The American Journal of Medicine

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Arcot Chandrasekhar, M.D. Ashok Kumar, M.D. November 5, 2013

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Date of download: 6/9/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Short Myelitis Lesions in Aquaporin-4-IgG–Positive.

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The American Journal of Medicine Obscured in Transparency: Healthcare Quality and Hospital Price Disclosure Michael U. Antonucci The American Journal of Medicine DOI: 10.1016/j.amjmed.2019.02.049 Copyright © 2019 Terms and Conditions

Fig. 1 MRI for a patient with prior pituitary tumor resection. Sagittal-T1 (A) and coronal-T2 (B) outside images were performed with suboptimal coned-down views (despite history) and were not repeated despite motion/artifact. More appropriately protocolled sequences (C,D) with technologist attention to patient discomfort/motion, reveal no recurrent tumor. The American Journal of Medicine DOI: (10.1016/j.amjmed.2019.02.049) Copyright © 2019 Terms and Conditions

Fig. 2 Diffusion-weighted-imaging on outside MRIs obtained 5years (A) and 6months (B) ago is extremely limited, uses incorrect technique, and poorly assesses the brain. As revealed by the temporally separate studies, this was not a “one-off” phenomenon. Diffusion is a fundamental technique, essential for diagnosing entities like infarct, and is strikingly inadequate. Repeat MRI (C) reveals a much higher quality, and illustrates the standard of care. The American Journal of Medicine DOI: (10.1016/j.amjmed.2019.02.049) Copyright © 2019 Terms and Conditions

Fig. 3 Sagittal T2 imaging of the cervical spine in a patient with prior surgery and abnormal cord signal (A) has low resolution, and was obtained with thick slices and few sequences (small boxed region at bottom). Repeat thinner-slice MRI (B) better visualizes residual narrowing and cord signal abnormality. This MRI was more time-consuming, with twice the slices and more sequences (box). It was ordered 4months later as the initial imaging was insufficient for surgical planning. The American Journal of Medicine DOI: (10.1016/j.amjmed.2019.02.049) Copyright © 2019 Terms and Conditions