With the recent improvements in diagnosis and treatment of distal radius and carpal injuries, the hand surgeons' expectations of relevant radiologic interpretation of imaging studies are heightened. Conventional radiographic examinations, as well as more sophisticated and invasive studies, have important roles in the evaluation of wrist fractures and dislocations. On the basis of physical examination results and the mechanism of injury, the onus is on the examining surgeon to pinpoint potential sites of bone or ligament disruption. After this evaluation, appropriate imaging studies appropriately performed and interpreted will help direct treatment and improve outcome with greater clarity and certainty.
Focal hepatic lesions constitute a daily challenge in the clinical setting. However, noninvasive methods can be useful in the detection and characterization of these lesions. The noninvasive diagnosis of liver lesions is usually achieved with contrast material-enhanced computed tomography and magnetic resonance (MR) imaging. Dynamic three-dimensional gradient-recalled-echo MR imaging provides dynamic contrast-enhanced thin-section images with fat saturation and a high signal-to-noise ratio and is excellent for the evaluation of various focal hepatic lesions. A comprehensive MR imaging examination in this setting includes T2-weighted and chemical shift T1-weighted imaging and demonstrates characteristic enhancement patterns that can be helpful in the diagnosis of most of these lesions. These enhancement patterns are seen during particular phases of contrast-enhanced imaging and include arterial phase enhancement, delayed phase enhancement, peripheral washout, ring enhancement, nodule-within-a-nodule enhancement, true central scar, pseudocentral scar, and pseudocapsule. Familiarity with these enhancement patterns can help in the identification of specific focal lesions of the liver.
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