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Mayfair Volume 47 Issue 07 ((INSTALL))

Increasingly it is being realised that MRI can be used not only to evaluate the anatomy of the thoracic outlet, in particular soft tissue structures that might be causing compression, but also to visualise actual compression of the brachial plexus directly. With the use of high-resolution MRI scanners with a 3.0 T magnetic field strength, MR neurography (MRN) allows nerve morphology and signal to be non-invasively visualised. This technique suppresses signal from surrounding soft tissue structures, including fat containing structures, and removes pulsation artefacts from flowing blood [40]. In this way, the exact site of compression as well as the structure causing the compression can be identified directly, instead of having to indirectly infer that the presence of a fibrous band may be the cause of compression in a patient with documented NTOS. Baumer et al. used high-resolution MRN in patients with suspicion of neurogenic or non-specified TOS to identify cases brachial plexus compression. All cases identified were subsequently verified by surgical exploration, showing good positive predictive value of this investigation. This study, however, did not verify by surgical exploration those without discernible defects on MRN, so the negative predictive value of this test is not known [41].

Mayfair Volume 47 Issue 07

A Nielsen spokesman told The Grocer: "Value growth was driven by price and duty increases, while volume sales reflect a market that is coming to terms with an unprecedented year; legislation and the poor summer took sales out of the market."

The first three books of the best-selling Victorian Gothic Collection in one volume! Includes: House of Shadows, Veil of Shadows, and Passage of Shadows. After losing her father and nearly losing her life when their ship sank off the coast of Cornwall, Adelaide Hampton Parke is faced with a terrible dilemma. Her stepmother has demanded that they immediately set sail for New York, but the very idea of stepping foot on board another ship and facing the uncertainty of a transatlantic crossing leaves her paralyzed with fear. 041b061a72


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