiology Videofluoroscopic examinations sleep apnea were abnormal and/or structural abnormalities functional and/or dysfunctional
the functional status and morphology of the heart after inflow correction procedures, supplementing clinical and echocardiographie evaluation of the patients. Venous anomalies are frequent in children with bibiary atresia and polysplenia. As part of the preoperative eva!-
932
#{149} Radiology
of 55 children with in 81%, with anatomic present in 52% and abnormalities in 29%.
March
1992
..
.
uation for liver transplantation, normality of the inferior vena ation in 12, left-sided inferior right hemiazygos continuation
Interventional
16 patients showed abcava with azygos continuvena cava in three, and in one.
Radiology
Technical developments have continued to occur in pediatric intervention. Percutaneously placed vena cava filters have been made smaller (i4 F) and can be safely placed in children. No series of pediatric patients treated thus has yet been presented. Another area of potential growth and development is placement of implantable infusion ports with either singleor double-lumen systems. Preliminary studies in adults have demonstrated that percutaneously placed infusion ports are safe and efficacious. Gallbladder intervention is becoming common, and the gallbladder may be used for access to the hepatobiliary tree for both diagnostic and therapeutic procedures. Applications reported in the adult population include percutaneous eholecystolithotomy and emergency cho!eeystostomy for acute chobecystitis. Comparison has been made between percutaneous transhepatic biliary drainage and percutaneous cholecystostomy for biliary drainage. Percutaneous eholecystostomy is technically easier and has a similar complication rate. Pediatric interventionalists are familiar with percutaneous puncture of the gallbladder for diagnostic testing; few therapeutic manipulations, however, have been performed with percutaneous cholecystostomy. Success in adults will open this area in the pediatric population. There is continued interest in pediatric percutaneous gastrostomy, and one group now places percutaneous gastrostomy tubes in outpatients. Stents are among the newest areas of interventional radiology and are currently used in the bibiary tree for treatment of both benign and malignant strictures, in the vascular bed for treatment of resistant or recurrent stricture, and to crcate portosystemic shunts. This technique also shows promise for a wide variety of pediatric conditions. Posttransplantation Radiology Posttransplantation studies in patients after liver transplantation showed transhepatie portal vein angioplasty was effectively used in the treatment of portal vein anastomotie strictures. Duplex Doppler US for evaluation of renal dysfunction before and after liver transplantation indicated that abnormal findings at renal Doppler US performed before liver transplantation indicated a greater risk for subsequent renal failure and hemodialysis requirement. Color duplex Doppler US was 100% sensitive in the diagnosis of severe renal artery stenosis with or without rejection. Quantitative ventilation-perfusion studies in patients after single-lung transpbantation indicated that increased perfusion to single transplanted lungs is generally seen. Increased perfusion over ventilation suggested a loss of vascular autoregulation in the transplant, and a progressive decline in transplant perfusion is associated with rejection.
Volume
182
#{149} Number
3
.
.
.
RSNA Endocrine
‘9 1 Meeting
Notes
Radiology
Congenital hypothyroidism may result from thyroid agenesis, hypoplasia, ectopia, or transitory malfunction. Congenital hypothyroidism was assessed with scintigraphy, US, and serum hormonal values. Scintigraphy demonstrated thyroid agenesis, ectopia, hypoplasia, and goiter. US accurately demonstrated the absence of the gland from its normal location in 51 of 52 newborns, with agenesis or ectopia seen by means of scintigraphy in 98%. US and hormonal values are sufficient the cause of congenital hypothyroidism, and phy may be delayed to confirm the diagnosis.
Musculoskeletal
to suggest scintigra-
Radiology
US examination and MR imaging examination for muscuboskeletal abnormalities are increasing in use. US of the pediatric elbow is sensitive in delineating the normal cartilage anatomy, extraarticular soft-tissue inflammation, and transphyseal fractures of the distal humerus. MR imaging evaluation of acute dislocation of the shoulder shows anterior glenoid labrum tear, Hill-Sachs besion, and Bankhart lesion with high sensitivity. Evaluation of patients with the human immunodeficiency virus-for the presence of osteomyelitis revealed a 2% prevalence of positive bone scans consistent with osteomye!itis in this group, with isolated organisms being those of the Staphylococcus and Salmonella species. Comparison of skeletal, metaiodobenzylguanidine (MIBG), and bone-marrow scintigraphy in the evabuation of neuroblastoma revealed that no method was clearly superior to the others, but MIBG 1-123 and skeletal scintigraphy are very sensitive to skeletal metastasis of neuroblastoma. Pediatric use of mercaptoacctyltriglycerine is helpful in following skeletal changes after bone marrow harvest to prevent the perception of such changes as being metastatic involvement by neuroblastoma. A previously unrecognized association among rib infarction, pulmonary infiltrates, and pleural effusion appearing as acute chest syndrome in children with sickle cell disease is helpful in the evaluation of patients with this enigmatic problem. MR imaging has been used to diagnose recurrent primary Ewing sarcoma and compared in accuracy with other imaging modalities. Local recurrence has been identified accurately in seven of eight recurrences, and MR imaging is more sensitive than computed tomography (CT) or bone scanning. Genitourinary and Gastrointestinal Radiology Detection of vesicoureterab reflux in infants by means of cyclic voiding cystourethrography (VCUG) is helpfub in increasing the sensitivity of VCUG to reflux. Seventy-six consecutively seen children aged less than 3 years with negative results of initial VCUG underwent a second cycle of bladder filling and voiding, with unsuspected reflux occurring in i7%. US was not found to be reliably sensitive in the detection of vesicoureteric reflux, and VCUG is still the modality of choice. Color Doppler US can be used to locate the base of the ureteric jet and corresponds cystoscopically to the position of the ureteric orifice. Measurement of the distance between the midline of the bladder and the ureteric orifice can aid in pre-
Radiology
#{149} 933
RSNA
‘9 1 Meeting
I
Notes
dieting vesicoureteral reflux, and a distance of 9 mm or less is accurately predictive of a negative VCUG result 90% of the time. Evaluation of mubticystic dysplastic kidneys in 48 patients who underwent sequential sonography showed a decrease in size in 71%, no change in size in 19%, and an increase in size of the involved kidney in 10%. Periphcrab vascular mapping of neurobbastoma by using color Doppler imaging represents a noninvasive method for mapping the relationship between neuroblastoma and retroperitoneal vessels preoperativeby and is considered extremely sensitive in such patients. The resistive index of renal lobular arteries in healthy children is relatively high compared with the expected bevel in adults. Resistive index is age-dependent, high in children aged up to 10 years, and commonly greater than .70 in children aged less than 6 months. Short inversion time inversion recovery (STIR) MR imaging has been compared with CT and lymphography for identification of retroperitoneal and iliac lymphadenopathy in patients with Hodgkin disease. STIR imaging allowed correct exclusion or depiction of lymphadenopathy in all 14 cases studied, and STIR MR imaging and CT were superior to lymphography in asscssment of the more cephalic periaortic nodes, with all lymph nodes more conspicuous on STIR MR images than on CT scans. Evaluation of a 5-year experience with pneumatic reduction of intussusception in 246 patients showed suecessful reduction in 199 cases (80.9%). Bowel perforation occurred in seven cases (2.8%), and intussusception recurred in 27 cases (11%). The single most important predictor of outcome in this series was length of duration of symptoms. Duplex Doppler ovarian sonography was used in 28 normal ovaries in 20 girls. The resistive index was .62 between days 7 and 22 of the menstrual cycle and .73 between days 0 and 7 and between days 22 and 28. Ovarian cysts identified at prenatal US in girls were evaluated and followed postnatalby. Forty-four prenatally detected cysts were seen, 38 purely cystic and six with an echogenie or mixed pattern. Twenty-three cases were followed sonographically, and 18 resolved within 1 year. Five showed a distinct reduction in volume during that time. The size of cysts varied between 2 and 86 cm3. Neuroradiobogy Neuroradiobogic assessment of pediatric patients mdieates that in the newborn evaluated with cranial US, coronal imaging alone successfully depicts all intraventricular bleeding, with no hemorrhage occurring that was detected on the parasagittal views alone. Color Doppler US is useful in identifying cerebral flow and the abnormal venous drainage of vascular anomalies. Fourteen color Doppler US examinations in patients with head and neck arteriovenous malformations indicated excellent correlation with angiographic findings and clinical evidence of high-output cardiac failure. Preembobization color Doppler US mapping of major feeders and estimation of arteriovenous flow and arterial peripheral resistance are used. After treatment, the effect
on flow to the arteriovenous malformation, normal brain circulation, and development of new feeders is assessed. Cranial CT examination of patients with herpes simplex encephalitis showed abnormalities in 15 of 16 scans, with bilateral hemisphere changes of low attenuation, ventricular compression, intracerebrab hemorrhage, and abnormal contrast enhancement identified as presentation of this encephalitis. MR angiography provides a clinically useful method for imaging vasculature of the pediatric brain and is an adjunct to spin-echo imaging. A bolus of gadopentetate dimeglumine can be used to detect asymmetry in blood flow dynamics of cerebral perfusion in children. Diffusion-weighted imaging in 33 infants is shown to be highly sensitive to myclination. Cerebrovascular results evaluated with MR angiographic techniques (three-dimensional time of flight, two-dimensional time of flight, and veloeity-compensated-uncompensated time of flight) were performed, and two-dimensional time of flight was useful in subtracting the high signal intensity from methemoglobin clot.
Magnetic
tion
934
#{149} Radiology
Resonance
(MR)
Use of contrast material-enhanced subtraction MR imaging in the evaluation of osteosarcoma response to adjuvant chemotherapy in 10 patients showed tumors appearing as high-signal-intensity masses, sometimes with enhancing capsules at beast 3 mm thick. These tumors had poor responses at histopathobogic evaluation. Osteogenic sarcomas, which were nonenhancing, with or without fully enhancing capsules, were good responders. Experimental work with periosteal implantation of the VX2 carcinoma and Ti- and T2-weighted and gadolinium-enhanced Ti -weighted images showed correlation with pathologic findings, although tumor boundaries depicted on MR images were larger than the actual tumor. This was due to the presence of a capsulebike hypervaseular connective tissue rim surrounding the tumor, which showed increased signal intensity on T2weighted and gadolinium-enhanced Ti-weighted images. The criteria of size, margin character, signal inhomogeneity, involvement of neurovaseular structures, tumoral vessels, and peritumoral edema did not allow adcurate distinction between benign and malignant softtissue masses at MR imaging. Similarly, the use of MR imaging in distinguishing benign and malignant vertebra! compression indicated that in the first 3 months after fracture, both benign and malignant vertebral cornpression fractures showed intermediate signab intensity on Tl-weighted images, enhancement with gadopentetate dimeglumine, and increased signal intensity on T2-wcighted and gradient-recalled-echo images. Posttraumatic fractures that were related to osteopenia and were more than 4 months old exhibited marrow signal intensity isointense to that of normal marrow, and neoplastic fractures exhibited diffuse decreased signal intensity on Ti-weighted images and either increased or no signal abnormality on T2-weighted gradient-recalledecho images. Investigation of the utility of MR imaging in cvabuaof hematopoietic
neoplasms
indicated
that
the
March
mo-
1992
:
...‘
A1RSNA9
,‘ S
dality
is useful
in patients
undergoing
77th
allogeneic
bone
ity with
Category
member
RSNA member-in-training AAPM member Nonmember program Nonmember radiologist
Nonmember
Hospital Qualified
participant
physicist
Nonmember Radiology
resident/trainee support personnel
executive non-health
Non-hospital-based
Other physician Commercial research Consultant Student Total
sciences medical
Total
Note-N/A * Medical
and
hospital
staff
personnel care provider
and development
professionals
Exhibitor
3
chemical
of North
shift
imaging
of the
pelvis
indicated
America
1991 Total Attended
1990 Total Attended
1989 Total
7,230
7,043
6,281
attendees
personnel
Attended
916 733
931 724
833 674
611 2,147
633 2,312
574 1,903
344 393
192
311
601 6,869 790
540 6,897 735
N/A
N/A
371
N/A
N/A 259
231 137
N/A 129 1,186*
N/A N/A 1,109*
21,700
19,457
279
Guest/spouse Press
#{149} Number
.,-
that the calculated fat fraction and the marrow Ti relaxation time calculated from water images were accurate in distinguishing marrow cellularity of less than 20% from marrow cellularity of greater than 20%, this information serving as a useful guide in directing bone marrow biopsy and harvest in patients before autobogous marrow transplantation.
Registration Figures: Radiological Society Assembly and Annual Meeting
RSNA
182
,
Scientific
Registration
Volume
1 Meeting
.
j
marrow transplantation. Marrow patterns indicated diffuse hypereel!u!arity before transplantation, and normal marrow signal intensity was recovered in all patients within a year after albogeneic transplantation. Many cxhibited the “band pattern” that is a typical response of the marrow to therapeutic intervention, including marrow transplantation. The time of response was variable. Correlation of biopsy-determined iliac marrow cellular-
Official
n-., ‘ Notes
,.
430
92 1,213 22,103
4,163 181
6,117 490
2,464 149
4,387 184 25,506
24,329
19,526
52,180
50,373
41,596
= not available. students only.
Radiology
#{149} 935
RSNA
1991
Program
Replacement
The following are abstracts of papers withdrawn after rectly in the program.
Abstracts
of papers (a) that were presented at RSNA’91 in replacement the program book was printed or (b) that were printed incor-
METHODS
has been imaged by using DSA and several MR The results of the dimension measurements revealed that the vessels were 0.42 mm ± 0.24 smaller than the computer model because of shrinkage of the polymer material used in manufacturing. A comparison of the physical phantom to x-ray measurements showed a difference of +0.18 mm ± 0.13. CONCLUSION: We have demonstrated that stereolithography can be used to
expanding
build a complex
66
Eleven an endovascular
patients stent.
PURPOSE:
with
with
total
occlusion
of the iliac arteries
angiography
MD
were
E.
#{149}
treated
AND MATERIALS: All the patients were treated with selfstents (Wallstent) that consists of stainless steel alloy filaments woven in a tubular fashion. All patients were men with a mean age of 66 years, ranging from 49 to 79 years. The length of occlusion varied from 3 to 15 cm. Three stents were placed in each of two patients, two stents in each of seven patients, and one stent in two patients each. The follow-up period ranged from I to 15 months, with a mean of 6 months. In all patients, a through-and-through guide wire was used; either both femoral arteries or the axillary and a femoral artery were used. The occluded segment was recanalized, and the stent was placed immediately after. RESULTS: There were no major complications related to the procedure. One of the stents occluded 3 days and 2 months after the placements. In both cases, the occlusion
was
resolved
asymptomatic CONCLUSION: surgical
with
urokinase
infusion.
up to 15 months. The use of endovascular
bypass
in
iliac
artery
The
rest
of the
patients
remain
occlusions,
may
especially
be an
when
long
to
segments
are
955 #{149}11:06AM Creation of a Complex Vascular Phantom for MR and X.Ray Anglography AR. Sanderson, ME, Salt Lake City, Utah #{149}E. Cohen, PhD #{149}W. Davis, MD
hollow
sions
We have
developed
representations
and
a technique
of complex
positions
to facilitate
to generate
vascular
research
beds
anatomically
of precisely
in quantitative,
middle
and
anterior
cerebral
AND
MATERIALS:
METHODS
creating
a computer
vascular
structure
produced based
dimensional by using
936
that
on x-ray
was
Phantom containing used
phantom.
to
The
dimensions
MR angiography and conventional
Radiology
#{149}
vessel
dimen-
multiple-modality
(MR
imaging.
artery
A
to the
arteries.
model
the physical
correct
known
angiography and digital subtraction angiography [DSAI) vessel phantom has been generated that represents the common carotid
was
D.
#{149}
PhD
PURPOSE:
construction the
drive
data set. The techniques.
representation
locations phantom
accomplished
by
representation
a stereolithography
geometric and
was
geometric
obtained dimensions
of the
machine
that
of the phantom from were
a
three-
vascular
phantom
can be imaged of the phantom
by
using
a geometric
with DSA and is in progress.
representation,
MR angiography
and
techniques.
11:24AM
957
#{149}
Imaging after Radiosurgery for Cerebral Arterlovenous Malformations LD. Lunsford, MD, Pittsburgh, PA #{149}D.S. Kondziolka #{149}A.H. Maitz, MS #{149}D.J. Bissonette, PA-C #{149} J.C. Rickinger, MD PURPOSE: To evaluate the role of cerebral angiography, MR imaging, and CT during and after stereotaxic radiosurgery for arteriovenous malformations Neurodlagnostic
(AVMs).
alternative
involved.
Parker,
that the phantom Further evaluation
MATERL4LS: In our first 3-year experience with gamma knife 227 patients underwent intraoperative stereotaxic angiography and were evaluated by means of serial posttreatment MR or CT imaging. RESULTS: AVM obliteration (defined as complete angiographic resolution) was obtained in 37 of 46 patients (80%) who were evaluated 2 years after radiosurgery. We reviewed sequential MR or CT images in 72 of our first 75 patients treated with radiosurgery. Twenty patients (2-year actuarial mcidence = 31%) developed post-radiosurgical imaging changes consisting of new regions of increased T2 signal on brain MR. Imaging changes were associated with headache or new neurological deficits in nine of 20 (45%) and were asymptomatic in 11 (55%). The onset of symptoms correlated with the presence of an AVM in an area of critical brain function and developed 5-18 months after radiosurgery. Imaging changes resolved completely by 19 months in 10 patients. In multivariate analysis, volume was the only factor significantly associated with the development of imaging changes. CONCLUSION: Cerebral angiography remains the benchmark by which suecessful AVM radiosurgery (total obliteration) can be defined. However, serial MR images, when possible, provide critical knowledge about the response of
METHODS
stents
The phantom techniques.
RESULTS:
#{149}11:33AM Endovascular Stent In Complete OcclusIon of the lilac Artery M. Maynar, MD, Minneapolis, MN #{149}A. Reyes, MD #{149}J.M. Puildo-Duque, Gornz, MD #{149} E. Otermin, MD #{149} W.R. Castaneda-Zuniga, MD
AND
radiosurgery,
the
AVM
associated
over
with
time
as
well
as
recognition
of
brain
parenchymal
changes
radiosurgery.
verified
March
1992
Comply with ACR, JCAHO and State
Quickly, Easily, Inexpensively! p
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Gastrointestinal Disease. 4th Series Barry A. Siegel, MD, Elias G. Theros, MD, Anthony V. Proto, MD, editors, and David H. Stephens, MD, section editor 1990 #{149} Cloth #{149} 600 pages #{149} $110.00 (members) #{149} $175.00 (nonmembers) #{149} $90.00 (residents)
to Vascular for the Complete Donald Ridgway, RVT 1992 #{149} Paper #{149} 275 pages
Introduction
A Guide
Review
#{149} $47.50
Flashcards
Adult EchoNascular/Physics/ Abdomen/OB/GYN Lori Green, RT, RDMS, RVT, Lori Sens, RT, RDMS, RVT 1990 #{149} Approx 230 questions
answers
each
#{149} $57.50
each/2
Nuclear Radiology. 4th Series Barry A. Siegel, MD, Elias G. Theros, MD, Anthony V. Proto, MD, editors, and James H. Thrall, MD, section editor
and
for $99.00
1990
#{149} Cloth
members) #{149} $90.00
#{149} 810 #{149} $175.00
pages #{149} $110.00 (nonmembers)
-
#{149} $90.00
#{149} $175.00
Imaging:
to Adult Echocardiography. Lori Green, RT, RDMS, RIfT, and Lori Sens, RT, RDMS, RVT Vols 1 and 2 #{149} $125 each/$225 the set
-
Introduction
to Cardiac
Doppler/Color
Flow Ultrasound Lori Green, RE RDMS, RVT, and Lori Sens, RT, RDMS, RVT 1990 #{149} Approx 60 minutes long #{149} $140.00
(nonmembers)
(residents) Techniques Instructional -
Carotid
of Vascular Videotapes
of the Lower
Saphenous Vein Mapping Venous Imaging Jean Eiison, RVT 1989 #{149} Approx 30 minutes #{149} $99.00 each
Color Flow Carotid
long
Imaging
Wilson, RVT 30 minutes long
-Introduction to Arterial and Venous Duplex Scanning Introduction to Carotid Duplex Scanning Lori Green, RT, RDMS, RVT, and Lori Sens, RT, RDMS, RVT 1990 #{149} Approx 60 minutes long #{149} $125.00
Vascular Laboratory Operations Manual: A Guide to Survival Claudia B. Rumwell, RN, RVT, editor 1989 #{149} Looseleaf #{149} 226 pages #{149} $175.00 Vascular Technology Review, 3d ed Barton A. Bean, RVT, Donna E. Cox, RN, RVT, and Keith Mauney, RN, editors 1 989 #{149} Paper #{149} 208 pages #{149} $55.00
Duplex
Exam
RADIOLOGY
APPLETON
& LANGE
Van Zant Street P.O. Box 5630 Norwalk, CT 06856 (800) 423-1359 25
The Abdominal Plain Film Stephen R. Baker, MD 1 990 #{149} Cloth #{149} 448 pages #{149} $99.95
Imaging:
Harold B. Rose, ScD, CCE, RVT, Auri Spigelman, MD 1989 #{149} Approx 30 minutes long #{149} $99.00 each
MARCH
Color Flow Evaluation
Videotapes
Radiation
(members)
information.
-Introduction
(residents)
Bioeftects and Management Barry A. Siegel, MD, David H. Stephens, MD, editors, and Louis K. Wagner, PhD, section editor 1991 #{149} Cloth #{149} 500 pages #{149} $110.00
of Cardiac
numbers
further
Vascular Anatomy and Physiology: An Introductory Text Ann C. Belanger, RN, RVT 1 990 #{149} Paper #{149} 208 pages #{149} $39.95
and
Techniques of Abdominal Imaging: Instructional Videotapes Introduction to Abdominal Sonography. Vols 1 3 Lori Green, RT, RDMS, RVT, and Lori Sens, RT, RDMS, RVT 1990 #{149} Approx 60 minutes long #{149} $1 25 each/$225 for 2/$299 the set Techniques Instructional
imaging
Techniques of Venous Imaging Steven R. Talbot, RVT, and Mark A. Oliver, MD, RVT 1 992 #{149} Cloth #{149} 200 pages #{149} $64.50 #{149} $89.00 for Video Companion
with
Audiocassettes -
or
Polly DeCann 1990 #{149} Approx #{149}$99.00
Scanning: Beginner
Neuroradlology Barry A. Siegel, MD, Elias G. Theros, MD, Anthony V. Proto, MD, editors, and Peter E. Weinberg, MD, section editor 1 990 #{149} Cloth #{149} 1 050 pages #{149} $180.00 members) #{149} $300.00 (nonmembers) #{149} $150.00 (residents) #{149} (2-vol set)
-
A. Oss,
Introduction to Ultrasound Physics Lori Green, RT, RDMS, RVT, and Lori Sens, RT, RDMS, RVT 1991 #{149} Approx 60 minutes long #{149} $125.00
Registry Magnetic Resonance Barry A. Siegel, MD, Elias G. Theros, MD, editors, and William G. Bradley, Jr., MD, PhD, section editor 1991 #{149} Cloth #{149} 770 pages #{149} $110.00 (members) #{149} $175.00 (nonmembers) #{149} $90.00 (residents)
-
Echocardiography Review Barton A. Bean, RVT, and Kathleen BS, RDMS, editors 1989 #{149} Paper #{149} 160 pages #{149} $55.00
phone
Extremities
32
White 22091
Chest Disease. 4th Series Elias G. Theros, MD, Barry A. Siegel, MD, editors, and Anthony V. Proto, MD, section editor 1989 #{149} Cloth #{149} 814 pages #{149} $90.00 (members) #{149} $1 50.00 (nonmembers) S
DAVIES,
current and
and
Atlas of Radiographic Positioning: Normal Anatomy and Developmental Variants Sharon Jaeger, DC 1990 #{149} Paper #{149} 384 pages #{149} $45.00
63A
Publishers’ Cardiovascular Nuclear Kenneth P. Lyons, MD 1990 #{149} Cloth #{149} 352 pages
Row MRI of the Knee (Clinical Diagnostic Imaging Series) Peter L. Munk, MD, and Clyde A. Helms, MD 1991 #{149} Cloth #{149} 208 pages #{149} $89.00
Medicine #{149} $99.95
MRI of the Pelvis: A Text/Atlas Hedvig Hricak, MD 1991 #{149} Cloth #{149} 562 pages #{149} $155.00
Ridge
Drive
MD
20878
Gaithersburg, (800) 638-8437 (301) 417-7500 Clinical
Imaging: An Atlas Diagnosis. 2d ed Ronald L. Eisenberg, MD 1991
Physical Principals 2d ed Perry Sprawls, MD
PUBLISHERS,
200 Orchard
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of Infants
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of Sports Injuries H. Berquist, MD #{149} Cloth #{149} 468 pages (tentative)
Imaging of the Lumbar Spine Harry J. Griffiths, MD, Richard Ellis, MD, and Benjamin Lee, MD 1990
#{149} Cloth
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Imaging Principles for Cardiac Angiography Robert J. Moore, PhD 1990
Liver Imaging Joseph T. Ferrucci, MD, and David Stark, MD 1990 #{149} Cloth #{149} 456 pages #{149} $110.00 #{149} An Andover Medical Book
Road
Scriptographic Booklets and Family Education
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Imaging Thomas #{149} $125.00
Exercises in Diagnostic Imaging C.J. Gaivey, MB, MCh, BAO, FRCR 1990 #{149} Paper #{149} 192 pages #{149} $34.95
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John R. Sty, MD, Robert G. Wells, MD, Robert J. Starshak, MD, and David C. Gregg, MD 1991 #{149} Cloth #{149} 1,200 pages (3-vol
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of Medical
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Comparative Cardiac Imaging: Flow, Anatomy, Quantitation Bruce Brundage, MD 1990 #{149} Cloth #{149} 564 pages #{149} $160.00 Diagnostic
Clinical Radiology of the Breast Eric J. Roebuck, MB, BS, DMRD, FRCR, and Roger W. Blamey, MD, FRCS 1990 #{149} Paper #{149} 208 pages #{149} $75.00
MRI of the Spine: A Case Study Approach Thomas E. St. Amour, MD, PhD, Steven C. Hodges, MD, Robert W. Laakman, MD, David E. Tamas, MD, Scott Evans, MD, and C. William Deaton, MD 1992 #{149} Cloth #{149} 1,200 pages #{149} $1 50.00 (tentative)
The Principles and Practice of Ultrasonography in Obstetrics and Gynecology. 4th ed Arthur C. Fleischer, MD 1990 #{149} Cloth #{149} 672 pages #{149} $95.00
ASPEN INC.
Breast Disease for Radiographers Jennifer Caseldine, R. W. Blamey, E. Roebuck, and C. W. Elston 1 989 #{149} Paper #{149} 1 92 pages #{149} $37.95
An Atlas of Forearm and Hand CrossSectional Anatomy with Computed Tomography and Magnetic Resonance Imaging correlation Roy A. Meals, MD, and Leanne L. Seeger, MD 1991 #{149} Cloth #{149} 199 pages #{149} $125.00
pricing)
and Malignant Bone Disease. Guide to Nuclear Medicine J.H. McKiiop and I. Fogelman 1 992 #{149} Cloth #{149} 1 52 pages (approx) #{149} In preparation Benign
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Clinician’s
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in Pediatric
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#{149} 264
pages
RADIOLOGY
and Joints:
A Guide
for Students.
2d ed
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pages
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MARCH
I
l
/L4%%4:
.4
::
U,.,
NEW
RADIATION
IOEFFECTS
L:’
available
flOW
. ... :
,
-
SYLLABUS
“‘
1.
\
I’
“r
with ACR’S new syllabi
Stay up-to-date High-Quality The
Teaching
American
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Self-Evaluation
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An answer sheet, test questions and a comprehensive syllabus are included with your package. After you have worked through the test, return your answer sheet to ACR before the scoring deadline. A category I credit and test score certificate will be sent to all program participants. Emphasis various
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Mail th cwder form along with yir paynnt to ACR, P.O. Box 2348, Merrificld, VA 22116.238. Fc Faster Service CALL 1-800-227-7762, or FAX y*ir order to 1.800.832-9227, 1.703.648.9176. . Reskknts must send oo( of res1ency accompanied by signanire of their przn director.
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to purchaser.
Publishers’
Row Diagnostic
Cardiovascular Applications of Doppler Ultrasound Abdul-Majeed Salmasi, MD, PhD, FACA, and Andrew N. Nicolaides, MS, FRCS, editors 1990 #{149} Cloth #{149} 369 pages #{149} $150.00
Clinical
L.
Clinical A.H.W. 1 989
Principles
and
Digital Imaging in Diagnostic Radiology John D. Neweil, MD, and Charles A. Kelsey, PhD, FACR, editors 1990 #{149} Cloth #{149}163 pages #{149} $49.95
Chest Radiographic Analysis Norman Blank, MD 1989 #{149} Cloth #{149} 670 pages #{149} $125.00 Practice of Nuclear Medicine Andrew T. Taylor, Jr, MD, and Frederick Datz, MD, editors 1991 #{149}Cloth#{149}471 pages #{149}$89.95
Ultrasonics:
Use of Instruments. 3d ed W.N. McDicken 1 991 #{149} Cloth #{149} 367 pages #{149} $65.00
Radiobiology. 2d ed Nias #{149} Cloth #{149} 304 pages #{149} $59.00
Doppler Color Imaging. Christopher RB. Merritt, 1 992 #{149} Cloth #{149} 296 pages #{149} In preparation
Vol 27 MD, editor (approx)
Doppler Echocardiography: An Illustrated Clinical Guide Peter Wilde, MRCP, FRCR 1989 #{149} Cloth #{149} 153 pages #{149} $69.00
Ultrasound: Volume 1, Abdominal Hylton B. Meire, David 0. Cosgrove, Keith C. Dewbury, and Peter Wilde, editors 1992 #{149} Cloth #{149} 512 pages (approx) #{149} In preparation
Duplex Doppler Ultrasound. Vol 26 Kenneth J. W. Taylor, MD, PhD, FACP, and D. Eugene Strandness, Jr, MD, editors 1990 #{149} Cloth #{149} 182 pages #{149} $59.95
Ultrasound: Volume 2, General Hylton B. Meire, David 0. Cosgrove, Keith C. Dewbury, and Peter Wilde, editors 1992 #{149} Cloth #{149} 512 pages (approx)
1 990
Clinical
Clinical
Essentials J. Robert
of Neuroimaging Kirkwood, MD
Cloth
#{149}
Guide to Nuclear Medicine and Philip J.A. Robinson #{149} Cloth #{149} 1 48 pages (approx)
CT and MRI of the Thorax. Vol 11 Elias A. Zerhouni, MD, editor 1990 #{149} Cloth #{149} 222 pages #{149} $65.00
#{149} In preparation
CTIMRI of the Genitourinary Tract. Vol 13 Stanford M. Goldman, MD, PhD, and Olga MB. Gatewood, MD, editors 1990 #{149} Cloth #{149} 305 pages #{149} $79.95
1992 #{149} In preparation
1 992
Diagnosis and Therapy of Fetal Anomalies. Vol 25 John C. Hobbins, MD, and Bepyl R. Benacerraf, MD, editors 1 989 #{149} Cloth #{149} 324 pages #{149} $55.00 Diagnostic Imaging of the Premature Infant Rodrigo Dominguez, editor 1992 #{149} Cloth #{149} 288 pages #{149} $89.95
Diagnostic Radiology: An AngloAmerican Textbook of Imaging. 2d ed Ronald G. Grainger and David J. Allison, editors 1992 #{149} 2,760 pages #{149} $450.00 (3-vol set)
66A
Ultrasound Mittelstaedt #{149} 864 pages (approx)
A Glance at Transesophageal Echocardiography Rami A. Gal 1992
#{149} Videotape
$95.00
#{149} 1 hour
#{149} VHS
40
minutes
PAL $110.00
Guidelines on Patient Care Radiography. 2d ed Christine Gunn 1 992 #{149} Cloth #{149} 232 pages (approx) #{149} In preparation
Handbook of Breast Imaging. Vol 4 Mary Eilen Peters, MD, Kathleen Scanian, MD, and Dawn R. Voegeli, MD 1989 #{149} Cloth #{149} 344 pages #{149} $68.00 Handbook of Pediatric Lori L. Barr, MD, editor 1990 #{149} Cloth #{149} 482 pages
Videotape to accompany above text: Case Studies in Intravascular Ultrasound Imaging Jonathan M. Tobis and Paul G. Yock, editors 1992 #{149} Videotape #{149} 1 hour #{149} In preparation Manual of Mammography AK. Tucker, editor 1 992 #{149} Cloth #{149} 288 pages #{149} In preparation
(approx)
Neonatal and Pediatric Ultrasonography. Vol 24 Diane S. Babcock, MD, editor 1989 #{149} Cloth #{149} 251 pages #{149} $52.50 Nuclear Cardiovascular Imaging: Current Clinical Practice Milton J. Guiberteau, MD 1990 #{149} Cloth #{149} 248 pages #{149} $71.95 Procedures in Diagnostic Radiology Terence Doyle, MD, FRACR, William S.C. Hare, MD, FRACR, Kenneth Thomson, MB ,ChB, FRACR, and Brian Tress, MB, BS, FRACR 1989 #{149} Flexible binding #{149} 235 pages #{149}$33.00
General CarolA.
#{149} VHS
Intravascular Ultrasound Imaging Jonathan M. Tobis and Paul G. Yock, editors 1 992 #{149} 272 pages (approx) #{149} In preparation
#{149} $94.00
Clinician’s
L.K. Harding
CT Review Janet ES. Husband, editor 1989 #{149} Cloth #{149} 266 pages #{149} $50.00
pages
Gastroenterology.
#{149} In preparation
CT of the Immunocompromised Host. Vol 14 Janet E. Kuhlman, MD, editor 1990 #{149} Cloth #{149} 194 pages #{149} $54.00
#{149} 497
Imaging of the Thyroid and Parathyrold Glands: A Practical Guide Brian Eisenberg, MD, editor 1 990 #{149} Cloth #{149} 209 pages #{149} $59.95
Imaging
Radiology in the Management of Cancer Richard J. Johnson, Brian Eddleston, and Robin D. Hunter 1990 #{149} Cloth #{149} 472 pages #{149} $125.00 The Radiology of Skeletal Disorders. 3d ed Ronald 0. Murray, MBE, MD, FRCP, FRCR, DMR, FACR, FRACR, FFR, RCSI, Harold G. Jacobson, BSc, BM, MD, FACR, FRCR, and Dennis J. Stoker, MB, BS, FRCP, FRCR 1990 #{149}Cloth#{149}2,368pages #{149}$395.00 Radiology of Skeletal Trauma. Lee F. Rogers 1 992 #{149} 1 644 pages (approx) #{149} In preparation
2d ed
#{149} $115.00
Handbook of Vascular and Interventlonal Procedures Dyer et al. 1 992 #{149} 256 pages (approx) #{149} In preparation
Sectional Anatomy by MRI/CT Georges Y. El-Khoury, MD, Ronald Bergman, PhD, and William J. Montgomery, MD 1990 #{149} Cloth #{149} 732 pages #{149} $185.00
A.
Surface Anatomy: The Anatomical Basis of Clinical Examination John S.P. Lumiey, MS, FRCS, FMAA(Hon), FGA 1990 #{149} Flexible binding #{149} 104 pages #{149} $19.95
RADIOLOGY
MARCH
Publishers’
Row
Surgical Pathology of the Nervous System and Its Coverings. 3d ed Peter C. Burger, MD, Bernd W. Scheithauer, MD, and F. Stephen Vogel, MD 1991 #{149} Cloth #{149} 737 pages #{149} $145.00
Handbook of Orthopaedic Terminology Ray F. Kilcoyne, MD, and Edward L. Farrar, 1990 #{149} Cloth #{149} 168 pages #{149} $29.95 (D) #{149} $35.00 (F) #{149} Cat No. 3537
Transvaginal Ultrasound Melvin G. Dodson, MD, PhD 1991 #{149} Cloth #{149} 284 pages #{149} $69.00
Gynecology.
Handbook
of Ultrasound Vol 1 Kurjak, MD, PhD
Asim 1990 #{149} Cloth #{149} $1 90.00 (F)
Trauma Radiology James J. McCort, MD, editor 1990 #{149} Cloth #{149} 484 pages #{149} $120.00
Handbook Gynecology. Asim 1990
Kurjak,
pages #{149} $159.95 #{149} Cat. No. 3253
#{149} 384
of Ultrasound
and
#{149} $1
NJ
07006
and
59.95(D)
3254
lntraoperative Radiation Therapy Ralph R. Dobelbower, Jr, MD, and Mitsuyuke Abe, MD, editors 1989 #{149} Cloth #{149} 384 pages #{149} $159.95 #{149} $189.95 (F) #{149} Cat. No. 6846
The CIBA Color Atlas of Human Anatomy. I st ed Frank H. Netter, MD 1989 #{149} Cloth #{149} 576 pages #{149} $120.00 Musculoskeletal System, Developmental Disorders, Tumors, Rheumatic Diseases and Joint Replacement. Vol 8, Part II Frank H. Netter, MD 1990 #{149} Cloth #{149} 290 pages (approx) #{149} $58.50 (approx)
CRC
PRESS,
2000
Corporate
Boca
Raton,
(800) 272-7737 (407) 994-0563
FL
INC. Boulevard 33431 (Florida
NW
(D)
10016
Imaging
of the Lung
Putman,
editor #{149} Cloth #{149} 752 pages
Monoclonal Antibodies in Immunoscintigraphy Jean-Francois Chatal, MD 1989 #{149} Cloth #{149} 432 pages #{149} $199.00 (D) #{149} $235.00 (F) #{149} Cat. No. 4716
#{149} $165.00
Electron Microscopy of the Lung D.E. Schranufnagel, editor 1 990 #{149} Cloth #{149} 608 pages #{149} $175.00
Modern Imaging of the Liver: Applications of Computerized Tomography, Ultrasound, Nuclear
Medicine and Magnetic
Resonance
Imaging MA. Wilson and F.F. Ruzicka, editors 1989 #{149} Cloth #{149} 616 pages #{149} $165.00
ELSEVIER
SCIENCE
PUBLISHING
Medical Management of Radiation Accidents Fred A. Mettler, Jr, MD, Charles A. Kelsey, PhD, and Robert C. Ricks, PhD, editors 1989 #{149} Cloth #{149} 400 pages #{149} $1 19.95 (D) #{149} $140.00 (F) #{149} Cat. No. 4865
INC.
COMPANY,
INC. 655
Avenue
NewYork,NY
(212)
of the Americas 10010
633-3837
Abnormal Fetal Growth Michael V. Divon 1991 #{149} Cloth #{149} 387 pages Magnetic
Resonance
#{149} $64.00
Imaging
Techniques Ajay M. Parikh, MD 1991 #{149} Cloth #{149} 349 pages
#{149} $56.00
only)
Antitumor Drug-Radiation Interactions Bridget T. Hill, PhD, and Angela S. Bellamy, PhD 1989 #{149} Cloth #{149} 304 pages #{149} $149.95 (D) #{149} $175.00 (F) #{149} Cat. No. 4620
Radiation Hormesis T.D. Luckey 1991 #{149} Cloth #{149} 256 pages #{149} $139.00 #{149} $165.00 (F) #{149} Cat. No. 6159
(D)
Creative Thinking and Problem Solving John Fabian 1990 #{149} Paper #{149} 200 pages #{149} $45.00 (D) #{149} $54.00 (F) #{149} Cat. No. L153
Radiopharmaceuticals and Brain Patholwith PET and SPECT Mirko Diksic, PhD, and Richard C. Reba, MD, editors 1990 #{149} Cloth #{149} 440 pages #{149} $195.00 (D) #{149} $230.00 (F) #{149} Cat. No. 4863
Dictionary/Handbook of Nuclear cine and Clinical Imaging Mario P. Iturralde,MD, editor 1989 #{149} Cloth #{149} 408 pages #{149} $95.00 #{149} $1 19.00 (F) #{149} Cat. No. 3233
3-D Imaging in Medicine Jayaram K. Udupa, PhD, and Gabor T. Herman, PhD, editors 1990 #{149} Cloth #{149} 368 pages #{149} $1 10.00 (0) #{149} $130.00 (F) #{149} Cat. No. 4294
ogy Studied
Effective Expert Witnessing Jack V. Matson 1990 #{149} Cloth #{149} 145 pages #{149} $55.00 #{149} $66.00 (F) #{149} Cat. No. L297 Functional Imaging in Movement Disorders W.R. Wayne Martin, MD, FRCPC, 1990 #{149} Cloth #{149} 280 pages #{149} $149.95 #{149} $175.00 (F) #{149} Cat. No. 5837
MA RCH
MadIson
(800) 228-1160 (2 12) 696-9000
1990
Image Reconstruction In Radiology J. Anthony Parker, MD, PhD 1990 #{149} Cloth #{149} 560 pages #{149} $1 19.95 (D) #{149} $139.95 (F) #{149} Cat. No. 150
Drive
Avenue
CE.
CIBA
14 Henderson West Caidwell, (800) 631-1181
DEKKER,
270
Diagnostic
(D)
In Obstetrics
#{149}
MARCEL NewYork,NY
Vol 2 MD, PhD
Cloth #{149} 384 pages #{149} $190.00 (F) #{149} Cat. No.
MEDICAL EDUCATION DIVISION
in Obstetrics
MD
Mcdi-
(D)
(D)
editor (D)
Tomographic Methods in Nuclear Mcdicine: Physical Principles, Instruments, and Clinical Applications Bhagwat D. Ahluwalia, PhD, editor 1989 #{149} Cloth #{149} 288 pages #{149} $149.95 (0) #{149} $1 75.00 (F) #{149} Cat. No. 6198 Ultrasound and Infertility Asim Kurjak, MD, PhD 1989 #{149} Cloth #{149} 240 pages #{149} $1 19.95 #{149} $140.00 (F) #{149} Cat. No. 4766
RADIOLOGY
Transvaginal Sonography. 2d ed han Timor-Tritsch and Shraga Rottem 1991 #{149}Cloth#{149}521 pages#{149}$65.00
FUTURA COMPANY,
PUBLISHING INC.
2 Bedford
Ridge Road P.O. Box 330 Mount Kisco, NY 10549 (800) 871-8761 #{149} (914) 666-7528 Telefax (914) 666-0993 Angiocardiography
in Congenital
Heart
Malformations Benigno Soto, MD, and Albert D. Pacifico, MD 1990 #{149} Cloth #{149} 680 pages #{149} $175.00 Cardiac Applications of Digital Angiography Alan G. Wasserman, MD, and Allan M. Ross, MD, editors 1 989 #{149} Cloth #{149} 320 pages #{149} $53.00
(0)
67A
Publishers’
Row CT and MR Imaging of the Pediatric Kenneth D. Hopper, MD
Clinical
Atlas of Transesophageal Echocardiography Martin Goldman, MD 1992 #{149} Cloth #{149} In preparation
1991
Orbit
Paper#{149} In preparation
#{149}
Imaging Correlation with Histology of Parathyroid Adenomas Gerard W. Moskowitz, MD 1991 #{149} Paper #{149} In preparation
Sectional Human Anatomy. 2d ed Man-Chung Han, MD, and Chu-Wan MD 1989 #{149} Cloth #{149} 240 pages #{149} $74.50
Kim,
Diagnostic Complications of Cardiac Catherization and Angiography: Prevention and Management Jack Kron, MD, and Mark J. Morton, MD. editors 1989
#{149} Cloth
Digital
#{149} 408
pages
Subtraction
and Children EN. Faerber, 1989 #{149} Cloth
Liver Tumors: Multidisciplinary Management W. John B. Hodgson, MD 1991 #{149} Cloth #{149} 250 pages #{149} $47.50
#{149} $55.00
Imaging
in Infants
MRI of the Thorax M. Sperber, MD, and MC.
MD #{149} 208
pages
#{149} $42.00
1991
Hans 1991
#{149}Cloth#{149}4l6pages#{149} $150.00
Signs
Videotape,
#{149} $95.00
Book
Sections and
1 and
Emission
Tomography
of the
Principles of Biliary Lithotripsy Alexander S. Cass, MBBS, and LeRoy Stahlgren, MD, editors 1989 #{149} Cloth #{149} 1 12 pages #{149} $25.00
H.
Ultrafast Computed Tomography in Cardiac Imaging: Principles and Practice William Stanford, MD, and John A. Rumberger, MD, editors 1 992 #{149} Cloth #{149} 368 pages #{149} $80.00
H.
GREEN,
INC.
8356
Olive Boulevard St. Louis, MO 63132 (314) 991-1335 Avoidance Syndrome Douglas H. Ruben, PhD In preparation
Computed Tomography Carol R. Archer, MD 1 991 #{149} Paper #{149} 200 pages #{149} $37.50
(approx)
Pediatric
Head Injuries
Avenue, 20814
MD
800
657-2652
MD
Therapy
Clinical Neutron Dosimetry. Part 1 Determination of Absorbed Dose in a Patient Treated by External Beams of Fast Neutrons ICRU Report 45 1990 #{149} Paper #{149} 90 pages #{149} $18.00 Photon, Electron, Proton and Neutron Interaction Data for Body Tissues ICRU Report 46
Handbook #{149} $24.50
1 992
of the Larynx (approx)
MEDICAL INC.
#{149} Paper
#{149} 205
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pages
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#{149} 328
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1990
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Radiation Therapy (1338) Ultrasound (5013) Upper GI Endoscopy (5006) 1990 #{149} Paper #{149} 16 pages
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Panoramic Radiology. 2d ed Olaf E. Langland, DDS, Robert P. Langlais, DOS, W. Doss McDavid, PhD, and Angelo M. Del Balso, MD, DDS 1989 #{149} Cloth #{149} 440 pages #{149} $65.00
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#{149}
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Textbook of Color Doppler Echocardiography Navin C. Nanda, MD 1 989 #{149} Cloth #{149} 359 pages #{149} $125.00 Urinary Calculi: ESWL, Endourology, and Medical Therapy James E. Lingeman, MD, Lynwood H. Smith, MD, John R. Woods, PhD, and Daniel M. Newman, MD 1989 #{149} Cloth #{149} 460 pages #{149} $55.00 The Visible Human Body: An Atlas of Sectional Anatomy G. Von Hagens, MD, L.J. Romrell, PhD, Michael Ross, PhD, and K. Tiedemann, PhD 1991 #{149} Cloth #{149}151 pages #{149} $49.95
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Radiology: Diagnosisllmagingl Intervention Loose Leaf Reference. 5 VoIs Juan M. Taveras, MD, and Joseph I Ferrucci, Jr, MD, editors 1990 #{149} 5,400 pages (approx) #{149} $550.00 #{149} Annual revision service $85.00 Radiology of Bone Disease. 5th ed George Greenfield, MD, FACR 1990 #{149} Cloth #{149} 962 pages #{149} $125.00
Atlas of Radiologic Imaging E. George Kassner, MD 1989 #{149} Cloth #{149} 688 pages #{149} $210.00 #{149} (2-vol set)
Breast Imaging Daniel B. Kopans, 1989 #{149} Cloth #{149} 416
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Atlas of Interventional Radiology Constantin Cope, MD, Dana Burke, and Steven Meranze, MD 1990 #{149} Cloth #{149} 234 pages #{149} $110.00
Manual
A Business
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Doppler Ultrasound in Cardiology: Physical Principles and Clinical Applications. 3d ed Liv Hatle, MD, and Bjorn Angelsen, Dr Techn 1991 #{149} Cloth #{149} 340 pages (approx) #{149} In preparation
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Clinical Magnetic Resonance Imaging Val M. Runge, MD 1990 #{149} Cloth #{149} 640 pages #{149} $110.00
#{149} $45.00
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Clinical Sonography. 2d ed Roger Sanders, MA, BM, BCh (Oxon), MRCP, FRCP 1991 #{149} Paper #{149} 395 pages (approx) #{149} $47.50
in Radiology #{149} $49.00
Diagnostic Radiology 1989 Alexander Margulis, MD, and Charles Gooding, MD 1989 #{149} Cloth #{149} 580 pages #{149} $99.00
Emergency Interventional Radiology M. Pinson Neal, MD, Jaime Tisnado, MD, and Shao-Ru Cho, MD 1 989 #{149} Cloth #{149} 444 pages #{149} $97.00
Diagnostic Radiology 1990 Alexander Margulis, MD, and Charles Gooding, MD 1 990 #{149} Cloth #{149} 600 pages #{149} $99.00
Essentials of Uroradiology E. Stephen Amis, Jr, MD, and Jeffrey Newhouse, MD 1991 #{149} Cloth #{149} 427 pages #{149} $85.00
Gastrointestinal Radiology: A Pattern Approach. 2d ed Ronald L. Eisenberg, MD 1989 #{149} Cloth #{149} 896 pages #{149} $135.00
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Radiology: A Multimodality Approach Rosalyn Kutcher, MD, Everett Lautin, and E. George Kassner, MD 1990 #{149} Cloth #{149} 296 pages #{149} $95.00
Magnetic Resonance Imaging of the Musculoskeletal System Javier Beltran, MD 1 990 #{149} Cloth #{149} 335 pages (approx) S In preparation MRI: Central Nervous System Walter Kucharczyk, MD, FRCP(C) 1990 #{149} Cloth #{149} 288 pages #{149} $79.50
MD,
H.
Imaging 1990 Fred A. Mettler, Jr, MD, MPH 1 990 #{149} Cloth #{149} 275 pages #{149} $90.00 Manual of Diagnostic Imaging: A Clinician’s Guide to Clinical Problem Solving. 2d ed William H. Straub, MD 1989 #{149} Spiral binding #{149} 373 pages #{149} $26.50 MRI of the Pelvis Marcia C. Fishman, MD, John L. Lovecchio, MD, and Harry L. Stein, MD 1 990 #{149} Cloth #{149} 272 pages #{149} $85.00
Musculoskeletal Bone Imaging John A. Markisz, MD, editor 1991w Cloth #{149} 432 pages #{149} $85.00
(approx)
Radiographic Measurements Robert Rosenberg, MD 1989 #{149} Paper #{149} 1 12 pages #{149} $16.50
RAII0LOGY
MARCH
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Pediatric Bone Imaging: A Practical Approach Saroosh Mahboubi, MD, editor 1989 #{149} Cloth #{149} 215 pages #{149} $85.00
MRI of MS and White Matter Murray A. Solomon, MD 1990 #{149} Videotape #{149} $125.00 MRI of Stroke and Hemorrhage Murray A. Solomon, MD 1992 #{149} Videotape #{149} $125.00
A Practical
Guide to Echocardiography and Cardiac Doppler Ultrasound Ibrahim A. Jawad, MD, FACC 1 990 #{149} Paper #{149} 1 50 pages #{149} $42.00
and Practice
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Radiographic Positioning Ronald L. Eisenberg, MD, Cynthia RT, and Chris May, RT 1989 #{149} Cloth #{149} 385 pages #{149} $75.00
1991
Dennis,
Echocardiography MD, and Norbert P.
#{149}Cloth#{149}2o8pages
Understanding MRI Jeffrey Newhouse, MD, and Jonathan Weiner, MD 1991 #{149} Cloth #{149} 175 pages (approx) #{149} $42.50 Video Atlas of Two-Dimensional Flow Doppler Echocardiography George M. Gura, Jr, MD 1 989
Cloth (Color Atlas)
#{149}
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MAGNETIC VIDEO 1633
hours)
#{149} 1 80
Bayshore
pages
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Dr. . Suite 94010
Available in all formats international) Marketing an MRI Center: Guide Murray A. Solomon, MD 1 989 #{149} Videotape #{149} $125.00
A Complete
Principles
of Internal
Mcdi-
12th ed
Jean D. Wilson, MD, Eugene Braunwald, MD, Anthony S. Fauci, MD, Kurt J. Isselbacher, MD, Joseph B. Martin, MD, Robert G. Petersdorf, MD, and Richard K. Root, MD 1991 #{149} Cloth #{149} 2,218 pages #{149} $95.00 (1-vol ed) #{149} $120.00 (2-vol set)
MD #{149} $125.00
MRI of the Sella and Parasellar Murray A. Solomon, MD 1989 #{149} Videotape #{149} $125.00
Region
MRI of the Shoulder Murray A. Solomon, MD 1992 #{149} Videotape #{149} $125.00 MRI of the Skull Base Murray A. Solomon, MD 1992 #{149} Videotape #{149} $125.00 MRI Physics and Instrumentation Murray A. Solomon, MD 1991 #{149} Videotape #{149} $125.00
Harrison’s Principles of Internal Mcdicine. 12th ed. Companion Handbook Jean D. Wilson, MD, Eugene Braunwald, MD, Anthony S. Fauci, MD, Kurt J. lsselbacher, MD, Joseph B. Martin, MD, Robert G. Petersdorf, MD, and Richard K. Root, MD 1991 #{149} Paper #{149} 880 pages #{149} $25.00 The Heart. 7th ed J. Willis Hurst, MD, Robert C. Schlant, Charles E. Rackley, MD, Edmund H. Sonnenblick, MD, and Nanette Kass Wenger, MD 1990 #{149} Cloth #{149} 2,400 pages #{149} $1 15.00 (1-vol ed) Imaging
of Athletic
Injuries:
MD,
A Multi-
modality Approach
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cine.
320
(including
MRI of Brain Tumors, Part I Murray A. Solomon, MD 1990 #{149} Videotape #{149} $125.00
MARCH
Color
RESONANCE REVIEW
Burlingame. CA (408) 925-8328
I.
Gastrointestinal Radiology Branko Plavsic, MD, Arvin E. Robinson, MD, and R. Brooke Jeffrey, Jr., MD 1992 #{149} Cloth #{149} 577 pages #{149} $89.00 (approx)
Harrison’s
MRI of the Lumbar Spine Murray A. Solomon, MD 1991 #{149} Videotape #{149} $125.00
#{149}$95.00
#{149} $85.00
and Gilmans The Pharmacological Basis of Therapeutics. 8th ed Alfred Goodman Gilman, MD, PhD, Theodore W. Rail, PhD, Alan S. Nies, MD, and Palmer Taylor, PhD 1 990 #{149} Cloth #{149} 1 81 1 pages #{149} $89.50
MRI of the Foot and Ankle Murray A. Solomon, MD 1 989 #{149} Videotape #{149} $125.00 MRI of the Knee Murray A. Solomon, 1992 #{149} Videotape
File Approach
Goodman
MRI of the Cranial Nerves Murray A. Solomon, MD 1992 #{149} Videotape #{149} $125.00
Gerald M. Pohost and Robert A. O’Rourke, MD 1991 #{149} Cloth #{149} 880 pages #{149} $175.00
Transesophageal Fiona Clements, de Bruijn, MD
Spines
of Cardiovascular
Imaging
Cranial MRI and CT. 3d ed S. Howard Lee, MD, Krishna C. V.G. Rao, MD, and Robert A. Zimmerman, MD 1991 #{149} Cloth #{149} 800 pages #{149} $150.00 Cranial MRI: A Teaching John Bisese, MD 1991 #{149} Cloth #{149} 382 pages
MRI of the Brainstem Murray A. Solomon, MD 1990 #{149} Videotape #{149} $125.00
Practical Pediatric Imaging. 2d ed Donald R. Kirks, MD 1 991 #{149} Cloth #{149} 800 pages (approx) #{149} $150.00 Principles
Disease
Order
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Services
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Applied Screen Film Mammography Gini Wentz, RT, and Ward C. Parsons, MD 1992 #{149} Paper #{149} 160 pages #{149} $32.00 (approx) Cardiac Nuclear Medicine Myron C. Gerson, MD 1991 #{149} Cloth #{149} 653 pages
#{149} $90.00
Clinical Doppler Echocardiography: Spectral and Color Flow Imaging Jose Missri, MD 1 990 #{149} Cloth #{149} 336 pages #{149} $80.00
RADIOLOGY
Interventional Radiology Renan Uflacker, MD 1991 #{149} Cloth #{149} 640 pages
#{149} $149.00
Mammographic Interpretation: A Practical Approach Marc J. Homer, MD 1 991 #{149} Cloth #{149} 368 pages #{149} $90.00 MRI Atlas of Normal Anatomy Anna K. Chacko, MD, Richard W. Katzberg, MD, and Aileen Mackay, MSR 1991 #{149} Paper #{149} 320 pages #{149} $79.00
71A
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MRI:
Row
A Teaching
File
MD #{149} 384
pages
#{149} $85.00
Pharmaceuticals in Medical Imaging Dennis P. Swanson, RPh, MS, Henry M. Chilton, PharmD, and James H. Thrall, MD 1990 #{149} Cloth #{149} 736 pages #{149} $95.00 Radiation Therapy Gunilla C. Bentel 1991 #{149} Paper #{149} 352
Atlas of Planar and SPECT Bone Scans Ignac Fogelman, MD, and B. David Collier, MD 1989 #{149} Cloth #{149} 320 pages #{149} $149.00 #{149} CV. Mosby/Martin Dunitz Publication
Planning
Pelvic Imaging: and MRI Arnold C. Friedman, MD 1989 #{149} Cloth #{149} 546 pages
An Atlas of Radiological Interpretation: The Bones J.F. Calder, FRCR, and G. Chessell, MEd 1 989 #{149} Cloth #{149} 286 pages #{149} $59.95 #{149} (Americas
pages
Clinical
An
Only)
Atlas of Roentgenographic ment. 6th ed Theodore E. Keats, MD 1991 #{149} Cloth #{149} 721 pages Atlas
of Ultrasonographic 2d ed Roger Sanders, MD 1 991 #{149} Cloth #{149} 256 pages
Measure-
#{149} 380
pages
File Approach
#{149} $95.00
Artifacts
and
#{149} $90.00
(approx)
Atlas of Ultrasound Measurements Barry B. Goldberg, MD, and Alfred MD 1 990 #{149} Cloth #{149} 477 pages #{149} $85.00
B. Kurtz,
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AFIP Atlas of Radiologic-Pathologic Correlation. Fascicle II. Cartilaginous Lesions of the Bone Richard Moser, Jr, MD 1990 #{149} Cloth #{149} 221 pages #{149} $50.00 & Belfus
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Atlas of Normal Roentgenographic Variants That May Simulate Disease. 5th ed Theodore E. Keats, MD 1991 #{149} Cloth #{149} 1,356 pages (approx) #{149} $169.00
72A
Cloth
#{149}
#{149} 302
pages
#{149} $94.95
of the Chest
#{149} $65.00
Current Practice of Interventional Radiology Sadoon Kadir, MD 1991 #{149} Cloth #{149} 779 pages #{149} $149.00 Publication
MD
Diagnostic Imaging in Emergency Medicine Peter Rosen, MD, et al 1991 #{149} Cloth #{149} 640 pages #{149} $115.00
Caffey’s Pediatric X-ray Diagnosis. 9th ed Frederic N. Silverman, MD, and Jerald P. Kuhn, MD, et al 1 992 #{149} Cloth #{149} 2,000 pages #{149} $300.00 #{149} (2-vol set)
Diagnostic Ultrasound Carol Rumack, MD, Stephanie Wilson, MD, and William Charboneau, MD 1991 #{149} Cloth #{149} 1 ,400 pages (approx) #{149} $225.00
Cardiovascular Magnetic Resonance Imaging Fernando Gutierrez, MD, Jeffrey J. Brown, MD, and Scott A. Mirowitz, MD 1991 #{149} Cloth #{149} 238 pages #{149} $99.00
Diagnostic Ultrasound of Fetal Anomalies David A. Nyberg, MD, Barry S. Manhony, MD, and Dolores H. Pretorius, MD 1990 #{149} Cloth #{149} 791 pages #{149} $162.00
Cartilaginous Tumors of the Skeleton (AFIP Atlas of Radiologlc-Pathologic Correlation. Fascicle II) Richard P. Moser, Jr, MD. COL, MC
Emergency Radiology. Theodore E. Keats, MD 1989 #{149} Cloth #{149} 526 pages
1990#{149}Cloth#{149} 221
Enhanced MR Imaging Val M. Runge, MD 1989 #{149} Cloth #{149} 367 pages
#{149} Hanley
& Belfus,
pages#{149}$50.00
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Chesney’s Radiographic Imaging. J. Ball, TDCR, and I Price, HDCR, 1 989 #{149} Cloth #{149} 400 pages #{149} $34.95
5th ed editors
Chest Radiology: Plain Film Patterns Differential Diagnoses. 3d ed James C. Reed, MD 1991 #{149} Cloth #{149} 434 pages #{149} $75.00
and
Brain Imaging: Normal Structure and Functional Anatomy L. Anne Hayman, MD, and Vincent C. Hinck, MD 1 992 #{149} Cloth #{149} 284 pages (approx) Clinical
(approx)
Atlas of Nuclear Medicine: Artifacts and Variants. 2d ed U. Von Ryo, MD, Abass Alavi, MD, B. David Collier, MD, Carlos Bekerman, MD, and Steven M. Pinsky, MD 1 990
pages
II
Lithotripsy
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Advances in Hepatobiliary Radiology Joseph Ferrucci, MD, and Didier G. Mathieu, MD 1990 #{149} Cloth #{149} 460 pages #{149} $95.00
#{149} Hanley
Oncology
Cross Sectional Analysis and Abdominal Wall Richard J. Wechsler, MD 1989 #{149} Cloth #{149} 359 pages
#{149} B.C. Decker Biliary
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Clinical Radiation CC. Wang, MD 1989 #{149} Cloth #{149} 480
#{149} $85.00
Treatment Planning and Dose Calculation in Radiation Oncology. 4th ed Gunilla C. Bentel, Charles E. Nelson, PhD, and K. Thomas Noeil, MD 1 989 #{149} 352 pages #{149} Paper #{149} $25.00
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Clinical Positron Emission Tomography Karl F. Hubner, MD, et al 1991 #{149} Cloth #{149} 336 pages #{149} $125.00
Comprehensive Radiographic Pathology Ronald L. Eisenberg, MD, and Cynthia A. Dennis, MD 1990 #{149} Cloth #{149} 393 pages #{149} $39.95
Variants. A Teaching MD
#{149} $98.00
#{149} $25.00
Radiographic Neuroanatomy: A Working Atlas Harry W. Fischer, MD, and Leena Ketonen, MD 1991 ‘Paper#{149}224pages #{149}$35.00 Spinal MRI: John Bisese, 1991 #{149} Cloth
CT, Ultrasound,
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$99.00
(approx)
2d ed #{149} $110.00
#{149} $75.00
Essentials of Caffey’s Pediatric X-ray Diagnosis Frederic N. Silverman, MD, and Jerald Kuhn, MD 1989 #{149} Cloth #{149} 1,170 pages #{149} $139.95 The Fracture Classification Ramon B. Gustio, MD 1991 #{149} Paper #{149} 186 pages
Manual #{149} $45.00
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$95.00
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Handbook of Neuroradiology Anne G. Osborn, MD 1991 #{149}Paper#{149}411 pages #{149}$36.95 Handbooks In Radiology - Chest Radiology Howard Mann, MD, and David G. Bragg, MD 1989 #{149} Cloth #{149} 255 pages #{149} $24.95 Handbooks in Radiology Neck Imaging H. Ric Harnsberger, MD 1 990 #{149} Paper #{149} 563 pages
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Magnetic Resonance Imaging of the Extremities: A Teaching File Leanne Seeger, MD, Vijay Chandnani, MD, and Richard Gold, MD 1 992 #{149} Cloth #{149} 320 pages (approx) #{149} $75.00 (approx)
Head and
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Imaging of AIDS P.M. Trotot,MD 1991 #{149} Cloth #{149} 304 pages
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MD
#{149} $89.00
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MD
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Radiology: Pattern and Differential Diagnosis Peter Renton, FRCR, DMRD 1 989 #{149} Cloth #{149} 31 2 pages #{149} $69.95
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Imaging of Children with Cancer Mervyn D. Cohen, 1991 #{149} Cloth #{149} 756
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#{149} $29.95
Handbooks in Radiology - Interventional Radiology and Angiography Myron Wojtowycz, MD 1990 #{149} Paper #{149} 441 pages #{149} $29.95 Head Peter 1991
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Endoscopy
and
Radiology. 2d ed John R. Bennett, MD, FRCP, and Richard H. Hunt, FRCP, FRCPEd, FRCPC 1990 #{149} Import #{149} 456 pages #{149} $120.00 Two-Dimensional Echocardiography and Cardiac Doppler. 2d ed Jay N. Schapira, MD, FACC, FACP, John G. Harold, MD, FACC, FACP 1990 #{149} Cloth #{149} 670 pages #{149} $105.00
and
Ultrasonography of the Urinary Tract. 3d ed Martin I. Resnick, MD, and Matthew D. Rifkin, MD 1991 #{149} Cloth #{149} 450 pages #{149} $95.00
Clinician
RaymondL. Powis, Schwartz, MD 1991 #{149} Casebound
PhD, and RobertA. #{149} 208
pages
#{149} $55.00
set)
Primer Interventional Ultrasound John P. McGahan, MD 1 989 #{149} Cloth #{149} 352 pages
of Sectional
Anatomy
with MRI
Workbook for MRI and CT of the Head and Neck. 2d ed Anthony Mancuso, MD, Ric Hamsberger, MD, and William Dillon, MD 1 989 #{149} Paper #{149} 250 pages #{149} $60.00
and CT Correlation $62.00
#{149}
Char/es P. Barrett, MD, and Lawrence 1990
82A
Approach
Irwin M. Freundlich, MD, and David Bragg, MD 1991 #{149} Cloth #{149} 572 pages #{149} $95.00
Therapeutic
#{149} $68.00
Imaging
1990
A Radiologic the Chest
pages
set)
Fundamentals of MRI Donald W. Chakeres, MD, and Petra Schmalbrock, PhD 1991
The Language of Fractures. 2d ed Robert J. Schultz, MD, FACS 1990 #{149} Cloth #{149} 372 pages #{149} $52.00
#{149} Paper
PhD, Steven J. Pollakoff, E. Holder, MD #{149} 128 pages #{149} $24.00
RADIOLOGY
Workbook for Quality Mammography Carolyn Kimme-Smith, PhD, Lawrence W. Bassett, MD, and Richard H. Gold, MD 1991 #{149} Paper #{149} 215 pages #{149} $60.00
MARCH
Moving? CT SCANNERS
FOR
SALE
Send
TECHNICARE
us your NEW address before you move
2060, 20600, I44OHPS ELSCINT 2002 SOMATOM 2 DR3 DRH
MRI
Send us a letter, card or Post Office change-ofaddress Indicate
present
corrections
label
with
G E TECHNICARE
form. and
your
us. Only
your
first
class
to your
new
At least five weeks Please
SIEMENS
PUCK
SIEMENS
your
move, X-RAY
notify-
and Subscription
.,
.. ,
OR
EQUIPMENT AOT
FILM CHANGERS
OR PHILIPS MOBILE C ARMS WITH TV MAMMOGRAPHY UNITS :
.. . .
:
.
.. .
...
,.. ,
SECTOR AND DOPPLER ULTRASOUND. GENERATORS, TUBES, TABLES AND IMAGE SYSTEMS LINEAR,
CASH
Dues
,,
90/90
PHILIPS DIAGNOST 73 SIEMENS SIREGRAPH B (1983) SIRESCOP 3 & OPTOMATIC GENERATOR.
OTHER
is forwarded
address.
before
R&F SYSTEMS
G E DXS 650 MONITROL
to
,
FONAR AND SIEMENS
G.E. RFX 90/90
return
:
SYSTEMS PICKER
COMPLETE
address
new
...
2020,
SIEMENS
...
& LEASE
G.E. 8800, 9800
PAID FOR USED
EQUIPMENT
Dept.
ThE RADIOLOGICAL SOCIETY OF NORTh AMERICA, INC. 1991
Northampton
Easton, Pennsylvania
MARCH
St. I 8042
RADIOLOGY
83A
ThINKOFUSASA PART-TIMEMEDICALPRACTiCEWITh FULL-TIMEHOBBIES. Time.
It’s what
enjoy
your
much
or as little
premiums
backhand career,
all physicians
pastimes
and
radiology
as much as you
costly
to more
wish
time doesn’t
on life as a CompHealth
like
have locum
had
as your
practice.
in places
where
overhead. with
they
And
your
84A
your
expertise
to pursue
It should
to be a full-time physician,
We now work with
of. Fortunately
CompHealth
freedom
family.
tenens
more
sound
there’s
represents
other quite
where
Freedom
Freedom
passions-from tempting.
call 1-800-328-3084.
RADIOLOGY
freedom.
is appreciated.
job. For information
technokglsts,
CompHealth,
can
to practice
as
from
trips
After
you
malpractice
abroad
to your
all, at this point
in your
CornpHeaU’h T
1
5
t’
S
t C
t
A
N
C
R
0
U
P
tool Call today for details. MARCH
RadLoogy
CLASSIFIED
SERVICES
POLICY As
service
a
made
to its readers,
to ensure
ries include
that
for
employment and residents, ment considered since
RATES
the
positions
facilities
we
RADIOLOGY ads
are
relevant
available, malpractice
the
are offers
right
is
catego-
for sale, medical
apparatus available
for sale, medical posts for interns
to refuse
advised or claims
effort
Acceptable
practices
and filled,
We retain
respondents for the
and every
of radiology.
fellowships,
equipment posts to be
insurance.
(Per insertion) 50 words or less-$70.00 51-100 words - $105.00 Each word over 100 - $0.95 per Box Number-$20.00 additional
advertising
practice
sought,
radiological academic
not relevant, and assume responsibility
cannot
classified
to the
positions
rent or sale, used bureau advertising,
and
accepts
any
to investigate of advertisers.
advertiseeach
offer
sor
word.
per each
insertion
(this
service
is optional).
TERMS Payment
must
North
accompany
America,
Inc.
order.
Make
Advertisers
who
checks
cancel
payable
to the
ads will
not
Radiological
receive
Society
of
refunds.
must ad
be copy
received typed
by the 20th of the second and double-spaced.
DISPLAY
CLASSIFIED
customer
supplied
negative
Customer
supplied
customer
supplied
cost
mechanical
-
copy
to be
set
1/4
or
lx
(3/’
and
X
18X
$715.00
$570.00
24X 36X
$680.00 $655.00
48X
$630.00
$540.00 $520.00 $500.00
(215)
ad
-
prepared
20%
43/4M
1/9 page (2/4” X 3/4’)
or
X 2/8)
4’/?
equal
one
Production
word.
Telephone
UNIVERSITY OF CHICAGO seeks academic radiologists with a special interest CT,
ul-
trasound, body MRI, Cl/CU and mammography. The Department has been reequipped during the past few years and replacements/upgrades of equipment continue.
Interested
call or forward ton, Box
Chairman,
BC/BE
their
applicants
nity
Department
Lip-
of Radiology, Chicago,
312-702Opportu-
Employer.
RADIOLOGIST-Part approximately 6 hours nights
PPM, 204B, 358-8113.
MARCH
should
CV to: Dr. Martin
429, 5841 S. Maryland Ave., IL 60637 (312-702-6024, FAX 1 161). Affirmative Action/Equal
or
calls
on
Inc., 1075 Kingwood,
time position, per weekday. No
weekends.
These
$275.00
tional
procedures.
$260.00 $250.00 $240.00
strong
interest
Production
Department
Manager
numbers
with
area
code
equal
one
Send
CV,
Kingwood Dr., Suite Texas 77339. Tel. (713)
word.
RADIOLO-
GIST-Large Radiology group in the Southeast is seeking a board certified, fellowship trained radiologist to join our practice. Referral base includes extremely active orthopedic group with internationally recognized sports medicine institute. Opportunity for research available if desired. Should also have interest in general diagnostic radiology. State-ofthe-art equipment including GE 1.5T Signa MRI (3D capability), GE 9800 HiLite CT, LU digital angiography suite, digital fluoroscopy and SPECT nuclear medicine cameras. Please send letter of interest and CV to Box R-3206.
RADIOLOGIST NEEDED FOR SOUTHEASTERN OHIO, $160,000-$180,000This area is known as the little Switzerland of Ohio with rolling hills, lakes, streams, and wooded areas. Great area to raise a family, thirty minutes from city. Hospital based practice with CT scanner, cross coverage, employment or independent contractor. Call 800/255-4419.
RADIoLoGY
are
tenure-
radiology,
CT,
MRI,
Section
provide
a
wide variety of case material in all interventional procedures-vascular, biliary, urology-with use of investigational devices such as C02, angioscopy, atherectomy and holmium lasers. Angiographic suites are available and an animal laboratory with veterinarian and instrument shop. The staff position in thoracic imag-
$375.00
MUSCULOSKELETAL
including,
skeletal
$305.00 $295.00 $285.00
$360.00 $340.00
AVAILABLE
imaging
level.
MR spectroscopy, metabolic bone disease, TMJ pathology and image processing. Active clinical and academic programs in the
$450.00 $430.00 $410.00 $395.00
250-7287
or abbreviations
abdominal
Please
page X
(2t/4M
add
RADIOLOGY Advertising 1991 Northampton Street Easton, PA 18042
INFORMATION Hockin, Advertising
POSITIONS
in
date.
10%
43/45)
$745.00
Lorraine
to publication
below
page
12X
FURTHER
Initials
add
$615.00 $590.00
ADDRESS FOR: AD COPY and BOX NUMBER REPLIES FOR
as noted
$640.00
$810.00 $775.00
6X
Professor
Angio/Interventional
-
X 43/4W)
4/2”
prior
ADS
1/6
page X 10”
1/3
(21/4”
month
and
track positions. An M. D. and Board certification or Board eligibility by the American Board of Radiology are required. Applicants must be eligible for licensure in the State of Florida. The Musculoskeletal Section includes clinical, research and teaching opportunities in diagnostic
DEADLINE Copy submit
THE DEPARTMENT OF RADIOLOGY AT THE UNIVERSITY OF FLORIDA IN GAINESVILLE-The Department is actively recruiting to fill three positions in the following subspecialties: Chest, Musculoskeletal and Angio/Interventional at the Assistant Professor, Associate Profes-
ing will dalities
be involved including
CT,
in all diagnostic moMRI and interven-
For in
teaching,
all
positions, patient
a care
as well as research is required. Systems available in the Department include: intravascular ultrasound, color-flow Dopplers, a new Toshiba Vascular Lab, angio suites with Philips C-arms and 1024 ADAC digital, a 1.5 T GE Advantage MRI with spectroscopy, a 1 .T Siemen Magnetom MRI, two GE 9800 Advantage CT scanners, three dimensional workstations, ICU electronic image display stations and Computed Radiography (CR) with an advanced PACS program. Application deadline for these positions is June 30, 1992 with a starting date as soon as possible thereafter. Applicants should send a CV to Jonathan Williams, M.D., Professor & Associate Chairman, Department of Radiology, University of Florida, Box 100374, JHMHC, Gainesville, Florida 32610-0374, Tel (904) 395-0291 . An Affirmative Action, Equal Employment Employer.
BC/BE DIAGNOSTIC RADIOLOGIST-Opportunity to join three man group in general radiology practice including all modalities (angio and interventional limited at this point). Hospital based with limited itinerant schedule. Generous salary leading to early partnership in prof. corp. Outstanding benefits with liberal fringes and vacation. Wonderful small midwestern community with great schools and bountiful cultural and recreational opportunities. Send CV to James P. Zachman, M.D., Radiology Dept., Rice Memorial Hospital, Wilimar, MN 56201 or call (612) 231-4530.
85A
INTERVENTIONAL
CLASSIFIED
SERVICES
sistant with
TWO
RADIOLOGY
terventionalist
General
Diagnosti-
cian. One of the most progressive hospital systems in the country is seeking a BE/BC Interventional Radiologist to join its 27-physician radiology department. There is ample opportunity for teaching and research. Utilizing state-of-the-art equipment, 60-80% angiography is possible, with two procedures per day with
CT, and
1-1 /2 days
for
general
ing. A General Diagnostic sition is also available with
film
read-
Radiology
po-
all modalities present including CT, DX, and MRI radiology. Excellent benefits package with a lucrative salary structure is available. For more information, please contact Michael Kirschner 1-800-327-1585.
GENERAL tablished sachusetts
RADIOLOGIST BC - Esprivate group in Western Masis seeking a general diagnostic with experience in CT, Ultra-
radiologist sound, MRI, and tional procedures.
nonvascular intervenPrimary assignment
is
at an 800 bed teaching hospital with diology residency program. Practice
a raalso
includes
and
three
community
hospitals
six private offices. Full partnership after one year. Available by July 1, 1992. Interested candidates should send CV’s to: W. Max Cloud, M.D., 130 Maple Street,
Springfield,
MA 01103.
level
bed
public
Cancer 60 bed
for
sites
hospital,
Hospital National Comprehensive
Departat as-
a radiologist
in Interventional
Clinical activity geles County/USC
POSITIONS-In-
and
professor interest
ABDOMINAL
RADIOLOGIST-
University of Southern California ment of Radiology has an opening
Radiology.
include Medical
the Center,
Kenneth
Los Ana 1500
Norris
Jr.
and Research Institute, a Cancer Institute desigCancer Center and
RADIOLOGIST-The
Department
of
Diagnostic
Radiology
of
the Montreal General Hospital, McGill University, has a position open for a Radiologist in Abdominal Imaging. Interest in interventional procedures and angiography would be an asset. The department is fully equipped with two new CT scanners, high field MRI, one new Angio
room
and
one
Interventional
room.
The
nated the new USC University Hospital, a 275 bed private facility. Experience or fellowship in interventional radiology is expected. Board Certification by ABR and eligibility for California licensure is
academic
mandatory.
Radiology. Please apply in writing to Dr. Patrice M. Bret, Department of Radiology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4.
submit
Interested
CV to James and Chairman,
fessor
applicants
should
M. Halls, M.D., ProDepartment of Ra-
diology,
LAC/USC Medical Center, 1200 North State Street, Box 329, Los Angeles, CA 90033. The University of Southern California is an Equal Opportunity/Affirmative Action Employer.
DIAGNOSTIC diate opening join
group
RADIOLOGIST-Immefor BC/BE Radiologist
of (8) in active
ing (2) hospitals
(480 beds)
practice
includ-
and
multispe-
to
cialty clinic. 1 10,000 examinations a year. Practice includes substantial CT, nuclear medicine, ultrasound, MRI, angiography and interventional. Located in pleasant community on Lake Michigan with easy access to Milwaukee and Chicago. Locums needed in interval. Contact Arnold Strimling, M.D., Dept. of Radiology, St. Mary’s Medical Center, 3801 Spring St., Racine, WI 53405. Phone 414-636-4311.
with
rank
will
be
the applicant’s
fications.
The
commensurable
experience
applicant
and
must
be
quali-
certified
by the Royal College of Physicians and Surgeons of Canada and have at least one year Fellowship training in Abdominal
OZARK MOUNTAINS-Immediate opening for recent American trained BC general radiologist, ideally with fellowship or interest in neuro/angio. Join group
of 4 in growing
ams.
Hospital
practice,
serves area population patient office being angio/interventional,
mammography, place.
ing and
of built.
a typical
city,
but
amenities. doors, drum,
200
radiology
home
in
practice.
Grow-
excellent Two
schools hours to
provides
Generous
ex-
beds,
120,000+. OutMRI, CT, NM, color doppler,
rural
community with family environment.
“big”
time
surprising
for family,
out-
and CME. Send CV to William LanMD; P.O. Box 1137; Mountain
Home,
AR 72653.
PEDIATRIC cal College pediatric diologist ing. These eral and services, services
RADIOLOGY-The
help
plan services
and implement for
Children’s
associate,
radiol-
upcoming
175-bed
Center.
positions
senior Pediatric
write
pediatric
the
Medical
non-tenured
sistant,
Medi-
of Georgia seeks one general radiologist and one pediatric rawith expertise in pediatric imagindividuals will provide genspecialized pediatric radiology guide the integration of imaging within pediatric radiology, and
ogy
The the
to
general
Not
60,000
expanding
are
or full
Tenured
at as-
professor
levels.
appointee will become Radiology Section.
Dr. Charles
or
available
G. Howell,
head Call
of or
Jr., Pediatric
Radiology Search Committee, Pediatric Surgery Section, Medical College of Georgia, Augusta, GA 30912-4070. (404) 7213941. MCG is an equal opportunity/affirmative action employer.
BC/BE
DIAGNOSTIC
RADIOLOGIST:
The
Veterans Affairs Medical Center, Salem, VA, is recruiting for a staff radiologist with general experience plus exper-
tise in CT. This
598-bed
affiliated with and is located
the University in the beautiful
Valley which has 200,000. Academic ing and
Medical
Center
a population appointment
to qualifications. new salary rates.
of over accord-
Excellent Call-back
benefits limited
with use of Teleradiology package Scanner. Interested applicants contact
Peter
ology Salem,
Service
Ext.
86A
RADIOLOGY
VA
2271.
P. Sforza,
M.D.,
or
call
for CT should
Chief,
(1 14), VA Medical 24153;
is
of Virginia Roanoke
Radi-
Center,
703-982-2463,
EOE.
MARCH
PEDIATRIC RADIOLOGY POSI’flONThe Department of Radiology, Children’s Medical Center and The University of Texas Southwestern Medical Center, is seeking a fellowship trained pediatric radiologist for entry at an associate or assistant professor level. Applicants should be interested in expanding their areas of expertise
and
interest
ing modalities. is a 263 bed Texas
and
hospital 1 12,000
into
high-tech
imag-
Children’s Medical Center tertiary referral hospital for
the
regional
states.
Last
year
the
had 7700 admissions and outpatient visits. The hospital
a busy
transplant
liver,
and
service
kidney
across
the There vice which
over has
including
with
from
United States and South Amenis an active neurosurgical serhad over 44 children with pri-
ca.
mary brain tumors referred in over the past year in addition to a large practice of children with congenital anomalies. The Hematology-Oncology team has 7 fulltime physicians and a 5 day a week clinic. The
Cardiology-Cardiothoracic
to general and subspecialty vices staffed by private and
MRA,
cardiac,
CT,
pediatric university-af-
ser-
and
3D
3D work
Diasonics
a dedicated
tional
digital
with
a
a Philips
Acuson
ultrasound, suite,
functions
station;
and
LX
Duplex
color
angio-interven-
fluoroscopy,
and
will
soon acquire updated nuclear medicine equipment. The department of radiology performs over 49,000 examinations annually including 2500 MR. nearly 4000 CT studies, over 250 interventional procedures, 3100 US, and 2200 fluoroscopic examinations. Staff radiologists also cover the
NNICU
tal, one There
at Parkiand
of the largest are
radiology
Medical
Center
hospital gressive
which enjoys administration
with
Memorial
The
is an
University
Hospi-
NNICUs
3 radiology
pediatric
in the US.
residents
and
3-4
fellows.
Children’s
exciting
innovative
a supportive, proand affiliation of Texas
em Medical School, one leading medical schools.
Southwest-
of the
country’s
Duties include clinical responsibilities in performing and interpreting pediatric radiology procedures, share resident and medical student teaching responsibilities and participate in ongoing research projects. Salary and benefits are among the best offered. Flexible work schedules are available for
parents letters
with
domestic
of inquiry
demands.
to Nancy
M.D.,
Director
of Radiology,
Children’s
1935
St.,
Dallas,
902-2305.
The
University
of
Southwestern opportunity/affirmative
Medical
Center action
is an em-
75235. Texas equal ployer.
(214)
Medical
DIAGNOSTIC RADIOLOGIST, izing in angiography, with some CT,
for
South
in confidence cian Group Dunwoody
30328,
Texas
specialMRI and
of
is an US/CT
fellowship.
Pennsylvania
Medical
The Uni-
Center,
Spruce Street, Philadelphia, call (215) 662-3046/3123.
PA
3400 19104
or
FAIRBANKS,
ALASKA-Four
tic radiologists
seek
diagnos-
partner
for di-
practice including General RaUltrasound, Nuclear Medicine, 1.5 T) and CT (GE 9800). Hospital and office practice. Desirable life style advantages in a university town. Unlimited access to the outdoors. Excellent sala-
ry,
benefits,
retirement
and
One year to full Douglas Hutchinson,
partnership. M.D.,
#5
99701,
Fairbanks,
AK
Permanente, P.C., a sIthle, multispeciaity group scring 3S0,00() members of Kaiser Permanente in the \orthwest Region, has an immediale opportunity al one of or two medical centers in the Portland area for a BG’BE
general Radiologist with au inlerest in mammography. Our I 2-member radiology department at Kaiser Sunnvside Medical Center is one of two departments providing a full range of services to this membership.
We offer a competitive
saiars and benefits package. including professional liahilit coverage, pension programs. sabbatical leave. For further information, please
(907)
M.D., at (503)
EOE.
vacation.
1919
Rahatzad,
652-2880. Forward CV to: Fred M. Nomura, M.D., Regional Medical Director, NORTHWEST PERMANENTE, P.C., 2701 N.W. Vaughn St., Suite 300, Portland, OR 972 10-5398.
KAJSER
Contact Lathrop
PERMANENTE
Northwest Physicians
Permanente PC and Surgeons
452-5092.
DIRECTOR OF ABDOMINAL IMAGING-The unified Department of Radiology at the Albert Einstein College of Medicine/Montefiore Medical Center is seeking a Director at the Associate Professor or Professor level for the newly organized Division of Abdominal Imaging. Based primarily at Montefiore, the successful candidate will be responsible for the practice and teaching of abdominal Radiology at two 800-bed teaching hospi-
tals
(Montefiore
and
Bronx
Municipal
Hospital Center). This is a unique opportunity to build the Division as organ systern imaging will go into effect for the first time in July 1992. The department currently has two MR units and is pursuing the acquisition of two further units. The salary and fringe benefits are highly competitive. Manhattan and Westchester County offer alternative life styles that are within an easy commute of the Bronx. If interested, please forward a CV to E. Stephen Amis, Jr., M.D., Professor and Chairman, Department of Radiology, Montefiore Medical Center, 1 1 1 E. 210th Street, Bronx, New York 10467. Einstein/ Montefiore is an affirmative action/equal opportunity employer.
NORTH
CAROLINA-Staff
available
for
$175-$200K+ base salary benefit package. Send CV
near
Wilmington.
ities.
Must
1-800-354-4050.
fifth
Oregon
Portland, Northwest
call: Mat
eastern
practice.
DIAGNOSTIC RADIOLOGIST
appoint-
versity of Pennsylvania is an equal opportunity affirmative action employer. Minority and women candidates are encouraged to apply. Please contact Peter H. Arger, MD, Chief US/CT Body Section, Radiology Department, University
this
hospital
to Samantha Lloyd, PhysiDevelopment, 5901 Peachtree Road, Suite C-65, Atlanta, GA
or call
a faculty
University of Pennsylvania at the Assistant or Associate Professor of Radiology level. The position is in the Ultrasound and Computed Body Tomography section. The level of the position will be determined by the applicants experience and expertise. Applicants must be Board Certified in Radiology and have experience in ultrasound and computed tomography. The minimum experience
BC
Jersey
or in process. plus excellent
M
Direct
Rollins,
Center,
Motor
available:
in the
versified diology, MRI (GE
pediatricians. The Radiology dehas state-of-the-art equipment a Philips 0.5T MRI which has
dedicated
position
ment
surgery
service sees a wide range of complex congenital heart disease. The hospital has a busy pediatric surgery service in addition
filiated partment including
ing
needed
heart,
referrals
THE RADIOLOGY DEPARTMENT OF THE UNIVERSITY OF PENNSYLVANIA MEDICAL CENTER has the follow-
North
Carolina Wide
be comfortable
tional radiology. Contact: Bonnie
sician 27715;
position Radiologist
Diagnostic
R
ADIflI
.OGY
provides
I
form
liability
medical
insurance
all ofour
locum
Rr tene,.5
Physicians
Temporary and
assignments
physicians
insurance wait
available. worries.
call
Rob
No
No
hassles.
Berton
Why
today:
1-800-878-3500 . . .
in
community
variety of modalwith intervenhospital facility. AM Care Phy-
Modern Jefferson, Search, P.O. Box 2816, 800-477-0600.
MDA
I o(’cllrrf),zce
Durham,
NC
UDA Medical
L()curn 3495 Holcomb
Tene
DoctorAssociates,
Bridge Road
Inc.
Permanent
Phvsicitn
Norcross.
GA 30092
#{149}
.
Srarcli .
(404) 2469191
87A
CLASSIFIED
SERVICES -
PHYSICIAN/RADIOLOGIST time opening for board-certified gist
in
shore ing,
a desirable
location.
southern
This
expanding
Must have and Nuclear
available
immediately.
P.O.
Box 729,
New
is an active,
hospital
practice. sound,
Full-
radiolo-
and
Jersey
challengoffice-based
training in CT, ultraMedicine. Position Send
Mt. Holly,
CV
to RABC,
NJ 08060.
NEURORADIOLOGIST-The section of Neuroradiology of the Department of Radiology at Northwestern Memorial Hospital, Chicago, Illinois, is seeking a fulltime staff member to participate in all clinical, educational and research activities, beginning on or before July 1, 1992. Applicants must have completed an approved residency in Diagnostic Radiology,
be certified
by
the
American
Board
of
Radiology, and be eligible for senior membership in the American Society of Neuroradiology. The applicant should have experience in all aspects of clinical neuroradiology, preference may be given to applicants
with
expertise
in current
MR
Michigan
and
proved
Water
three
fellowship).
tional
Avenue
Tower). has three fellows
(ACGME
An
active
ap-
intervenservice
by an integrated
brovascular
of
The section neuroradiol-
neuroradiologic
supported
area
service.
is
clinical
cere-
Diagnostic
equip-
ment includes a new DFP 65 biplane 1024 matrix Toshiba DSA system with stereo fluoroscopic capabilities, two MR scanners with a two scanner acquisition in progress, and 3 GE 9800 CT scanners, all well staffed with excellent ancillary personnel. Northwestern University is an Affirmative Action/Equal Opportunity Employer.
Hiring
is contingent
upon
eli-
gibility to work in the United States. Salaries and benefits are maintained at high levels. Address inquiries and a current curriculum vitae to: Eric J. Russell, M.D., Director of Neuroradiology, Northwest-
.
Scheduling
.
Personal
Responsibility
em Memorial Hospital, Ct/Suite 3420, Chicago, (312) 908-2462.
710
will have recently completed residency training and be interested in pursuing a career in academic radiology with an emphasis on research. Collaboration with the basic science departments is encour-
aged.
For uncompromised to quality locum tenens call:
commitment
1-800-366-1884
VISTA 675
East
Salt Lake
Tenens
STAFFING 2100
Group
City, Utah
Suite
and
successful
candi-
in clinical of research.
radiolThe
can be tailored
of the individual; provide a competitive
and fringe benefits support for a period
it
to
is desalary
as well as ancillary of two years at which
390
84 106-9813
spoiling prove
of the
employ
this
de-
Street,
Bronx,
Montefiore
Department of Radiology, Medical Center, ill E. 210th New
York
is an affirmative employer.
RADIOLOGY
10467.
Einstein/
action/equal
applying
technique
to imaccuracy;
combined
to
with
study metabolism. or Biochemistry
quired as well as strong biophysical chemistry, electrical
the
surface
field gradient localization
technique in Chemistry
engineering
re-
background mathematics,
and
computer
skills and abilities for the application
in pro-
in NMR rein biochemis-
try and medicine. These involve 1) spin relaxation time T, and T2 and NOE effect measurements in vivo; 2) RF and shaped
pulse sequence design and improvement; 3) NMR image technique; 4) NMR detection probe design and spin decoupling optimization; 5) development and application of NMR spatial localization method in particular the inhomogeneous surface-spoiling magnetic field gradient method,
experience
with
ISIS
and
STEAM localization method; 6) employing the surface-spoiling gradient method to detect carbon-13 and proton-i NMR signals from deep-lying tissues (such as brain, liver, leg, muscle) in vivo; 7) development of computer software for RF magnetic field and gradient field calculation coil
and for simulation NMR phenomena
of the surfacein biomedical
8) application NMR spectrum Knowledge
in
and developediting techmetabolic
path-
ways, reaction cycle modeling, biochemical molecular structure (e.g. glycogen), chemical kinetics and exchange
processing
in tissue
in vivo;
expe-
rience in tissue extraction and animal preparation. $28,000 per year. Send resume to Job Service Technical Unit, Connecticut Department of Labor, 200 Folly Brook 06109-Job
Boulevard, Order
Wethersfield, #3095235.
CT calls
No
please. LOUIS
TAL,
A. WEISS a 372
bed
MEMORIAL
affiliate
of The
HOSPIUniversity
of Chicago. Facilities include two new Acuson ultrasound machines and a GE Highlight Advantage CT. Both inpatient and outpatient areas are being redesigned. Applicants should have broad experience in general diagnostic radiology and
angiography.
or research
An
would
mensurate should be board
provide
and
magnetic spatial
tan and
County
and
inhomogeneous
successful the faculty Academic
Westchester
improving
improving
time the individual is expected to have obtained at least partial grant funding for the continuation of their work. Manhat-
opportunity
88A
is flexible
the interests signed to
Chairman, Montefiore
SOLUTIONS South,
program
can be spent to the area
sirable alternative life-styles within an easy commute of the Bronx. Interested candidates should submit their CV to E. Stephen Amis, Jr., M.D., Professor and
VISTA A Locum
Up to 50% of the
date’s time ogy related
mechanism;
technique
nique.
IMAGING RESEARCH POSITIONThe Unified Department of Radiology of the Albert Einstein College of Medicine/ Montefiore Medical Center is offering imaging research positions beginning either July 1992 orJuly 1993. The ideal candidate
posi-
the sensitivity of NMR signal improve spatial localization
application; ment of
N. Fairbanks Illinois 60611,
Flexibility
Freedom
and
accuracy;
gram; search
North
rate
enhancing detection;
in
ogists
Professional
over
POCE Ph.D.
the
ASSOCIATE
tion in New Haven, CT. NMR research involving biochemistry and biophysics. Position involves studying spin relaxation properties of glycogen and other molecules; investigative studies of insuun resistant diabetes in man; determination of human cerebral metabolic turn-
applications or interventional procedures. A demonstrated interest in and facility for clinical research and teaching is highly desirable. Northwestern Memorial Hospital is an 800 bed general hospital Chicago (near of neuroradiology
.
POSTDOCTORAL
in teaching
The
applicant will be appointed to at the University of Chicago. rank and compensation cornwith experience. Candidate
practice
in
should
send
Chambliss, gy, Weiss
interest
be advantageous.
certified
Illinois.
their
M.D., Memorial
and
licensed
Interested
CV
or phone:
Department Hospital,
to
parties
James
of Radiolo4646 North Illinois 60640,
Marine Phone Chicago
Drive, Chicago, 312-878-8700. The University is an Equal Opportunity/Affir-
mative
Action
of
Employer.
MARCH
‘.,
--‘.
vie have an excellent private practice opportunity fcr a Radiologist to join a very successful two-man group in a hospital-based practice with separate billing. Our radiology group is affiliated with Marietta Memorial Hospital, a 225bed acute care facility and we also provide services for Sistersville General Hospital, a 30-bed facility nearby. Our encatchment area is over 100,000 and we also receive referrals from peripheral counties. The radiology department at Marietta Memorial Hospital is fully equipped with state-ofthe-art technology including: CT, color-doppler ultrasound, angiography, mammography and nuclear medicine. Our new MRI unit will replace our mobile unit and will be installed October 1991. We perform approximately 50,000 procedures annually. A well-rounded general radiologist with experience in interventional procedures is preferred, hut not required. Candidates should be board certified or in the examination process. An extremely attractive salary and benefit package is being offered leading to full partnership. Marietta is nestled in the confluence ofthe Ohio and Muskinghum Rivers in Sutheastem Ohio and is approximately 2 . 5 hours from Cleveland and a two hour drive to Columbus for an easy “getaway.” Please forward your CV and/or call Susan Panther, Radiology Specialist, Physician Services of America, Suite 250, Browenton Place, 2000 Warrington Way, Louisville, KY 40222, 1-800-626-1857, ext. 236.
MARCI
I
RADIOLOGY
89A
CLASSIFIED
SERVICES
INTERVENTIONAL
RADIOLOGIST-
MARYLAND-The ology, University System/Hospital additional faculty
of Maryland Medical in Baltimore is seeking members for the Sec-
tions
Radiology,
Department
of Pediatric
Nuclear
(double
of Radi-
Ultrasound,
boards
desired),
G.I.,
Marshfield Clinic Department of Radiology is seeking a fellowship-trained Interventionalist to join its thirteen members. The department is subspecialized and
Mammography, ma/Critical
Care
Fellowship
training
provides
quired where appropriate. The medical center is an 800 bed acute care hospital and tertiary referral center with an active
cians
services in all
to more
branches
than
rience
350 physi-
of medicine
and
sur-
gery. State-of-the-art equipment is available including two fully-equipped angiographic suites, two MRI scanners, four CT scanners, and three active cardiac cath labs. Very busy clinical and hospital practice.
Total
mately and year.
examinations:
1,300
friendly,
small
town
of
atmosphere.
For ad-
Radiology,
Marshfield
Clinic,
with
quality
lifestyle
54449
to
join small
comprehensive diagnostic modalities, and two freestanding imaging centers. Generous time off available with
in Oklahoma
affiliated
is now
versity of new a
VA
under
City.
Prefer
young radiologist with MR training. Call Dept. of Radiology at Bethany General Hospital, (405) 787-3450 ext. 280, Dr. Killebrew.
department
per-
hospital
to and
and
commensurate
teaching.
radiologists
are
rank
with
experience.
and
as a pro-
fessional corporation offering excellent fringe benefits. Baltimore is a superb place
in which
to live
of the problems ty values, etc.)
ington,
and
work.
a large enough
It has
Philadelphia,
all
metropolitan to avoid most
(traffic, inflated of our largest cities.
and
New
properWash-
York
are
readily accessible. Only 3 hrs. from the Ocean City Maryland. Submit CV to: Geraid S. Johnston, M.D., Department of Di-
agnostic
Radiology,
Baltimore, 8667 ext.
Equal
22 5. Greene
MD 3477.
21201 or call “Affirmative
Opportunity
Employer”
courages minority
applications groups.
Street,
North Shore Radiology’s four Board Certified Radiologists are recruiting a fifth full time individual. This rapidly
expanding
group
provides
cover-
age at five Community Hospitals and two Offices in North Eastern Wisconsin.
Approximately
56,000
exams
per year. No Angio. Teleradiology for call. Inhouse CT at most locations planned for summer I 99 1. Mobile MR available soon. Group
members
choose their own can live in any of our towns, or in nearby cities, areas or surrounding country-
life style, hospital resort
side. County
Green
and
Easy
drive
and
to Wisconsin’s Door University of Wisconsin
Bay.
Excellent compensation and vacation package. Early partnership for Board Certified Associates. Contact
of
Fax:
90A
(608) (608)
clinical
255-6262
833-9234
is
of large core breast biopsies. 12,000 mammograms, 1,000 wire localizations, 500 guidand 150 core biopsies are annually. This wealth of clinicoupled with an excellent
staff
provides
nity
for
tion.
Candidates
cation.
Please
Director
SCHOOL,
RADIOLOGY,
a full-time diagnostic radiologist the Breast Imaging Section. This based facility has four mammorooms, two with ultrasound. In there is a mammo-test unit for
performance More than preoperative ed aspirations performed cal material
unlimited
collaborative
opportu-
clinical
must contact
of Diagnostic
have Jack
US/CT/MRI diologist,
- LOS with
M.D.,
established
practice
Mark 9 US Competitive
units and a 2T salary leading
Hospital
is an equal
MEDICINE
University
opportu-
PHYSICIAN-
of
California,
Davis
School of Medicine has a full-time faculty position available in the Nuclear Medicine Division of the Department of Radiology. Appointment will be at the Assistant/Associate/Full Residence
Professor Professor
or
level (InClinical
of
Radiology Series). Candidates must Board Certified in Nuclear Medicine, gible for licensure in California, an academic background
be eli-
and have Nuclear
in
Medicine. Since this position will be open until filled please forward curriculum vitae, a letter outlining background and interests in teaching/research and the names
of
possible.
five
references
as
Applications March
will
31, 1992.
promptly
as
not be accept-
Reply
to: William
of Radiology, 2516 Stockton Ticon II Building, Sacramento, 95817. The University of Cali-
Action
groups
Opportunity/Affirma-
Employer
plications
in
300
bed
Siemens to full
partnership. Contact A. K. Raja Rao, M.D., St. Vincent Medical Center, 2131 W. Third St., Los Angeles, CA 90057, 213/484-7901.
RADIOLOGY
Ear
employer.
NUCLEAR
tive
hospital near downtown LA and private office in adjacent building. Equipment includes-two GE 9800 CT scanners, two ATL MRI.
and
imaging inecho-planar
Massachusetts. Interested individuals should contact Dr. James Thrall, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114. Massachu-
California fornia is an Equal
needed to 1992. This
includes
Eye
from and
and
encourages
members
of
ap-
minority
women.
ra-
training
body imaging group in July
Massachusetts
Department Boulevard,
Brigham
ANGELES-BC
fellowship
cross-sectional join 8 member
radiation oncology, neck radiology at the
E. Brant, M.D., Chairman, Search Cornmittee for Nuclear Medicine Physician,
certifi-
E. Meyer,
Radiology,
supervi-
bilities. The applicant must be able to secure a license to practice in the state of
ed after
investiga-
board
and Women’s Hospital, 75 Francis Street, Boston, MA 02115; (617) 732-6269. Brigham and Women’s Hospital/Harvard Medical School is an affirmative action/ equal opportunity educator and employer.
well
0. Adhur Stiennon III MD Suite 220, One South Park Street Park Regent Medical Building Madison, WI 53715 Phone:
seeking to head hospital graphic addition,
OF
and
en-
members
MEDICAL
DEPARTMENT
referral research will in-
capabilities), color-flow doppler and pet scanning. Interventional procedures also possible for interested individuals. We are seeking assistant/associate professor 1evels, but rank and salary will be commensurate with experience and qualifications. Generous fringe benefits and retirement package offered. Liberal vacation and meeting policy, limited on-call responsi-
nity
DIRECTOR OF BREAST IMAGING, THE BRIGHAM AND WOMEN’S HOSPITAL/HARVARD
teaching
Infirmary. State-of-the-art cludes MRI (with advanced
The
NORTh SHORE RADIOLOGY ASSOCIATES OF MADISON S.C.
care,
setts General
1-800-866Action/
and
from
patient
neighboring
Academic organized
dude
opportunity
a high-quality both clinical and Responsibilities
Uni-
in the Spring of 1992. The duties faculty members will include re-
salary
is an exciting in
gery, neuropathology, as well as head and
324
and to the
This
will
with
connected
radiology.
sion of neuroradiology fellows and radiology residents. Both clinical and basic research opportunities are available within radiology and in cooperation with strong programs in neurology, neurosur-
a year.
construction
search The
re-
examinations
the amenities of center, yet is small
FULL-TIME RADIOLOGIST group of three. Pratice includes hospital
1000
WI
new
The
200,000
expe-
certification
Depart-
Massachusetts
General Hospital is seeking a radiology board-certified, fellowship trained senior member of the American Society of Neuroto participate practice offering opportunities.
TrauRadiology.
or equivalent ABR
practice.
over
beds
per
send letter/ Department
North Oak Avenue, Marshfield, or call collect at (715) 389-3474.
varied
be adjacent
in
please M.D.,
A
cases
catheterizations medicine
ditional information, CV to Thomas Gallant,
desired.
forms
approxi-
angio/interventional
2,700 cardiac State-of-the-art
and
Neuroradiology, and Skeletal
NEURORADIOLOGIST-The ment of Radiology at the
-
PHYSICIAN/RADIOLOGIST radiology
group
with
multiple
private
Large of-
fices seeks a board-certified radiologist interested in a full-time position. Responsibilities
include
general
Special
training
in CT,
and/or cellent
Nuclear Southern
Medicine New
radiography.
ultrasound,
MRI
is preferred. ExJersey location.
Competitive salary and benefit Position available immediately. to RABC, P.O. Box 729, Mt. 08060.
package. Send CV Holly, NJ
MARCH
THE DIVISION
OF NUCLEAR
CINE-Oregon
Health
RADIOLOGIST
MEDI-
Sciences
sity, Portland, Oregon invites applications for a faculty position available immediately either part-time in nuclear medicine
or
nuclear
medicine
full-time
divided
between
and another
division
of
diagnostic radiology. Position requires that Radiologist be certified by either American Board of Radiology (Special Competence in Nuclear Radiology) and/ or American Board of Nuclear Medicine. Send CV and references to William Weidner, M.D., Chairman, Diagnostic Radiology, UHN-72, Oregon Health Sciences University, Portland, OR 972013098. OHSU is an affirmative action equal
opportunity
employer.
OREGON, TAINS ON group tirement.
NORTHEAST 1-84-Three
MOUN-
radiologist because of repractice; prima-
needs new partner Three hospital
ry hospital is trauma and referral center for three counties and has CT, angio, interventional, US with color Doppler, and SPECT Medical
NM staff,
most
equipment. 40 physicians
specialties.
annually, the
same
start.
Full
for experienced dential. Eastern Box
849,
MRI in 1992. representing
Community
with four year college reational opportunities. dry climate. Minimum
of
13,000
and
abundant Intermountain of 12 weeks
as other financial person.
partner Inquiries
Oregon
La Grande,
recoff
partners
from first
year confi-
Radiology,
OR
97850.
P.O.
(503)
963-
1474.
retired.
affiliated
FULL-TIME
FACULTY
individual
selected
will
be in charge
University Medicine.
Hospital Candidates
should Board
be of
trained
in interventional
of
within the Section in at Stanford
and the School of for this position
diplomates Radiology
of the American and fellowship
radiology.
Can-
didates should have extensive clinical experience with all aspects of diagnostic and therapeutic vascular procedures. Non-invasive vascular laboratory experience is preferable. Stanford University is corn-
mitted
to
increasing
women
and on its faculty applications
curriculum
representation
of
members of minority groups and particularly encourages from such candidates. Send
vitae
and
the names
of at least
three references to Michael Dake, M.D., Chairman, Vascular Radiology Search Committee, Department of Radiology,
Room
H-2333,
Center,
Stanford
Stanford,
University CA
world
CALIFORNIA
Medi-
94305.
famous
CENTRAL
MR. cine fied
Interventional, skills to join Radiologists.
offices, Centrally
RADIOLOGIST
in a town
of about
20,000
the
in
35,000
surrounding to David
send inquires/CV M.D., Professional
X-Ray,
Suite
2, Lompoc,
US, group Two
Nuclear of 7 Board hospitals,
CT, MediCertiprivate
service to nearby communities. located to San Antonio, Austin,
Houston, Corpus Chnsti. Good family environment. Contact James Neumann, M.D., Box 3610, Victoria, TX 77903 (512) 578-0317.
MARCH
with
another
area. Please L. McAninch, 1 1 1 1 East Ocean CA 93436.
FOOTHILLS-General
radiology position with emphasis on imaging. Progressive radiology group looking for fourth B.C/BE. partner with MRI training. 124 bed community hospital and private office practice. All imaging modalities covered, including Nuc Med,
U.S., CT, Mammo and interventional. California R-3202.
and
some
community.
INTERVENTIONALIST/NEURORADIOLOGIST-The Cleveland Foundation
has
a staff
in the Division emphasis Candidates agnostic
of Radiology
available
with
special
cerebrovascular techniques. must be board certified in DiRadiology, eligible for Senior
Membership
sure
Clinic
position
on
in the
in the state
ASNR
of Ohio,
as well
and
as licen-
have
a clini-
cal background in interventional neuroradiologic procedures. This position within neuroradiology will fulfill a cornplement of five full-time neuroradiologists at a 1,200 bed teaching hospital and large out-patient facility serving the clinical disciplines of Neurosurgery, Otolaryngology, Neuro-opthalmology, Adult and Pediatric Neurology. Diagnostic irnaging and interventional equipment are state of the art and well staffed with excel-
lent
ancillary
personnel.
For further
de-
Thomas J. Masaryk, of Neuroradiology, CCF, 9500 Euclid OH 44195, Phone:
tails please contact: M.D., Head, Section Division of Radiology, Avenue, Cleveland, (216) 444-6653.
DIAGNOSTIC RADIOLOGIST SANTA BARBARA,CALIFORNIA A large muftispecialty clinic is seeking a Board Certified/Board Eligible diagnostic radiologist. Competence necessary in CT, Ultrasound, and MRI. Send CV to: M.D.
Monica
Micon,
or Ella
Wong, M.D.
Sansum
angiography
Growing Send
Northern CV. to Box
Medical
Clinic
P.O. Box 1239 Santa
Barbara,
CA 93102
Make Track&.. . . .
CHAIRPERSON, RADIATION ONCOLOGY
to your nearest
mailbox
and
thelatest
for of the
send
copy
free Consumer InformatIon Catalog.
The Albert EInsteIn College and Its University Hospital,
of MedicIne
Medical
a Chairper-
son
Center,
for
the
are seeking Department
Montefiore of Radiation
Oncology.
It lists about 200 free or low-cost government publicatIons on topics like health,
with
COAST-
general radiologist position immediately for challenging in a three-man general radiology This includes a hospital-based and office-based practice. Must be qualified in all aspects of general radiology, including xeromammography, CT, ultrasound, diagnostic nuclear medicine, and MRI scanning. Limited invasive radiology, with no angiography or invasive vascular work. Location on the central coast of California
careers,
DIAGNOSTIC
Greenbrier
Full-time available practice group.
CALIFORNIA
POSITION
vascular radiology activities Cardiovascular/Interventional the Department of Radiology
with
Hotel and Resort located in the Greenbrier Valley, garden spot of West Virginia. Quiet lifestyle with abundant recreational opportunities and easy access to large Eastern metropolitan centers. Candidates must be board-certified in diagnostic radiology and have some practice experience. Contact: Herbert Pope, M.D., The Greenbrier Clinic, White Sulphur Springs, West Virginia 24986.
Avenue,
AVAILABLE, STANFORD UNIVERSITY - VASCULAR RADIOLOGIST-The
cal
NEEDED-Senior partFree-standing diagnostic medical clinic seeking second Radiologist for non-interventional type practice in small culturally oriented community in Southeast West Virginia. Rare opportunity to associate with nationally known group where highest quality medicine is the standard, under unparalleled working conditions. The Greenbrier Clinic is ner
Univer-
nutrition, money
management, federal
send
your
address Consumer Center Department
Pueblo, Us
and name
and
to: Information
be Board certified in have admlnistrative experience in an academic hospital environment, and be eligible for an academic appointment at the professor 1evel. Qualified applicants are invited to respend. The Albert Einstein College of Medicine/Montefiore Medical Center is an Affirmative Action/Equal Opportunity Employer. Radiation
Colorado
81009
must
Oncology,
Inquiries and applications should sent to Stephen Arnie, M.D., Chairman, Departmnt
MT
GeneralServlces
RADIOLOGY
Just
benefits.
The applicant
MedIcal Bronx,
of
Radloio9y,
be
Montefiors
Center, 111 East 210th Street, New York 10467.
Admlnlstrauon
91A
CLASSIFIED
DIAGNOSTIC HO-Four a fifth qualified ology. sound,
SERVICES
- IDA-
RADIOLOGIST
man radiology group seeking Board Certified radiologist; highly in all aspects of diagnostic radiThe practice includes: MRI, ultranuclear medicine, angiography/
interventional, tunity activities
ASSISTANT OLOGIST-The
for
and
CT. Excellent
oppor-
someone who enjoys such as skiing, fishing,
camping and frequently Community has a four college and a community within 40 minutes versities. 13 weeks two years leading
outdoor hunting,
year round golf. year liberal arts college, and is
of two major state univacation annually and to partnership. If inter-
ested please send CV to Mark W. Peterson, M.D., 531 4th Ave., Lewiston, Idaho 83501. ABDOMINAL Harvard Medical
Women’s position
RADIOLOGIST-The School, Brigham
Hospital for
an
has a full-time
facilities
exciting yen inal
make M.D., Brigham
ab-
Outstanding case mix this
opportunity.
E. Seltzer, Imaging,
an
Please
hospiand re-
unusually
contact
Ste-
Co-Director, Abdomand Women’s Hos-
pital, 75 Francis Street, Boston, tel. (617) 732-6301. Harvard School, Brigham and Women’s an affirmative educator and
faculty
academically-inclined
dominal radiologist. tal setting, equipment, search
and
action/equal employer.
MA 021 15, Medical Hospital is
PROFESSOR,
MR
RADI-
CHEST/BREAST
Department of Radiology at The University of Texas Medical School at Houston and the Hermann Hospital are recruiting for a full-time MRI Radiologist at the Assistant Professor level,
beginning
July
1, 1992. Preference
will
be
ence.
ABR
certification
Responsibilities
will
required.
include
and interpretation neuro MRI, as well resident and fellow clinical and tunities are MR facilities
is
monitoring
of both body and as medical student, teaching. Extensive
basic science research opporavailable. The Department’s are state-of-the-art and locat-
ed in a beautiful spacious setting, which include a l.5T GE Signa unit with proton spectroscopic capability. A second 1.5T GE System, with spin echo (FSE), will be installed
MR Angiography, fast and phased array coils, in the first quarter of
1992. The Department basic science research facilities
include
also has an active program; research
a small
bore
MRI
system
employer. encouraged
curriculum to:
vitae
Bharat
terim gy,
and
Raval,
three
M.D.,
Chairman, The
Women to apply.
University
School-Houston, 2.132, Houston,
of
and
In-
of RadioloTexas
RADIOLOGY LTD. OF TUCSON, ARIZONA OPENING FOR A RADIOLOGIST WITH ANGIO/INTERVENTIONAL EXPERTISE-Radiology Ltd. is
hospitals,
three
three
separate
in Tucson,
private
CT/MRI
Arizona.
tional. with vidual
and two who are services offices,
imaging
We
are
cruiting another general fellowship training in
and
centers
currently
re-
radiologist with angio/interven-
This individual will be employed three years to full partnership. Indiis to be based primarily at Tucson
Medical Center, the largest hospital coyered by our practice. Currently TMC has the greatest load of interventional cases. Cross-coverage
hospitals and
of advanced
will
the
other
cases
be shared
by
radiologists
at other
this
with
person
advanced
interventional skills as needed (for exampie when cross-coverage is needed to coyer an interventionalist tion). General radiology
and
MRI
is also
individual If interested
Broome, ondelet BC/BE
to be performed
by this
responsibilities. to: Robert
0.
MD, Radiology Ltd., 6516 E. CarDr., Tucson, AZ 85710. DIAGNOSTIC
KANSAS CITY, openings Kansas Kansas University MRI,
who is on vacaincluding CT, US
as part of core send CV
VA
affiliated
Center.
hospital.
CT,
NM, special procedures. Staff physician and department chief position available. Reply to Dr. Sarah Taylor, Chair, Radiology Search Committee, VAMC Kansas City (1 1 1), 4801 Linwood Blvd. Kansas City, MO 64128, (816) 861-4700 Ext. 3491.
92A
US,
Medical
RADIOLOGY
tion and eligibility for or licensure state of Florida required. Academic and
compensation
by the rank,
commensurate
qualifications.
Interested
with
parties
should
forward CV’s to: C. A. Poole, M.D., Professor and Chairman, Department of Radiology (R-308), P.O. Box 016960, Miami, FL 33101. The University of Miami is an
equal
opportunity/affirmative
action
DIAGNOSTIC
em-
RADIOLOGIST-The
Regional
Center
group
clear
of Fort Myers,
diagnostic radioloa new associate. The
covers
two
private
offices
acute
care
hospital
with
fluoroscopy,
Medicine,
radiology.
MRI,
The
and
group
ing
of diagnostic
Nuclear
Nuinterven-
new DO! a versatile is skilled in
radiology
Medicine,
a
has recently
assumed coverage of a growing MD hospital. We are seeking M.D. or DO. radiologist who
all aspects
and general
ultrasound,
CT,
includ-
neuroradiology
and interventional radiology, preferably with fellowship training in MRI, including musculoskeletal, neuroradiology, or interventional. A competitive salary, excellent benefits and partnership are being offered. Dunwody, Regional Myers,
Please forward CV to Barbara Office Manager, Radiology Center, 3680 Broadway, Fort FL 33901.
DALLAS,
cialty
TEXAS-12
group
radiologist
seeks for
member
board
sub-spe-
certified
immediate
general
opening.
lowship training preferred sider qualified individual pertise. CT/ultrasound,
Fel-
but will conwith special exMRI, nuclear
medicine, or angiography background particularly helpful. All imaging modalities available (state of the art CT, angio,
ultrasound, MRI
R & F, SPECT
center).
Salary
and
nuc.
med.,
bonuses
are
and excel-
lent. Health and malpractice paid. No buy-in to partnership. Send CV to H. Stuart Peake, M.D., P.O. Box 814129, Dallas, TX 75381.
(214)
THOUSANDS AWAY WITH
888-7055. OF DOCTORS IT-KRON pioneered
curn tenens so you could tice, and your life, where
RADIOLOGISTS/
MISSOURI-Immediate City
cluding mammography, ultrasound and needle localization required. The University of Miami/Jackson Memorial Medical Center is a tertiary referral and level 1 trauma center that will soon be opening a state-of-the-art breast center. Extensive teaching involved and an interest in clinical research is assumed. Board certifica-
tional
opportunity
at four
procedures. imaging in-
radiology,
Suite
a group of twenty three full-time part-time diagnostic radiologists the major providers of radiology
and interventional expertise in breast
400-bed
Medical
643 1 Fannin, Texas 77030.
or equivalent all aspects of CT, MR. ultra-
Florida, an eight-man gy group, is seeking
(3) references
Department
in
Radiology
and minorPlease send
Professor
RADIOL-
ployer.
with spectroscopy capabilities. The University of Texas at Houston is an equal opportunity ities are
with subspecialty training experience and interest chest imaging including
sound Similar
given to candidates with fellowship training in MRI, body imaging, neuroradiology or one year of academic MRI experi-
IMAGING
OGIST-The Department of Radiology of the University of Miami School of Medicine is seeking an academic radiologist
take
GET lo-
your
you want to go. You work as much as you when you want. While we guarantee
income. Pay your expenses. And the best malpractice insurance
practhem want, your
provide around.
It’s a total package. And it’s only available from KRON. Call KRON at 1-800-MEDICAL. KRON is Locum Tenens Practice Made Perfect.
MARCH
r
-
-
-
-
-
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-I
I AREYOU I LOOKING FORA I NEWJOB? I I I I \I I 1-000-077-3080 I L Most Radiologists find selecting a new practice a confusing and tedious process. This should not be the case. Since Meridian Radiology Recruiting specializes in Radiology, we understand your needs. Our stafftakes the time to learn your specific interests, modalities, practice preferences, and professional objectives. Our experience enables us to make informed, accu rate assessments regarding practice opportunities. We pre. sent to you only those practices that fulfill your personal and professional needs.
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If you are serious
right practice,
I
‘
about finding the and your time is valuable,
then call Meridian today.
MERIDIAN k’
Suite
556, 1507 E. Franklin
ALL INQUIRES
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MARCH
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RADIOLOGISTS
I I I I I I I I I
Enjoy
the
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Demand is high nationwide for temporary radiology coverage. Attractive positions are available to meet your personal and professional goals.
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escape the hassles, politics paperwork associated medicine today. R Retirees - work as little much as you want to.
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CLASSIFIED
SERVICES
L
WITH
A LI-
CENSE FROM ANY STATE, Loma VA Hospital has positions available
Linda for a
board
certified/eligible
and
DIAGNOSTIC
DOMINAL
RADIOLOGIST
IMAGING-The
of Missouri-Columbia
desirable.
Tenured
available
at Assistant
fessor levels. J. Churchill, ogy,
with CT,
able.
expertise US, MRI). Fellowship
ski
and nontenured and
Address inquiries M.D., Department
University
of
to: Robert of Radiol-
Missouri-Columbia
Hospital and Clinics, One Hospital Drive, Columbia, MO 65212. An Equal Opportunity/Affirmative Action Employer.
State
CHIEF pital
to: Radiology Street,
Trenton,
838 W
Center,
Valley
HosN.Y.
Stream,
Veterans
Hospital,
management
422Op-
accepting
is currently
has
equipment.
all
Send
state-of-the-art
illa, M.D., Radiology Medical Center, Bay
applica-
9363.
trauma
ography Skill in
and interventional teaching, interest
patient,
use of radiography, computed tomography,
curriculum Professor
mative
in
vitae to: C. and Chairman,
action
in-
ultrasoangi-
procedures. clinical
re-
A.
Poole, Depart-
employer.
IMMEDIATE
TLE
OPENING
IN THE SEAT-
AREA-Diagnostic
seeks
BC/BE
Radiologist
associate
to join private
con-
ventional radiology outpatient practice. Early buy-in possible. Modern equipment in comfortable, established surroundings. Good referring physician base. ACR Accredited Mammography. Call 206-283-
call J. Bon-
Service (114), Pines, FL (813)
the
the
ment of Radiology (R-308), University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33101. The University of Miami is an equal opportunity/affir-
imaging
CV and/or
of
cluding nography,
send M.D.,
Medicine,
is recruiting staff a new, opening in
search, and licensure to practise medicine in the state of Florida required. Academic rank and compensation commensurate with qualifications. Applicants should
Benton
(714) Equal
VA Medical Cenaffiliated with the Florida School of
VA 398-
8144
EOE.
CHIEF HARBORVIEW
I
for further
OF
information.
RADIOLOGY MEDICAL
CENTER
The
U.
.,.
CaIif#{244}ikj
Growing six-physician panership requires radiologist (BC by 7/92) competent in standard modalities incIudinr trasound, mammograp and CT-little or no interventional. Requires competence in MR and independent reading in multiple out-patient multi-site clinics and at central imaging center (system has 80,000+ yearly examinations and is rapidly growing). Reasonable hours, minimal weekend and call responsibilities. Excellent salary leading to full partnership. Great opportunity to enjoy career and life. Call, or submit CV to: ,
I/,
Ruthan 338-4798 825-4401
1826 Orange Redlands. 94A
1 1201
RADIOLOGIST-The ter, Bay Pines, Florida, University of South
Carve Your
(714)
parks.
Employer.
Center
ous salary and fringes. CV. and inquiries to Magill Associates, 475 Northern Blvd., Great Neck, N.Y. 11021. Telephone (516) 482-9303. Fax (516) 482-2646.
(800)
mountain theme
De-
University
the spring of 1992. The unit will be a selfcontained facility within the Jackson Memorial Medical Center, a 1500 bed tertiary facility and level 1 trauma center. Candidates must be Board certified with fellowship training and/or experience in the
east
coast of Florida in the St. Petersburg/ Tampa metropolitan area, only minutes from the Gulf of Mexico. The Medical
seeks an experienced Radiologist for its four member group. Excellent facilities indude MR 1ST. Affiliate of N.Y.U. Gener-
Southern
70 miles
beaches,
southland
A
is accept-
tions for a board-certified staff radiologist in general diagnostic radiology preferably with MRI experience. This Medical Center is located on the beautiful west
08618.
OF RADIOLOGY-Franklin Medical
state
is located
near
and
portunity
BUCKS
Jersey
Angeles
resorts
morial
NEW
Affiliates, New
Linda
radiologist.
any
Street, Loma Linda, CA 92357. 3069 TELEFAX (714) 422-3106.
COUNTY, PENNSYLVANIA seeks general radiologist with good ultrasound and mammography skills. Excellent benefits. No weekends, no call. Full or part time.
Respond
from
RADIOLOGISTS-The of Radiology of the
of Miami School of Medicine for trauma radiologists to state-of-the-art trauma center
This is a 500 bed full service hospital with a comprehensive diagnostic facility including ultrasound, CT and MRI, integrated with Loma Linda University Medical Center Residency Training Program. Opportunities to pursue clinical or academic interests. For additional information contact: Peter Dure-Smith, M.D., Chief, Radiology (114), Jerry L. Pettis Me-
Pro-
LARGE PRACTICE IN CENTRAL JERSEY AND ADJACENT
Loma
TRAUMA partment
neuroradiologist
diagnostic
license
of Los
tracks
Associate
a general
current
University and Clin-
Hospital
ics is seeking a radiologist in abdominal imaging (GI, Board certification required.
AB-
-
TO CALIFORNIA
Richard
Chairman,
Smith outside
University of Washington School of Medicine, Seattle, WA, invites nominations and applications for the position of Chief of Radiology at Harborview Medical Center, a University of Washington teaching hospital. We seek an experienced physician/administrator with strong commitment to academic radiology, patient care, and teaching. The candidate must be board certified by the American Board of Radiology and meet the academic requirements for Professor or Associate Professor at the University of Washington School of Medicine. The individual chosen as Chief of Radiology will be responsible for all professional radiologic and nuclear medicine services and must have vision, vigor, and will to build an academic radiology program commensurate with the mission of Harborview Medical Center. The University of Washington is an affirmative action, equal opportunity employer. Please send CV to:
University
CA
in CA
Tree Lane CA 92374 RADIOLOGY
K. Root,
MD
Professor of Medicine HMC Radiology Search 325
of Washington Ninth Avenue ZA-65
Seattle,
WA 98104-2499
Committee
MARCH
ANGIOGRAPHER/ crossroads?
A one
able at a nationally in the Washington certified, fellowship
rapher tion
beginning may
DISCOVER
INTERVENTIONAL you at a
RADIOLOGIST-Are
year
position
career
is avail-
recognized institution DC area for a board trained angiog-
July
be particularly
1, 1992. attractive
This
posi-
to grad-
uating fellows, individuals considering relocating to this highly desirable geographic local or persons seeking a position for a sabbatical year. Reply in confidence
with
CV
to Box
R-3204.
CHAIRPERSON, RADIOLOGY - The University of Cincinnati seeks applicants for the position of Director (Chair) of the Department of Radiology. Individuals interested in being considered should send their curriculum vitae to: Donald Shumrick, MD, Dept. of Otolaryngology, University of Cincinnati College of Medicine, 231 Bethesda Avenue, Cincinnati, OH 45267-0528. Affirmative Action/Equal Opportunity Employer. We offer a smokefree work environment.
SOUTHERN INDIANA-Radiologist to join seven member group in hospital and office practice. Some interest and experience in interventional studies and/or MRI
desirable
but
all
areas
of
BC
WYOMING-Two
radiologists
seek
HMO’s
package
with
benefits
financial
including
8 weeks
P.O.
and
qualify
of
SER-
Radiology,
for
with population is a 2 year commu-
and
Salary
outdoor
6652.
such
as
skiing,
and Teton Mountains. CV to William R. Sweetwater Radiology,
Drive (307)
203,
Rock
back-
and fishing Gorge RecWind River
Please reply with Compton, M.D., P.C., 1208 Hilltop
Springs,
WY
82901
382-4832.
style. Send
Salary letters
or evening
mammography.
practice
call. Need Great
leading to equal partnership. and CV to: Box R-3201.
RADIOLOGY
exlife
degree,
is based
re-
To
board
certifica-
on academic
benefits
M.D.,
aging,
The
is pro-
along with to: Teresita Divison
University Sciences
an
Univer-
Sciences, Street, (501)
of
is
Opportunity
OPENING
FOR BC/BE GENERAL with experience in
ventional a group hospital
and
Medical
Allentown,
Center,
PA
for
to join a 160-bed PA, about
of Philadelphia.
includes
eral Radiology, Medicine. Please Shohadai, M.D.,
RAInter-
Radiology
radiologists in Allentown,
northwest
practice
for Ac-
Employer.
Vascular
of four located
Slot Little 686-
Arkansas
Affirmative
tion/Equal
DIOLOGIST
a L.
of Im-
of Radiology,
sity of Arkansas for Medical 581, 4301 West Markham Rock, AR 72205. Telephone Medical
rank,
package
Director,
Department
60 miles
private
teaching,
programs. candidate
Address inquiries, Curriculum vitae,
Angtuaco,
interests
M.D.
a generous
nity college and superb outdoor and indoor community recreation facilities. School systems are ranked excellent nationally. Located 3 hours east of Salt Lake City. The surrounding area is ideal for packing, hunting, boating, with accessibility to Flaming reational area and the Uintah,
care
appointment,
have
vided. current
Wyoming There
served.
to direct
clinical
tion in Nuclear Medicine, and the desire to head a medical school section. Teaching and administrative experience are de-
daily
Box
background
southwestern of 50,000
in
MARCH
radiology
Strong
faculty
sirable.
No night
T. Cook, M.D., IN 47716-5249.
MEDICINE
Department
search,
off per year and full partnership at 2 years. The hospital is located in a high mountain desert community of 20,000 in
perience
to partnership. 5249, Evansville,
competing
or PPO’s.
expertise
leading
NUCLEAR
VICE-The
should
No
groups,
group.
years
CHIEF,
procedures.
Competitive
two
recently
Univeristy of Arkansas for Medical Sciences, Little Rock, AR invites applications for Chief, Nuclear Medicine Service. We seek an individual with academic tract
BOSTON-Expanding
for
young
third
trained BC/BE general radiologist to join a growing, independent practice in a modern, 100 bed hospital. 27,000 procedures annually including full service ultrasound, nuclear medicine with SPECT, mammography, CT, and mobile MRI. Limited angiography and interventional
will be considered. All imaging modalities, including MRI available in 400 bed hospital. 90,000 examinations annually. salary
a
all aspects
The of Gen-
CT, US and Nuclear call or send CV to: Asad Allentown Osteopathic 1736
Hamilton
18104.
Tel:
Street,
(215)
770-
8700.
95A
PARTNERSHIP
CLASSIFIED
SERVICES
SUPERB PARTNERSHIP LAS VEGAS-Rapidly member service tal has
group practice imaging centers an immediate
POSITION IN expanding seven covering two full and a small hospiopening. We are
looking for an additional Board radiologist with an uncommon tion to excellence in patient outpatient facilities include: Angio with a 4-bed recovery Mammo, 3 SPECT, plus R & excellent opportunity for a position with a well respected
growing
community.
Please
Dr. Mark Winkier, land Parkway, Las
SDMI, Vegas,
Certified
dedicacare. Our 2 MR. 2 CT, area, 5 US, 5 F. This is an partnership group in a
send
CV to
2950 5. MaryNV 89109.
UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AT CHICAGO has an opening for a Board Certified, Diagnostic Radiologist with interest in abdominal imaging including CT, MRI, Ultrasound, GI and GU Radiology. The position offers a balance of clinical, teaching and research activities. Salary and faculty rank are appropriate to experience. Please send inquiries along with CV to: Steven Pinsky, M.D., Professor and Head of Radi-
ology,
University
of Illinois
at Chicago,
1740 West Taylor Street, Chicago, 60612, (312) 996-0234. UICOMC EO employer offering competitive and benefit package.
Illinois is an AA/ salary
DIAGNOSTIC RADIOLOGIST lLl)i(ilV
Oregon I ‘)-IllCIllhCl’
cXJ)alldiflg
l)Sl)iLtl S(CkS R(’JBL Radiologist for half-tuneposiliollilli
‘dOd clinic-based
O)Uj)
the possihilitof becoming full lime. The l)oSitioIl ould have PriIll:tY reponsihiliLv for I S. (T. Iluoro, films 111(l :Ll)iraliooc1ologies. Opportunities iailahle ill inanuiiogrtph , (lepending 01)00 interest and training: )OSSihlV Mill in the future as OlLIflW increases.
:Lre l)L1I of a successful mttltisl)ecialtv I I%1() I)r.tctiCe, located in the beautiful Ptcific \oiihwesl, which offers sLtte-of4lietrt e(luipnlent and (,
excellent
sahLrv/henefits
l:xlremelv iiients/2 Forward
M.D.,
Kaiser
Medical
Center,
Dept. of Radiology, SOSS N. (;reeley Me., Portland, OR 972 17.4’91.
EOE.
Ce
KAISER Northwest Physicians
rector
of the section
of MRI. The other
po-
agnostic modalities. Ground has just been broken on a new 25,000 sq. ft. radiology wing, which will be furnished with stateof-the-art cancer
equipment. center, and
New rehab
trauma hospital
built. Excellent compensation fits package leading to full Beaches Angeles
and only
sunny
weather.
large-city 2 hours
center, being
and benepartnership.
amenities of Los away. Year-round
Ample
free
time
to enjoy
Southern California and the unparalleled recreational opportunities offered by the resort community of Palm Springs. Direct inquiries to Marvin J. Friedenberg, M.D., Desert Hospital, Department of Radiology, 1150 North Indian Canyon Dr., Palm Springs, CA 92262.
DIAGNOSTIC
RADIOLOGIST
skills in CT, MR. Nuclear Medicine Board Certified practice in Eastern
Interventional, to join group Radiologists. Washington.
a new
multi-modality
center, and two private for long term practice notch school system,
first
rate
universities.
fishing,
boating, Crecelius, M.D., Suite 18B, Spokane, 2385.
with US and of eight Growing 228 bed
imaging
offices. Potential is excellent. Top including three
Excellent
hunting,
skiing. Contact L. E. N. 5901 Lidgerwood, WA 99207. 509-482-
NORTHERN CALIFORNIA-For a radiologist who desires a semi-retirement type of practice in central, northern California in a geographical location equidistant from the San Francisco Bay Area, Carmel-Monterey Peninsula, Yosemite and Sierra ski areas. Full-time radiologist wishes to share practice and provide equal, bountiful time off periods for trayel, leisure and relaxation. Call (209) 6670216 after 6:00 PM (PST).
rM.
PERMANENTE Permanente PC and Surgeons
IMMEDIATE
OPENING
for BC-BE diag-
nostic radiologist for night call and weekend work to join a two member P.C. in a 220 bed community hospital, Birmingham, Alabama area. Home video telemetry provided with few night calls. US, CT, NM, rare angiogram or interventional procedure, general diagnostic radiology. No MRI. Negotiable, competitive salary
with tirement
excellent plan.
benefits, Full
insurance
partnership
Contact Charles Baker, na Road, Birmingham, (205) 481-7193.
96A
PALM
package.
low turnover ( 2 retireresignations in l)1sl 21) ears) C.%. to: Laurie Forrest,
Bess
IN
sition requires a physician with mammography experience to direct imaging in the Breast Health section of a new Comprehensive Cancer Center. The group covers a 350-bed hospital and 2 offices in a desirable, rapidly expanding area of Southern California. MRI facilities indude 1.5 T Picker Vista HPQ with MRA package, ViStar imaging computerand 1.5 I GE Signa. Other equipment includes 3 CT’s, a Cemax image processor, 2 Acuson Color-flow Doppler US, 4 nuclear cameras including 2 SPECT, and all other di-
hospital,
Portland,
POSITION
SPRINGS, CA-Well-established 9member group has openings for 2 board certified radiologists. A physician with a strong background in MRI is sought as di-
RADIOLOGY
and
re-
potential.
M.D., 2650 AltadeAlabama 35243,
ACADEMIC
FACULTY
POSITION
AVAILABLE
as a Diagnostic in Chest,
Radiologist. GI, Ultra-
Subspecialization
sound or Interventional is desired. The Medical University of South Carolina is seeking radiologists for academic positions. Candidates must be Board Certified or Board Eligible. Salary and Academic Rank commensurate with Contact: Kenneth M. Spicer, Interim Chairman, Radiology, University of South Carolina, Avenue, Charleston, S.C.
(803)792-4267.
AAEOA.
DIAGNOSTIC
RADIOLOGIST,
NORTHEAST-Must all aspects of diagnostic
ing MRI and at a 250-bed private
angio. rural
office.
9800
CT,
experience. M.D., Ph.D., Medical 171 Ashley 29425-0720.
be experienced in radiology includ-
To join referral
group of four hospital and
Equipment
1.0 T MR.
includes
biplane
GE
angio
with
DSA, SPECT and color Doppler. Small community in the Catskill Mountains, two hours drive from New York City and 31/2
hours
leading
from
Boston.
Excellent
to partnership.
quiries
to David
Mountain
FULL
Hall,
Road,
TIME
CV
M.D.,
954 Ohayo
Woodstock,
BC/BE
salary
Send
and
NY
in-
12498.
DIAGNOSTIC
RA-
DIOLOGIST-Immediate opening. Outstanding opportunity at well-established private outpatient facility in suburban Philadelphia area. Experience needed in MRI. Full service includes General Radiology, Mammography, CT, NM, US, MRI. No night calls. Competitive salary leading to early partnership. Good Benefits. Contact I. Darocha, M.D., (215) 543-8860.
EMORY UNIVERSITY MEDICINE is seeking sition
as a staff
SCHOOL
applicants neuroradiologist.
OF
for a p0The divi-
sion is staffed by four full-time neuroradiologists and an interventional neuroradiologist. There are also four neuroradiology fellows. We have four 1 .5 TesIa MRI units, one 4.7 Tesla small bore MRI unit,
and
seven
CT scanners.
inquiries
to: James
Director,
Neuroradiology,
Please
C. Hoffman,
Department
Radiology/Neuroradiology, versity School of Medicine, Road,
N.E.,
Atlanta,
4583,
(404)
727-0899
HARTFORD, Board Certified
GA
direct
Jr., M.D., of
Emory Uni1364 Clifton 30322,
(404)
727-
(FAX).
CT-Position
available
Radiologist
to join
for
an es-
tablished group of 8. Practice includes hospital and four private offices, all fully equipped including CT. Mammography experience would be helpful. Competitive starting salary and benefits. Please enclose CV with initial correspondence to: Jeffrey Blau, 40 Hart Street, New Britam, CT 06052; 203-229-2059.
DIAGNOSTIC
RADIOLOGIST-Three
member radiology group seeks fourth radiologist with interventional skills to join them in a suburban community hospital practice in northern Ohio, twenty mm-
utes from the boating sures of Lake Erie and
and fishing pleaits islands. Interest-
ed applicants please call or write to: Dr. Matthew Gutowicz, Jr., 23 Patrician Drive, Norwalk, Ohio 44857. (419) 6688101 Ext. 6205 or 6208.
MARCH
HEAD AND NECK/NEURORADIOLOGIST-The Cleveland Clinic Foundation has a staff position available in the Division of Radiology with special emphasis on head and neck radiology. Candidates must be board certified in Diagnostic Radiology, eligible for Senior Membership in the ASNR as well as licensure in the state of Ohio, and have a clinical background in ENT procedures. This position within neuroradiology will fulfill a complement of five full-time neuroradiolo-
gists
at a 1,200
bed
teaching
hospital
and
large
out-patient facility serving the clinical disciplines of Neurosurgery, Otolaryngology, Neuro-ophthalmology, Adult and Pediatric Neurology. Diagnostic imaging and interventional equipment are
state
of the art and well
staffed
with
VETERANS
cian
board
diology.
eligible/board Subspecialty
CENphysiin Rachest,
GI or interventional radiology is but not essential. This 1,142-bed care Medical Center is affiliated with the Medical College of Georgia. Faculty appointment commensurate with qualification and experience. Augusta en-
joys a moderate
climate,
reasonable
living, numerous recreational and institutions of higher equal opportunity employer. tional information, contact marik, M.D., Chief, Radiology
cost of
facilities learning. An For addiGeorge T. JaService, at
(404) 823-2236.
excel-
GREAT
PEOPLE,
SEE
THE
COUNTRY, WORK WHERE YOU’RE REALLY NEEDED-Join CompHealth, nation’s
largest
locum tenens medical staff. Work when you choose. Teach and learn from colleagues in facilities across the country. Accept or decline any assignment. Enjoy the security of a guaranteed income if you prefer. You’ll earn an excellent income, and your malpractice insurance, travel, housing, local transportation, and licensure will be paid in full. Call today-1-800-328-3084.
IMMEDIATE
OPENING-BC/BE
Diag-
nostic
Radiologist to join eight board certified radiologist incorporated practice covering three hospitals with approx 700 beds and 100+ physician multispecialty clinic. All modalities represented. Must be willing to participate in all aspects of general radiology. Excellent fringe bene-
fit package ing
with
to early
buy-in.
Practice
Valley.
competitive
shareholder
located
Excellent
schools.
Send
Business PA., P.O.
salary status
in Arkansas
public
CV or contact:
Manager, Box 1827,
lead-
at modest and
private
June
Radiology Fort Smith,
River Martin,
Services, AR 72902,
782-5035.
FELLOWSHIPS
FELLOWSHIP IN US/CT/ANGlO-INTERVENTIONAL-A one year fellowship
program
available
POSITIONS
SOUGHT
TRAINED
BOARD
FlED
INTERVENTIONAL GIST-with two years
experience
at
major
seeks
opportunity art patient care. getic and highly
lent
reply
academic
center,
to provide state Bright, personable, motivated, with
references.
Please
CERTI-
RADIOLOpost-fellowship
Geographically to Box
flexible.
R-3207.
JULY 1992 SECOND OLOGY RESIDENCY SOUGHT-Radiology ing first year seeks to transfer search-oriented university-affiliated enced engineer varied research
of the enerexcel-
YEAR RADIPOSITION resident
July,
POSITIONS-The
De-
partment of Radiology of the Brigham and Women’s Hospital-Harvard Medical School has one or two year fellowship positions in the following areas: (1) cardiovascular and interventional, (2) neuroradiology, (3) CT/US/MR. (4) oncoradiology, (5) chest, (6) bone, (7) nuclear medicine, (8) computer science. For more
information tae specifying
please
send
your
curriculum
vi-
of interest to: B. Leonard Holman, Chairman, Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115. Harvard Medical School and Brigham and Women’s Hospital are equal opportunity, affirmative action employers.
area M.D.,
complet-
large private hospital into second year of reacademic university or program. Experiwith strong interest and background in imaging and interventional technologies. Reply via FAX: (602) 982-2391.
EXPERIENCED,
beginning
1992 at Lehigh Valley Hospital Center in Allentown, PA. LVHC is a 492 bed acute care, university affiliated hospital. The fellowship program offers training in CT (head and body), ultrasound, angiography (neuro and visceral), and interventional radiology. MRI experience is also available. For further information contact Robert Kricun, M.D., Department of Radiology, Lehigh Valley Hospital Center, P.O. Box 689, Allentown, PA 18105.
FELLOWSHIP
RECENTLY
(501)
MEDICAL is seeking a certified interest in
444-6653.
MEET
the
GA
skeletal, desirable tertiary
lent ancillary personnel. For further details please contact: Thomas J. Masaryk, M.D., Head, Section of Neuroradiology, Division of Radiology, CCF, 9500 Euclid Avenue, Cleveland, OH 44195. Phone: (216)
AFFAIRS
TER, AUGUSTA,
in
YOUNG,
TERVENTIONALIST
FACULTY
(ABR,
UNIVERSITY
Miami
IN-
SCHOOL
SCVIR)-
seeks
private practice position leading to full partnership. Can perform general radiology, including MRI, Ultrasound, CT. Prefer medium to large hospital in urban or suburban location. Available March 1992. Please respond to Box R-3203.
OF
OF
MEDICINE
Department of Radiology is recruiting faculty for the UM/Jackson Memorial Medical Center, a 1500 bed tertiary care referral center. Positions available to meet expanding clinical and academic programs in:
CT/ULTRASOUND AREA-4 Breast Centers (ACR accredited), general ultrasound (heavy OB/GYN) desires associate leading to partnership. Fellowship or extensive experience in mammography and/or ultrasound desirable. Superb opportunity for ambitious Board Certified radiologist. Reply to Irwin Schiller, DO., Cohn J. Wells, M.D., Breast Diagnostic Centers, 411 Strander Blvd. #303, Seattle, WA 98040,
GENERAL
SEATTLE
(206)
575-9123.
RADIOLOGY
MUSCULOSKELETAL NUCLEAR MEDICINE
CLASSIFICATIONS Positions available Positions sought Fellowships Announcements of courses or symposia
Practices
CENTRAL
MAINE
- PART
TIME-
General Radiologist wanted to supplement dynamic, congenial 5 man group in new hospital department. Work 30 weeks, no weekends. Live in 4 season recreation area close to coast and mountains with time to enjoy them. Competitive salary
and benefits. (207) 786-3571.
MARCH
Contact
Peter
Rutherford
RADIOLOGY
VASCULAR/INTERVENTIONAL
ACCEPTED
postgraduate
for sale
Medical facilities for rent or sale Used radiologic equipment & apparatus for sale Medical employment bureaus Academic posts to be filled Available posts for interns & residents Malpractice insurance
RADIOLOGY
PEDIATRIC EMERGENCY Candidates eligible, equivalent
RADIOLOGY RADIOLOGY
must be Board certified with fellowship training experience. Rank and
ry commensurate Send
CV.
with
C.
A. Poole,
Department
qualifications.
School P.O.
M.D.
and
Chairman
of Radiology
University
(R-308)
of Miami
of Medicine Box
Miami, AN
or or sala-
to:
Professor
EQUAL
IMAGING
016960 33101
Florida
AFFiRMATIVE
OPPORTUNITY
ACTJON/
EMPLOYER
97A
CLASSIFIED
SERVICES
MUSCULOSKELETAL
RADIOLOGY
FELLOWSHIP-Applications are now being accepted for a musculoskeletal fellow position for 1992 at the Cleveland Clinic Foundation (CCF). CCF is a thousand bed tertiary care teaching medical center with a large radiology residency program. Local, national and international patients provide for an interesting and varied mix of bone pathology. Training includes all aspects of musculoskeletal radiology including MR. CT, arthrography, biopsy, bone densitometry, and a large plain film experience. Fellowship includes patient care, teaching, and research. There is a close working relationship with the Orthopedic, Rheumatology, and Endocrinology departments. There are presently four musculoskeletal staff in the section. For further information please contact Bradford J. Richmond, M.D., Head, Section of Musculoskeletal Radiology, Desk A-21, 9500 Euclid Ave., Cleveland, OH 44195 or phone 216444-3931.
ULTRASOUND FELLOWSHIP for physicians
PRECEPTORIAL PROGRAMS-Programs
AND
and technologists in diagnostic ultrasound are offered under the medical direction of Dr. E. A. Lyons. Areas of instruction are offered in abdominal, ob/gyne (endovaginal), small parts, peripheral and abdominal color Doppler. Preceptorship training is available thoughout the year and is adapted to meet individual needs. Fellowships are twelve months and commence in July. The de-
partment clinical
offers exposure,
as visiting
professor
teaching film For additional Clifford
an excellent and teaching file
Health Street, R3A
1R9;
FELLOWSHIP IN OLOGY-UNIVERSITY DA-The in the
Division Department
University
video
wide such tapes,
reference
library.
information contact Section of Diagnostic
S. Levi,
trasound, Sherbrook Canada,
lecture
and
staff, aides
of Florida
Sciences Winnipeg, (204)
Centre, Manitoba,
Dr. Ul820
787-3208.
PEDIATRIC OF
RADIFLORI-
of Pediatric Radiology of Radiology at the
offers
a one-year
fel-
lowship training in Pediatric Radiology, starting July 1993 and July 1994. Three full-time pediatric radiologists provide training in conventional radiology and fluoroscopy, ultrasound, neonatal imaging, CT, MRI, and interventional/angiog-
raphy
techniques.
Supplemental
training
in nuclear medicine is available. Facilities include dedicated standard r/f rooms, 4 color-Doppler ultrasound machines, 2 GE CT units, 3 MR units, ICU electronic image transfer and computed radiography (CR). Opportunity to participate or conduct clinical and basic research is available. Applicants must be eligible for Iicensure in the State of Florida. Contact person is: Jonathan L. Williams, M.D., Director of Pediatric Radiology, Department of Radiology, Box 100374, University of Florida, Gainesville, Florida 32610-0374. Tel (904) 395-0291 . The University of Florida is an equal opportunity/affirmative action employer.
98A
FELLOWSHIP IN MUSCULOSKELETAL RADIOLOGY-UNIVERSITY OF FLORIDA-The Department of Radiolo-
FELLOWSHIP
gy is offering musculoskeletal fellowship positions beginning July 1993 and July 1994. The fellowship currently centers on a 548-bed hospital with wide exposure to skeletal pathology, including more than 200 new musculoskeletal tumors per year. The fellowship experience includes clinical, research, and teaching opportunities in diagnostic skeletal radiology, CT, MRI, MR spectroscopy, metabolic bone disease, TMJ pathology, and image processing.
Swedish
Systems
available
include:
one 1 .5T whole
body spectroscopy/imager, two GE 9800 Advantage CT scanners, and one image processing workstation (DM1) for multiplanar (MPR) and three dimensional (3D) reformation. At the fellow’s discretion, the experience could be expanded to indude aspects of nuclear medicine and the adjacent 473-bed VA Hospital which is equipped with a 1.5T whole body spectroscopy/imager and a Picker 1200 CT scanner. Applicants must be eligible for
licensure CV
in the William
State
of Florida.
Montgomery,
Send
a
Department of Radiology, Box 100374 JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0291. The University of Florida is an equal opportunity/affirmative
action
to
M.D.,
employer.
WAYNE STATE UNIVERSITY BODY MRI FELLOWSHIP-The Department of Radiology, Wayne State University is offering a new Fellowship in Body MRI commencing July 1, 1992. The MR Center includes a 4.7T animal imager and stateof-the-art iT and 1.5T magnets with a 2nd 1ST to be installed in fall 1992; one whole body magnet is dedicated to research. In addition, the physically connected Children’s Hospital has a .35T magnet dedicated to pediatric patients. The Medical Center has 1200 beds and broad referral base leading to a busy dinical service covering all ages and all body systems. There is an active research program in both imaging and spectrosdopy with full time MR physicist, biochemist and graduate students. The Fellowship is a 1 year program with a potential second year for a Fellow with strong research interests. Interested candidates should contact Renate L. Soulen, M.D., MR Center, Harper Hospital, 3990 John R, Detroit, MI 48201, or call 313-745-9542.
FELLOWSHIP OLOGY-The
IN PEDIATRIC RADIDepartment of Radiology,
Bowman Gray School of Medicine, Wake Forest University, offers a one-year fellowship in Pediatric Radiology beginning 1 July 1992. Training will include conventional radiology, neonatal radiology, ultrasound, computed tomography, MRI, and interventional techniques. Facilities include digital fluoroscopy and PACS, ultrasound units with Doppler and color flow Doppler capabilities, 6 CT units and 3 MRI units (l.5T). Opportunities to participate in both clinical and basic research, including PET scanning. Contact Thomas E. Sumner, M.D., Department of Radiology, Bowman Gray School of Medidine, Medical Center Boulevard, WinstonSalem, North Carolina 27157-1088.
RADIOLOGY
1-year Hospital in the
IN
Fellowship Medical
Hospital Pacific
ULTRASOUND-A is available Center,
is the
Northwest.
at Swedish Seattle, WA.
largest The
hospital Ultrasound
Department is responsible for all aspects of ultrasound including abdominal, gynecologic, obstetric (including high risk), pediatric, vascular, and small parts US. Fetal echocardiography and adult echocardiography are also performed within the department. The sonologist performs a wide variety of ultrasound procedures including needle biopsy, abscess drainage, biliary lithotripsy, intraoperative US, and US-guidance for um-
bilical
vein
sampling,
amniocentesis,
chorionic villous sampling, and fetal therapy. State-of-the-art equipment includes color flow imaging, duplex Doppler, transvaginal and transrectal ultra-
sound.
Fellows
sonologists sound and
work
with
one
of four
are dedicated to ultrain teaching. Academic time is granted to promote research and publication. Requirements include satisfactory completion of a 4 year accredited Radiology training program and active interest in ultrasound. Address inquiries and curriculum vitae to: David A. Nyberg, M.D. or Barry S. Mahony, M.D., Department of Ultrasound, Swedish Hospital Medical Center, 1229 Madison Street, Suite 1150, Seattle, WA 98104. Phone: (206) 386-2380, Fax: (206) 386-6312.
SPECIAL
who active
IMAGING
FELLOWSHIP-At
the Johns Hopkins Hospital, Department of Radiology starting July 1, 1993, a unique opportunity for a year of excellence in clinical and/or research in medical imaging. Active body CT service (>16,000 studies per year) on state of the art equipment with special areas of inter-
est including
oncology,
immunocompro-
mised host, inflammatory bowel disease, and 3-dimensional imaging. Research in imaging includes image processing of CT and MRI data using PIXAR Image Computers, Sun Workstations as well as NeXT and Apple Computers. The candidates will be able to devote a significant portion of the year to research and will be a sponsored fellow of the Winthrop Research Fellowship. Interested applicants should write or call Elliot K. Fishman, M.D., Department of Radiology, The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21205, (410) 955-5173.
FELLOWSHIP
IN ULTRASOUND
AND
BODY CT/MRI-One-year fellowships in ultrasound and body CT/MRI beginning July 1, 1992, and July 1, 1993, are being offered by the New York HospitalCornell Medical Center. The department provides state-of-the-art equipment, including Acuson and ATL ultrasound, GE 9800 CT, and GE Signa 1.5 Tesla MR. Wide variety of ultrasound examinations indude abdominal, Ob-Gyn, color doppler, small parts, neonatal head, transvaginal, and transrectal. Applicants should be ABR eligible or certified. Send CV to Elias Kazam, M.D., Department of Radiology, New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, New York 10021.
MARCH
NEURO/ENT VERSITY OF
-
FELLOWSHIP FLORIDA-The
UNI-
Department of Radiology offers several 2-year post-residency fellowship training positions available July 1993 and July 1994. The fellowship offers excellent clinical material, comprehensive and modern equipment subspecialty cal practice include
and experienced four-person faculty. In addition to cliniand training, responsibilities graduate and undergraduate medical instruction in neuroradiology as well as participation in departmental research activities. Minimum requirements include successful completion of an accredited radiology residency. Applicants must be eligible to obtain a medical Iicense in the State of Florida. For additional information contact Ronald Quisling, M.D., Professor, Department of Radiology, Box 100374 JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0291. The University of Florida is an equal opportunity/affirmative action employer.
FELLOWSHIP partment radiology,
Medicine position
POSITIONS-The
of Radiology, Section Emory University is offering a 2 year
beginning
July,
Deof NeuroSchool of fellowship
1992.
A wide
range of clinical and research experience is available including active pediatric, ENT, and interventional neuroradiology. Equipment includes 4 high field MRI units, 7 CT scanners, 2 neuroangiographic suites, and 3 Color Doppler Ultrasound units. Weekly interdepartmental conferences are conducted with the departments of neurology and neurosurgery. Contact James C. Hoffman, Jr., M.D., Director, Neuroradiology, Emory University School of Medicine, Department of Radiology/Neuroradiology, 1364 Clifton Road, N.E., Atlanta, GA 30322; (404) 7274583. Emory University is an equal opportunity/affirmative action employer.
THE NEWLY RENOVATED AND EQUIPPED DEPARTMENT OF RADIOLOGY AT THE ALBANY MEDICAL COLLEGE AND CENTER IN ALBANY, NEW YORK offers the following Fellow-
ACCREDITED FELLOWSHIPS DIATRIC RADIOLOGY AND RIC NEURORADIOLOGY-Depart-
ship positions each year: (1) Abdominal Imaging-The Abdominal Imaging Fellowship encompasses all aspects of MRI, Ultrasound, CT and other advanced techniques in imaging the abdomen. Four state-of-the-art MRI and four CT scanners as well as five color Doppler Ultrasound units are utilized daily. Contact: James C. Peters, M.D. regarding this Program. (2) Neuroradiology-This Fellowship encompasses the full range of advanced neuro imaging including MRI, CT, Angiography and Myelography. Contact: Wilham A. Wagle, M.D. (3) Angiography and Interventional Radiology-Three advanced angiographic suites are utilized daily for a full range of vascular and interventional procedures. Contact: Mohammad S. Sarrafizadeh, M.D. All Program Directors listed above may be contacted at the Department of Radiology A-113, Albany Medical Center, Albany, NY 12208, (518-445-3277) or contact Matthew D. Rifkin, M.D., Chairman, Department of Radiology, A-113, at the above address. Albany Medical Center is an equal opportunity/affirmative action employer.
one- or two-year fellowships radiology beginning July
INTERVENTIONAL MAMMOGRAPHY AND BREAST IMAGING FELLOWSHIP-The University of Arizona is offering a flexible one-year fellowship in interventional mammography and breast imaging for 1992-1993. The section performs more than 12,000 mammograms per year and over 500 breast interventional procedures, including percutaneous, stereotaxic breast needle biopsy, preoperative localizations, and galactography. Equipment includes 6 state of the art mammographic units and 3 stereotaxic devices. The fellowship will include 20% academic/protected research time and up to four months could be spent in other ar-
eas of body FELLOWSHIP OLOGY-The
IN
PEDIATRIC
RADI-
Department of Radiology, Children’s Hospital and Medical Center (CHMC) and University of Washington (UW), Seattle, offers an ACGME accredited fellowship that begins July 1, 1993.
Training
is in the largest
Children’s
Hos-
pital in the Northwest and includes exposure to all aspects of pediatric imaging on state-of-the-art equipment and under the supervision of eight pediatric radiologists. CHMC, a 208-bed medical center
and
UWMC
approximately
neonatal
care
unit
perform
53,000 exams annually. Training encompasses neuroradiology, vascular/interventional, nuclear medicine, oncologic imaging, MRI, ultrasound, computed tomography, neonatal imaging, and radiography and fluoroscopy. There is ample opportunity and time alloted for clinical and basic research projects. Candidates must be board-certified or qualified in diagnostic radiology. CHMC and UW are equal opportunity/ affirmative action employers. A letter of inquiry and curriculum vitae should be sent to Eric L. Effmann, M.D., Director, Department of Radiology, Children’s Hospital and Medical Center, P.O. Box C-5371, Seattle, WA 98105, (206) 526-2166.
MARCH
have
imaging
active
clinical, basic sessment/outcome
(CT, US, or MRI). We
research
program
science
and
as-
reindude: relocation allowance, office space with computer, and funds to attend national meetings. Salary $37,500. Must be BC/BE. For further information please contact: Laurie L. Fajardo, M.D., Director, Mammography and Breast Imaging, University of Arizona, 1501 N. Campbell lated
breast
imaging.
analysis Other
including
technology research benefits
Ave., Tucson, Arizona 85724. Application deadline: April 1, 1992. The University Arizona is an Equal Opportunity/Affirmative Action Employer.
of
POSITION AVAILABLE (July 1992 or sooner)-Neuroradiology Fellowship (one year) for BC/BE radiologist. Section contains 3 neuroradiologists and services neurosurgery, neurology and ENT departments, including extensive skull base surgery. Interventional neuroradiology experience included. Compensation is highly competitive. Equal opportunity/ Affirmative action employer. Send CV to: Dr. B. Azar-Kia, Department of Radiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153.
RADIOLOGY
ment
of
Medical
Radiology,
Center,
year
pediatric
ship
program
IN PEPEDIAT-
Children’s
Cincinnati,
Hospital
Ohio
neuroradiology
is also
offers
in pediatric 1, 1993. A one-
offered
fellow-
and
may
be
taken separately or combined with one year of adult neuroradiology fellowship at the University of Cincinnati Medical Center. Children’s Hospital Medical Center (CHMC) is a 355-bed institution. The Department performs over 105,000 radiological examinations annually in
the largest
children’s
hospital
latory practice in the United Department has 14 full-time diatric radiologists, 6 fellows,
resident
trainees.
Five
pediatric
and ambuStates. The faculty peand many
radiolo-
gy and one pediatric neuroradiology fellowship positions are available annually. Training includes all aspects of pediatric imaging: neonatal radiology; neuroimaging; musculoskeletal radiology; cardiovascular and thoracic imaging; abdominal imaging; oncologic imaging; ultrasonography; nuclear medicine; computed tomography; MRI; and vascular/interventional procedures. The Department has an active clinical service with state-of-the-art equipment as follows: digital fluoroscopy; Acuson, Al, and ATL ultrasound units with Doppler and color-flow Doppler capabilities; planar SPECT gamma cameras; GE 9800 Quick CT scanner, 1ST GE MRI with spectroscopy; and cardiac catheterization/angiographic suite with digital vascular imaging. The fellowship provides a broad clinical experience in pediatric radiology as well as numerous opportunities to participate in both clinical and basic research. Candidates must be Board certified or Board qualified in Diagnostic Radiology and obtain an Ohio Medical License. Salary and fringe benefits are highly competitive. Applications are due prior to January 1992 with interviews scheduled during the fall and winter of 1991-92. There are numerous career opportunities in pediatric radiology in academic and private practice settings. To receive more information about the fellowships at CHMC or careers in pediatric radiology, please contact: Donald R. Kirks, M.D., Director, Department of Radiology, Children’s Hospital Medical Center, Cincinnati, OH 45229-2899. (513) 559-8058. Children’s Hospital Medical Center and the University of Cincinnati College of Medicine are Affirmative Action/Equal Opportunity Employers.
KEEP
YOUR
CLASSIFIED AD an additional $20.00 per insertion, we’ll assign a box number to your ad. Responses will be sent to you as soon as they are received. Send your ad to: Radiology Advertising Production Department 1991 Northampton Street Easton, PA 18042
CONFIDENTIAL-For
99A
ABDOMINAL SHIP-UNIVERSITY
IMAGING OF
The Department versity of Florida
of Radiology is offering
cal fellowships ginning
Minimum
FELLOWFLORIDAat the Uni1-year clini-
in abdominal
in
FELLOWSHIPS AT THOMAS JEFFERSON UNIVERSITY HOSPITAL-The
SERVICES
CLASSIFIED
July
1993
imaging and
requirements
July
include
be1994.
success-
ful completion of an accredited radiology residency. The fellowship includes training in all aspects of abdominal imaging (gastrointestinal and genitourinary radiology, CT, MRI and ultrasound) by a 4person subspecialty faculty. The program offers full clinical experience and research opportunities. Applicants must be eligible to obtain a medical license in the State of Florida. Research Fellowships are also available in abdominal imaging. For additional information contact Pablo R. Ros, M.D., Professor, Department of Radiology, Box J-374 JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0288. The University of Florida is an equal opportunity/affirmative action employer and encourages applications from women
and
minorities.
PEDIATRIC
RADIOLOGY
FELLOW-
SHIP-Egleston Children’s Hospital at Emory University offers a one-year fellowship in Pediatric Radiology beginning July 1, 1992. Training includes conven-
tional
radiography,
ultrasound computerized
cine,
digital
(including tomography,
MRI,
fluoroscopy,
color doppler), nuclear medi-
neuroradiology,
and
interven-
tional techniques. Egleston Children’s Hospital is a 225 bed tertiary care pediatric hospital on the Emory University campus which performed 50,000 imaging studies in 1990. The department is staffed by seven pediatric radiologists and one pediatric neuroradiologist. Two fellowship positions are available eac#{241} year. The application deadline is April 1, 1992. Candidates must be board certified or board eligible in Diagnostic Radiology. For ad-
ditional
information,
please
address
in-
quiries to Dr. Turner Ball, c/o Radiology, Egleston Children’s Hospital, 1405 Clifton Road, N.E., Atlanta, Georgia 303221101. Egleston Children’s Hospital is an Equal Opportunity/Affirmative Action
Employer.
RESEARCH VENTIONAL
FELLOWSHIP IN INTERRADIOLOGY-A two-
year position is General Hospital,
pital
in Pittsburgh,
available a 746-bed
at Allegheny teaching hos-
for a research
fellow
in an innovative program in interventional radiology research beginning July 1992. The fellow will participate in imaging studies directed at ablation of tumors in the liver, prostate, lung and brain. Per-
cutaneous
methods
ed disks also responsibilities
opportunities
are
of removing
being pursued. will be included
to
pursue
herniatClinical as well as
individual
re-
search interests. Candidates must be board certified/board eligible in radiology. Please send CV to Dr. Gary Onik, 320 East North Ave., Pittsburgh, PA 15212.
100A
Department of Radiology at Thomas Jefferson University Hospital in Philadelphia offers the following fellowship programs each year: (1) Ultrasound/CT/ MRI-Jefferson’s ultrasound division is one of the largest in the world and performs all currently available exams, including obstetrical, vascular, lithotripsy, invasive, endoluminal, etc. We also operate four GE 1.5T MRI units and three CT scanners. Contact Barry Goldberg, M.D. regarding this program. (2) Cardiovascular/Interventional-this division is housed in a new suite containing Philips angio units with DSA, and performs the full range of vascular and nonvascular interventional procedures. Contact Geoffrey Gardiner, Jr., M.D. (3) Neuro/ENT radiology-very active clinical services supply a wealth of material to this divi-
sion,
which
is housed
in a Neurosciences
Imaging Center containing all imaging modalities. Contact Carlos Gonzalez, M.D. (4) Breast Imaging-Jefferson’s new breast imaging center performs approximately 85 studies per day, including ultrasound and needle localizations. Contact Stephen Feig, M.D. (5) Chest-includes
biopsies
and
CT. Contact
Robert
being low
Clinic
accepted position
RADIOLOGY are now
for a musculoskeletal felfor 1993 at the Cleveland
Foundation
(CCF).
CCF
is a thou-
sand bed tertiary care teaching medical center with a large radiology residency program. Local, national and international patients provide for an interesting and varied mix of bone pathology. Training includes all aspects of musculoskeletal radiology including MR. CT, arthrography, biopsy, bone densitometry, and a large plain film experience. Fellowship includes patient care, teaching, and research. There is a close working relationship with the Orthopedic, Rheumatology, and Endocrinology departments. There are presently four musculoskeletal staff in
the
section.
For
further
information
please contact Bradford J. Richmond, M.D., Head, Section of Musculoskeletal Radiology, Desk A-21, 9500 Euclid Ave., Cleveland, OH 44195 or phone 216-4443931.
FELLOWSHIP
IN
ULTRASOUND,
BODY CT AND MRI; July 1992, also July 1993. 1 year program featuring ultrasound, body CT, body MRI and noninvasive vascular diagnosis. Send CV, or for information contact: William Zwiebel, MD, Dept. of Radiology, University of Utah Hospital, Salt Lake City, Utah 84132; (801) 581-7553.
RADIOLOGY
Commencing July 1, 1992, position is available for board certified radiologist to receive fellowship training in MR. CT, Ultrasound, and interventional procedures guided by those modalities in the Department of Radiology, University of Southern California. This program offers superb training supervised by academically productive faculty in rich clinical setting. Excellent opportunities exist for supervised hands-on-training in MR, MR angiography, CT, CT-guided procedures, Ultrasound, including color Doppler sonography and ultrasound-guided procedures. The Department of Radiology has state-of-the-art and prototype equipment in all modalities and offers excellent opportunity to achieve expertise in body imaging and related interventional techniques. Interested candidates should contact Philip W. Rails, M.D., Chief of Body Imaging and Interventional Radiology, LAC/USC County Hospital, Box 631, 1200 North State Street, Los Angeles, CA 90033 or (213) 226-7207. USC is an equal opportunity/affirmative action employer.
Steiner,
M.D. (6) MRI-a dedicated body MRI program, including excellent research opportunities in addition to a large clinical case load. Contact Donald Mitchell, M.D. (7) Ultrasound-a dedicated ultrasound program. Contact Barry Goldberg, M.D. (8) Musculoskeletal-includes MRI of the musculoskeletal system. Contact David Karasick, M.D. All program directors listed above can be contacted at the Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107. Jefferson is an equal opportunity/ affirmative action employer.
MUSCULOSKELETAL FELLOWSHIP-Applications
FELLOWSHIP IN BODY IMAGING AND INTERVENTIONAL RADIOLOGY, USC SCHOOL OF MEDICINE-
INTERVENTIONAL
RADIOLOGY
-
The Montreal General Hospital, Department of Radiology, seeks one clinical fellow in intervention and related abdominal imaging techniques to begin July 1992. The Montreal General Hospital is one of the major McGill University teaching hospitals. The department has a volume of over 130,000 examinations per year. The fellow will perform vascular and non-vascular interventional procedures as well as diagnostic Ultrasound, CT and MRI. Training facilities include state of the art equipment in ultrasound, computed tomography, angiography, and Magnetic Resonance Imaging. The fellow will be involved in clinical work and will have research and teaching responsibil-
ities. Requirements
include
completion
of
an accredited diagnostic radiology training program. Send inquiries including CV and 3 references to: Patrice M. Bret, M.D., Radiologist-in-Chief, The Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada. Telephone (514) 934-8003.
FELLOWSHIP TERVENTIONAL
IN VASCULAR AND RADIOLOGY-The
IN-
University of Arizona is sponsoring oneyear fellowships in vascular and interventional radiology beginning July 1, 1992 and July 1, 1993. In depth clinical experience and training in all aspects of interventional radiology will be offered. Facilities at the University Hospital (300 bed) and Tucson Veteran’s Hospital (300 bed) include state-of-the-art angiographic, CT, and MR units. Opportunities for research and teaching also provided. Interested applicants should submit a current CV and three letters of recommendation (including one from the program chairman) to Gerald D. Pond, M.D., Head, Section of Vascular and Interventional Radiology, University of Arizona Health Sciences Center, Tucson, AZ 85724. For further information please contact Linda Fowler at (602) 694-7136.
MARCH
FELLOWSHIP IN ANGIO/INTERVENTIONAL RADIOLOGY-The Department of Radiology Florida is offering residency clinical beginning in July giographic suites
Philips
C-arms
at the University of several one-year postfellowship positions 1993 and July 1994. Anare available, two have
with
1024
ADAC
digital,
and a new Toshiba Vascular Lab. The Department has intravascular ultrasound color-flow Doppler and angioscopy equipment. Training includes all interventional procedures-vascular, biliary, urology, etc. as well as experience with investigational devices such as CO2. angioscopy, atherectomy, and holmium lasers. An animal laboratory, a full-time veterinarian, and an instrument shop are available. Applicants must be eligible for Iicensure in the State of Florida. For further information contact Irvin F. Hawkins, M.D., Professor, Department of Radiology, Box 100374JHMHC, Gainesville, Florida 32610-0374; Tel (904) 395-0291. The University of Florida is an equal opportunity/affirmative action employer.
2 YEAR LOWSHIP RIC/ADULT
NEURORADIOLOGY IN A COMBINED PROGRAM-The
FELPEDIATfirst
CARDIOVASCULAR TIONAL RADIOLOGY THE JOHNS HOPKINS
/ INTER VENFELLOWSHIPS, HOSPITAL-
TheJohns Hopkins Hospital has one position open for its 1 year CVIR training program beginning July 1992. The program has been redesigned to provide strong clinical experience in a wide variety of vascular and nonvascular interventional procedures including: angiography; angioplasty; percutaneous atherectomy; intravascular ultrasound; thrombolytic therapy; varicocele, tumor, and AVM embolization, caval filters; percutaneous central venous catheter placement; percutaneous abscess drainage; and complex urologic and biliary intervention including percutaneous biliary endoscopy and biliary atherectomy for biopsy. In addition, daily morning conferences, a private CVIR patient admitting service, and a weekly vascular clinic strengthen the total patient care concept of this program. Superb interaction with both the vascular surgery and general surgery services help to facilitate an understanding of the evaluation, care, and treatment of CVIR patients outside the department. Research time for both clinical and laboratory sciences is available. The candidate will also
year is full-time pediatric neuroradiology at the Children’s Memorial Hospital in Chicago. Children’s is a 265 bed pediatric
participate
hospital
planned upgrades including a new room with a Siemens Angiostar, giving us three dedicated CVIR rooms and two shared rooms. Our division includes six full-time staff, 19 dedicated technologists and five full-time RNs performing over 12,000 exams per year. Interested candidates should contact Floyd A. Osterman, Jr.,
with
3 full-time
pediatric
neuro-
radiologists, rologists. imaging
4 neurosurgeons and 3 neuWithin the Division of Neuro(neuroradiology) are 2 CT scanners (GE 9800 Quick and Philips LX), one 1.5T Signa MR. 4 Acuson (1 color dopper) ultrasound scanners and a new Siemens digital and conventional angiographic and myelographic unit (functioning Jan uary 1992). Training will be in all modalities of diagnostic neuroimaging of the head, neck and spine (MR. CT, ultrasound, myelography and angiography) and interventional neuroradiology in children. The second year will be adult neuroradiology at Northwestern University Medical School/Northwestern Memorial Hospital (750 bed private hospital) with complete training in MR. CT, US, myelography, angiography, head and neck radiology and interventional neuroradiology. The next opening is July 1, 1992. Address inquiries and curriculum vitae to: Sharon E. Byrd, M.D. Head, Divi-
sion
of Neuroimaging,
diology, Children’s 2300 Children’s Plaza, Tel. (312) 880-3565/FAX Eric J. Russell, M.D. diology, Department 3420, Northwestern 710 N. Fairbanks/Olson go, IL 60611, Tel. (312) 908-9029.
Please
Department
of Ra-
Memorial Hospital, Chicago, IL 60614, (312) 880-3572 or Director of Neuroraof Radiology, Suite Memorial Hospital, Pavilion, Chica(312) 908-2462/FAX
support
the
dent
V ‘
MARCH
CANCER
SOCIETY#{174}
Our
ly undergoing
M.D.,
Chief,
and
with
of CVIR, The Johns 600 N. Wolfe St., Phone Number
IN VASCULAR AND RADIOLOGY-The
Balti(301)
IN-
University of Arizona is sponsoring oneyear fellowships in vascular and interventional radiology beginning July 1, 1992 and July 1, 1993. In depth clinical experience and training in all aspects of interventional radiology will be offered. Facilities at the University Hospital (300 bed) and Tucson Veteran’s Hospital (300 bed) include state-of-the-art angiographic, CT, and MR units. Opportunities for research and teaching also provided. Interested applicants should submit a current CV and three letters of recommendation (including one from the program director) to Gerald D. Pond, M.D., Head, Section of Vascular and Interventional Radiology, University of Arizona Health Sciences Center, Tucson, AZ 85724. For further information please contact Linda Fowler at (602) 694-7136.
A CLINICAL
FELLOWSHIP
with
time
research
A wide
and
numerous
breadth
POSITION
ING CLINIC DIOLOGY
FOR
SALE
RADIOLOGY AND
SALE
- FREE STANDDIAGNOSTIC
HOSPITAL PRACTICE
BASED RAIN SOUTHWESTERN SUNBELT. Annual collected fees-Clinic $700,000, Hospital practice $960,000. Only Radiologists in City of 45,000 with drawing area population of 100,000. Sale price based on real estate and equipment values only with attractive owner financing to qualified parties. Real estate approximately $280,000 and equipment including conventional XRay, Fluoroscopy, Ultrasound and ACR Accredited Mammography $400,000. Three retiring Radiologists available for transition period as employees or on Loaim tenens basis as required. Reply to Box R-3205. All replies will be acknowledged.
MISCELLANEOUS
MRI VISITING FELLOWSHIPS IN SAN FRANCISCO AREA-Intensive, highly structured one to six week courses in Clinical Magnetic Resonance with emphasis on head, spine and musculoskeletal imaging. Live instruction with over 25 hours of dual projection slide presentations and overhead case presentations in week one. Extensive teaching file and updated videotape library. Course has been running for over six years. More than four hundred visiting fellows have been trained. References from former visiting fellows available. Certificate awarded on completion. For further information, please contact Murray A. Solomon, M.D., MRI Learning Center, 1633 Bayshore Drive-Suite 320, Burlingame, CA 94010. Phone (408) 925-8328. NORTH BAY MRI TUTORIALS-A comprehensive one-week course of instruction features over 30 hours of dual slide projection. Orientation lectures coyer basic principles, protocol issues and fundamentals of image interpretation. Heavy emphasis is applied to current dinical applications, including craniospinal, musculoskeletal and abdomino pelvic examinations. Extensive videotape library and up-to-date teaching file is supplemented with case reviews and readout sessions. Rotating faculty includes Kelly, Bell, Brant-Zawadzki, Clark, Crues, Kucharczyk and Morgan. Well-equipped conference room/imaging center is located in Fairfield, CA adjacent to the Napa Valley between SF and Sacramento. For course dates, contact Mary Kelly, course coordinator, (916) 753-2337.
projects
of interven-
tional radiology procedures is done in a busy practice covering two hospitals. For more information contact: Eric VanSonnenberg, M.D., Professor of Radiology and Medicine, Chief of Interventional Radiology, UCSD Medical Center, 225 Dickinson Street, San Diego, CA 92103.
RADIOLOGY
PRACTICE
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is current-
renovations,
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AMERICAN
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CANCER
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MARCH
The MISSOURI Counselors:
Board
Contudfrom
TEXAS
G. David Dixon, MD Robert R. MacDonald, Fong V. Tsai, MD, Kansas City
NEW YORK Counselors:
Bulletin
David Cheris, MD Theodore Robinson,
Counselors: Jr, MD
WASHINGTON MD
Arthur Sega!, MD Jeffrey A. Cooper, MD, Albany Brian K. McCandless,
Gordon Calderwood, MD W. P. Evans Ill, MD Harvey M. Goldstein, MD Loma L. Laird, MD, Nacogdoches
Counselor: John N. Roehr, MD Elizabeth J.M. Carter, MD, Tacoma
WISCONSIN
Counselor: John C. McDermott, George H. Beihobek, MD Thomas A. Tomsick, MD Peter P. Hindel, MD, Beavercreek Kedarnath B. Joshi, MD, Toledo
Jae M. Koh, MD, Steubenville
OREGON Counselor: Gerald Warnock, MD Christopher J. Morgan, MD, Portland
MD David E. Enerson, MD, Stevens Point Richard J. Jochem, MD, West Allis
CANADA BRITISH COLUMBIA Counselor: Ron Campbell, MD Sidney S. Joss, MD, Victoria Kenneth 5.5. Kaan, MD, New Westminster
Joel I. Cossrow, MD, Pittsburgh Hugh H. Hoke, MD, Lancaster Mitchell 0. Schnall, MD, Landsdowne
Johann H. Bonow, MD, Germany
Matthias Brado, MD, Germany James CS. Chan, MD, Hong Kong Robert P. J. Fabiny, MD, Australia Young-Mm Han, MD, Korea
Warwick W. Herbert, MD, Australia Knstian
0. Herrlin,
MD, Sweden
Johnson, MD, Australia
Shinichi Kan, MD, Japan Yves M. Menu, Sr, MD, France Isamu Narabayashi, MD, Japan Ron 0. Norman, MD, Australia Antonio Orlacchio, MD, Italy Ethna M. Phelan, MD, Australia Margaret S. Phelan, MD, England Norbert Rilinger, MD, Germany Regenfledis Schoemaker, MD, Germany Annie Sibert, MD, France L. Yvonne Eliza Ticket, MD, Belgium Harry S.L. Tjiong, MD, The Netherlands Stamos J. Trakadas, MD, Greece
Keil Volker, MD, Germany MANITOBA
PENNSYLVANIA Counselors: William L. Campbell, MD Beverly G. Coleman, MD Anne P. Dunne, MD
page
CORRESPONDING Hameed H. Al-Taleb, Sr, MD, Kuwait Helge Baum, MD, Germany
Sylvia
MD, Albany
OHIO Counselors:
kst
Counselor: CliffordS. Levi MD Susan C. Holt, MD, Winnipeg
MEXICO Counselors:
Francisco Quiroz, MD Patricia Silva, MD Gaspar Cantu, MD, Mexico City Jose L. Criales, MD, Iztapalapa
Paula T. Messina, MD, Mexico City Jaime A. Saavedra, MD, Colonis del Valle
Eberhard A. Walter, MD, Germany
The
Bulletin
Board
of the Radiological of North America RSNA
Oak
Dues
New
Trustees
R&E
.
to
1 992
Applicants
organizers
which lowing
to
Meet
The
Review
took the
Stauffer, and tant
RSNA
dia,
consult
Office with training
the
Sod-
the
Information about medical practices, produced Its first new and asked each memthe integrity of the col-
Society Invoice to verify
dues ber
members provide the
Dr
Ernest
Ferris,
RSNA
guests
wishes as a member.
proofreading.
and data
good entry
scale of the project at its precluded traditional Our regret is that the
only foolproof” proofreading the first time the member asked to review the data. Dr Ferris went on to say,
aware
that
errors
that members nienced. Our bear with us
Corrections taken over the your questions
Membership (708)
must
humor errors.
have
have hope through
to the data telephone; will
be
We
and
cannot however,
addressed staff
by
by
deadline
meet
Trustees of the RSNA Reand Education Fund will in Chicago on April 10. Mem-
bers of the Scholar Review PanelDr Helen Redman, Dr William Hendee, Dr Robert Parker, Mr Wffliam Edwards, and Mr Harvey Pickerwill travel to Chicago earlier and will interview
the
selected
didates on April 9. Decisions on all awards will be made and applicants should know review by late
K. of
Scholar
can-
of the 1992 on April 10,
and nominees the results of the April.
of address
letter
and MD,
SecretarySociety
it
of
202 1 SprIng Road, Brook, Illinois
Counselor:
of-
are
struments,
not
FLORIDA Counselor: Walter P. Scott, MD Roberto J. Calderon, Jr, MD, Miami
submission
Counselors:
persons,
of
Brian 0. Mulligan, MD, Lisle
Radiol-
to
any
may physics,
KENTUCKY
events,
subspecialties,
may dard or current concepts They should be identified cal and will be reviewed chairman of the Program tee, Dr William A. Murphy, Louis, Missouri.
. The following is for RSNA membership,
a list
as-
include, in-
places,
Papers
and
or-
Counselor: J. Matthew Schwab, MD Fang-Kum Loh, MD, Lexington Allan Paris, Jr, DO, Louisville
MASSACHUSE1TS Counselor: Herbert F. Gramm, MD Peter 0. Clarke, MD, Brookline
be stanlength. as historiby the
MICHIGAN
Commit-
Counselors:
Jr,
Rodolphe E. Langevin, MD, Milton
of St
within of this
as
30 list,
Burton Ellis, MD Henrj Van Der Kolk, MD Meketa M. Schlega, MD, Grosse Pointe
MINNESOTA
of applicants published
provided by the bylaws of the Society. Society members are asked to review these names. Should a member have a question concerning the eligibility of an applicant, days of the publication
Vlastimil Capek, MD David Lewis, MD
forms
related
Topics limited to,
Martin Leborgne, Sr, MD, Miami
ILLINOIS
of ScienScienpresenta-
the Program Comsoliciting papers of
interest
MD
materials
applicant 1992 meeting
of Imaging.
Lawrence N. Rappaport,
Zachary Rattner, MD, New Haven
Society
to the
for
Oaks
CONNECTICUT
Society. potential
for 1992 RSNA Current Concept,
historical
publications,
571-7873.
signed
Thomas R. Cain, MD Clime A. Handy, MD Guy Juillard, MD Hideyo Minagi, MD Sheila Moore, MD James Moorefleld, MD Robert M. Agulnek, MD, Sherman
J.
Remember, mittee is also
at
the
withheld and reconsidof Censors.
CALIFORNIA
were
Paper, tific Exhibit, and infoRAD tions is May 1 . Application are In the January issue
pect but
that be
In-
ogj.
be
Oak
request
60521.
organlz-
completed
1 if the to attend the
ganizations.
S The search
Delhi,
of the reminds
June
tific
inconveyou will last step.”
Ferris, Radiological
600,
meeting
submitted
applications
are
occurred
been is that this
Department
is
J.
Suite
department staff re1 ,500 membership were distributed during
that be
U The
occurs actually
mark your “Confidential”
protest
RSNA assisfor scientific
secretary-general
199 1 meeting Ernest Ferris
their
graciousness in helping correct
Please
America,
Congress.
applicants fice
eration
North
of Dr Sudarshan the
applications
secre-
should
membership investigation by the Board
Counselors:
tary-treasurer, speaking on behalf of the Board, expressed his appreciation to all of the members for
The sheer inception
Delmar
representatives
U Membership port that over the Dr
member
applicant’s pending
to Ernest Treasurer,
and
lected data.
600
director;
to New
with
RSNA
Aggarwal,
RSNA
1992 Suite
the
ers. the
their
Mr
Hedland, director
traveled
to
Asian
Parker,
executive
Mr Merle executive
The
ety
place RSNA
meetings,
*._
to
6th
of Radiology inof RSNA reprethe Congress, immediately folmeeting, December
14-18, 1991. Dr Robert 1992 RSNA president;
Dr Parker Attends Asian Oceanian Congress
. One year after were fIrst asked
of the
Oceanlan Congress vited a contingent sentatives to attend
Invoice
March
-
Executive Offices, 202 1 Spring Road, Brook, Illinois 60521 #{149} (708) 571-2670
.
Receive
Members
Society
Counselor: William Thompson, MD James S. Erwin, MD, Winona
(continued
on preceding
page)
