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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Critical Findings: Timing of Notification in Neuroradiology" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3918" />
<meta name="DC.Date" content="2014-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2014 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Timely reporting of critical findings in radiology has been identified by The Joint Commission as one of the National Patient Safety Goals. Our aim was to determine the magnitude of delays between identifying a neuroradiologic critical finding and verbally notifying the caregiver in an effort to improve clinical outcomes.

MATERIALS AND METHODS: We surveyed the time of critical finding discovery, attempted notification, and direct communication between neuroradiologists and caregivers for weekday, evening, overnight, and weekend shifts during an 8-week period. The data were collected by trained observers and/or trainees and included 13 neuroradiology attendings plus fellows and residents. Critical findings were based on a previously approved 17-item list. Summary and comparative t test statistics were calculated, and sources of delays were identified.

RESULTS: Ninety-one critical findings were recorded. The mean time from study acquisition to critical finding discovery was 62.2 minutes, from critical finding discovery to call made 3.7 minutes, and from call made to direct communication, 5.2 minutes. The overall time from critical finding discovery to caregiver notification was within 10 minutes in 72.5% (66/91) and 15 minutes in 93.4% (85/91) of cases. There were no significant differences across shifts except for daytime versus overnight and weekend shifts, when means were 2.4, 5.6, and 8.7 minutes, respectively ( P &lt; .01). If &gt;1 physician was called, the mean notification time increased from 3.5 to 10.1 minutes ( P &lt; .01). Sources of delays included inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers.

CONCLUSIONS: Direct communication with the responsible referring physician occurred consistently within 10–15 minutes after observation of a critical finding. These delays are less than the average interval from study acquisition to critical finding discovery (mean, 62.2 minutes).

CF
:   critical finding
ED
:   emergency department
TJC
:   The Joint Commission" />
<meta name="DC.Contributor" content="S.E. Honig" />
<meta name="DC.Contributor" content="E.L. Honig" />
<meta name="DC.Contributor" content="L.B. Babiarz" />
<meta name="DC.Contributor" content="J.S. Lewin" />
<meta name="DC.Contributor" content="B. Berlanstein" />
<meta name="DC.Contributor" content="D.M. Yousem" />
<meta name="article:published_time" content="2014-08-01" />
<meta name="article:section" content="Practice Perspectives" />
<meta name="citation_title" content="Critical Findings: Timing of Notification in Neuroradiology" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Timely reporting of critical findings in radiology has been identified by The Joint Commission as one of the National Patient Safety Goals. Our aim was to determine the magnitude of delays between identifying a neuroradiologic critical finding and verbally notifying the caregiver in an effort to improve clinical outcomes.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We surveyed the time of critical finding discovery, attempted notification, and direct communication between neuroradiologists and caregivers for weekday, evening, overnight, and weekend shifts during an 8-week period. The data were collected by trained observers and/or trainees and included 13 neuroradiology attendings plus fellows and residents. Critical findings were based on a previously approved 17-item list. Summary and comparative &lt;i&gt;t&lt;/i&gt; test statistics were calculated, and sources of delays were identified.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Ninety-one critical findings were recorded. The mean time from study acquisition to critical finding discovery was 62.2 minutes, from critical finding discovery to call made 3.7 minutes, and from call made to direct communication, 5.2 minutes. The overall time from critical finding discovery to caregiver notification was within 10 minutes in 72.5% (66/91) and 15 minutes in 93.4% (85/91) of cases. There were no significant differences across shifts except for daytime versus overnight and weekend shifts, when means were 2.4, 5.6, and 8.7 minutes, respectively (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01). If &amp;gt;1 physician was called, the mean notification time increased from 3.5 to 10.1 minutes (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01). Sources of delays included inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Direct communication with the responsible referring physician occurred consistently within 10–15 minutes after observation of a critical finding. These delays are less than the average interval from study acquisition to critical finding discovery (mean, 62.2 minutes).&lt;/p&gt;" />
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<meta name="twitter:title" content="Critical Findings: Timing of Notification in Neuroradiology" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Timely reporting of critical findings in radiology has been identified by The Joint Commission as one of the National Patient Safety Goals. Our aim was to determine the magnitude of delays between identifying a neuroradiologic critical finding and verbally notifying the caregiver in an effort to improve clinical outcomes.

MATERIALS AND METHODS: We surveyed the time of critical finding discovery, attempted notification, and direct communication between neuroradiologists and caregivers for weekday, evening, overnight, and weekend shifts during an 8-week period. The data were collected by trained observers and/or trainees and included 13 neuroradiology attendings plus fellows and residents. Critical findings were based on a previously approved 17-item list. Summary and comparative t test statistics were calculated, and sources of delays were identified.

RESULTS: Ninety-one critical findings were recorded. The mean time from study acquisition to critical finding discovery was 62.2 minutes, from critical finding discovery to call made 3.7 minutes, and from call made to direct communication, 5.2 minutes. The overall time from critical finding discovery to caregiver notification was within 10 minutes in 72.5% (66/91) and 15 minutes in 93.4% (85/91) of cases. There were no significant differences across shifts except for daytime versus overnight and weekend shifts, when means were 2.4, 5.6, and 8.7 minutes, respectively ( P &lt; .01). If &gt;1 physician was called, the mean notification time increased from 3.5 to 10.1 minutes ( P &lt; .01). Sources of delays included inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers.

CONCLUSIONS: Direct communication with the responsible referring physician occurred consistently within 10–15 minutes after observation of a critical finding. These delays are less than the average interval from study acquisition to critical finding discovery (mean, 62.2 minutes).

CF
:   critical finding
ED
:   emergency department
TJC
:   The Joint Commission" />
<meta name="og-title" property="og:title" content="Critical Findings: Timing of Notification in Neuroradiology" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/35/8/1485" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Timely reporting of critical findings in radiology has been identified by The Joint Commission as one of the National Patient Safety Goals. Our aim was to determine the magnitude of delays between identifying a neuroradiologic critical finding and verbally notifying the caregiver in an effort to improve clinical outcomes.

MATERIALS AND METHODS: We surveyed the time of critical finding discovery, attempted notification, and direct communication between neuroradiologists and caregivers for weekday, evening, overnight, and weekend shifts during an 8-week period. The data were collected by trained observers and/or trainees and included 13 neuroradiology attendings plus fellows and residents. Critical findings were based on a previously approved 17-item list. Summary and comparative t test statistics were calculated, and sources of delays were identified.

RESULTS: Ninety-one critical findings were recorded. The mean time from study acquisition to critical finding discovery was 62.2 minutes, from critical finding discovery to call made 3.7 minutes, and from call made to direct communication, 5.2 minutes. The overall time from critical finding discovery to caregiver notification was within 10 minutes in 72.5% (66/91) and 15 minutes in 93.4% (85/91) of cases. There were no significant differences across shifts except for daytime versus overnight and weekend shifts, when means were 2.4, 5.6, and 8.7 minutes, respectively ( P &lt; .01). If &gt;1 physician was called, the mean notification time increased from 3.5 to 10.1 minutes ( P &lt; .01). Sources of delays included inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers.

CONCLUSIONS: Direct communication with the responsible referring physician occurred consistently within 10–15 minutes after observation of a critical finding. These delays are less than the average interval from study acquisition to critical finding discovery (mean, 62.2 minutes).

CF
:   critical finding
ED
:   emergency department
TJC
:   The Joint Commission" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node13575--5" data-node-nid="13575" id="top-node-13575--6629999487" data-pisa="ajnr;35/8/1485" data-pisa-master="ajnr;ajnr.A3918" data-apath="/ajnr/35/8/1485.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Critical Findings: Timing of Notification in Neuroradiology</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S.E. Honig</span>, <span class="highwire-citation-author" data-delta="1">E.L. Honig</span>, <span class="highwire-citation-author" data-delta="2">L.B. Babiarz</span>, <span class="highwire-citation-author" data-delta="3">J.S. Lewin</span>, <span class="highwire-citation-author" data-delta="4">B. Berlanstein</span> and <span class="highwire-citation-author" data-delta="5">D.M. Yousem</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1485-1492; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3918 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-13575--6629999487" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S.E. Honig </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.E.%2BHonig%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Honig%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.E.%2BHonig%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">E.L. Honig </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.L.%2BHonig%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Honig%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AE.L.%2BHonig%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">L.B. Babiarz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.B.%2BBabiarz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Babiarz%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.B.%2BBabiarz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">J.S. Lewin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.S.%2BLewin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lewin%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.S.%2BLewin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">B. Berlanstein </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BBerlanstein%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Berlanstein%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AB.%2BBerlanstein%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D.M. Yousem </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.M.%2BYousem%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yousem%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.M.%2BYousem%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Timely reporting of critical findings in radiology has been identified by The Joint Commission as one of the National Patient Safety Goals. Our aim was to determine the magnitude of delays between identifying a neuroradiologic critical finding and verbally notifying the caregiver in an effort to improve clinical outcomes.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> We surveyed the time of critical finding discovery, attempted notification, and direct communication between neuroradiologists and caregivers for weekday, evening, overnight, and weekend shifts during an 8-week period. The data were collected by trained observers and/or trainees and included 13 neuroradiology attendings plus fellows and residents. Critical findings were based on a previously approved 17-item list. Summary and comparative <em>t</em> test statistics were calculated, and sources of delays were identified.</p>
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<p id="p-4"><strong>RESULTS:</strong> Ninety-one critical findings were recorded. The mean time from study acquisition to critical finding discovery was 62.2 minutes, from critical finding discovery to call made 3.7 minutes, and from call made to direct communication, 5.2 minutes. The overall time from critical finding discovery to caregiver notification was within 10 minutes in 72.5% (66/91) and 15 minutes in 93.4% (85/91) of cases. There were no significant differences across shifts except for daytime versus overnight and weekend shifts, when means were 2.4, 5.6, and 8.7 minutes, respectively (<em>P</em> &lt; .01). If &gt;1 physician was called, the mean notification time increased from 3.5 to 10.1 minutes (<em>P</em> &lt; .01). Sources of delays included inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> Direct communication with the responsible referring physician occurred consistently within 10–15 minutes after observation of a critical finding. These delays are less than the average interval from study acquisition to critical finding discovery (mean, 62.2 minutes).</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">CF<span class="def-item-dt-sep"></span></dt><dd>critical finding<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">ED<span class="def-item-dt-sep"></span></dt><dd>emergency department<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">TJC<span class="def-item-dt-sep"></span></dt><dd>The Joint Commission</dd></dl>
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      <div class="highwire-cite-title">Critical Findings: Timing of Notification in Neuroradiology</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.E.</span> <span class="nlm-surname">Honig</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">E.L.</span> <span class="nlm-surname">Honig</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">L.B.</span> <span class="nlm-surname">Babiarz</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">Lewin</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Berlanstein</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.M.</span> <span class="nlm-surname">Yousem</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1485-1492; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3918 </span></div>
  
  
  
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      <div class="highwire-cite-title">Critical Findings: Timing of Notification in Neuroradiology</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.E.</span> <span class="nlm-surname">Honig</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">E.L.</span> <span class="nlm-surname">Honig</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">L.B.</span> <span class="nlm-surname">Babiarz</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">Lewin</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Berlanstein</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.M.</span> <span class="nlm-surname">Yousem</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1485-1492; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3918 </span></div>
  
  
  
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