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Emergency Radiology

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https://www.readbyqxmd.com/read/29340878/core-curriculum-case-illustration-tubo-ovarian-abscess
#1
Nehal Mohamed Ibrahim Saloum, Ahmed Saied Sabry, Shaimaa Abdelhassib Fadl
This is the 47th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.erad.org/page/CCIP_TOC .
January 17, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29335899/the-ultrasonographic-whirlpool-sign-in-testicular-torsion-valuable-tool-or-waste-of-valuable-time-a-systematic-review-and-meta-analysis
#2
Jared McDowall, Ahmed Adam, Louis Gerber, Callistus O A Enyuma, Sunday J Aigbodion, Sean Buchanan, Abdullah E Laher
PURPOSE: A positive whirlpool sign (WS) is defined as the presence of a spiral-like pattern when the spermatic cord is assessed during ultrasonography (US), using standard, high-resolution ultrasonography (HRUS) and/or color Doppler sonography (CDS), in the presence of testicular torsion. The objective of this review was to assess the validity and accuracy of this sign by performing a comprehensive systematic literature review and meta-analysis. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (August, 2017), using the following databases: BMJ Best Practice, Cochrane Library, Embase, PubMed, Scopus, and Web of Science...
January 15, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29330668/impact-of-duplicate-ct-scan-rate-after-implementation-of-transfer-image-repository-system-at-a-level-1-trauma-center
#3
Charles W Sheppard, Amy L Groll, Cindy L Austin, Simon J Thompson
PURPOSE: The regionalization of trauma in the USA results in frequent transfers of patients from a primary hospital ED to a higher level trauma facility. While many hospitals have a Picture Archive Communication System (PACS) which captures digital radiological images, these are often not available to the receiving institution resulting in duplicate imaging. The state of Arkansas instituted a trauma image repository (TIR) in July 2013. We examined whether implementation of this repository would impact CT scan duplication in the trauma system...
January 12, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29327108/computed-tomography-for-occult-fractures-of-the-proximal-femur-pelvis-and-sacrum-in-clinical-practice-single-institution-dual-site-experience
#4
Jacob C Mandell, Michael J Weaver, Bharti Khurana
PURPOSE: The purpose of this study was to evaluate the diagnostic performance of CT for assessment of occult fractures of the proximal femur, pelvis, and sacrum. MATERIALS AND METHODS: A retrospective review was performed on patients who received a CT of the hip or pelvis for suspected occult fracture after negative or equivocal radiographs performed within 24 h. The official radiology report was utilized for the determination of CT findings and calculation of sensitivity and specificity...
January 11, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29327107/imaging-of-pediatric-neurovascular-emergencies
#5
Yang Tang, William C Goodman, Michael D Maldonado, Xinli Du
Pediatric strokes are rare but critical diagnoses to make in the emergency setting. They are associated with a set of pathologies that are not frequently encountered in the adult population. Some of these diseases have variable clinical presentations and imaging appearance depending on the age of onset and severity of the underlying pathologies. This article reviews the differential diagnoses and noninvasive imaging evaluation of pediatric cerebral ischemic and hemorrhagic diseases.
January 11, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29327106/mdct-of-ductus-diverticulum-3d-cinematic-rendering-to-enhance-understanding-of-anatomic-configuration-and-avoid-misinterpretation-as-traumatic-aortic-injury
#6
Steven P Rowe, Pamela T Johnson, Elliot K Fishman
Acute aortic injuries are not common in the setting of severe blunt trauma, but lead to significant morbidity and mortality. High-quality MDCT with 2D MPRs and 3D rendering are essential to identify aortic trauma and distinguish anatomic variants and other forms of aortic pathology from an acute injury. Misinterpretation of mimics of acute aortic injury can lead to unnecessary arteriography and thoracic surgery. Since most traumatic injuries occur in the distal arch, radiologists must be cognizant of the range of appearances of variants related to the ductus diverticulum...
January 11, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29306977/acute-appendicitis-in-childhood-oral-contrast-does-not-improve-ct-diagnosis
#7
Crystal R Farrell, Adam D Bezinque, Jared M Tucker, Erica A Michiels, Bradford W Betz
INTRODUCTION: We compared the diagnostic accuracy of CT performed without and with oral contrast for suspected appendicitis in children. METHODS: In this retrospective cohort study, we reviewed abdomen/pelvis CT scans with IV contrast performed between 2011 and 2015 for suspected appendicitis. Oral contrast was used routinely before August 2013 and eliminated from the CT protocol thereafter. Diagnostic accuracy of CT was compared with operative/pathology reports, and included a 30-day follow-up period for non-surgical patients...
January 6, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29299700/emergent-spinal-mri-in-ivdu-patients-presenting-with-back-pain-do-we-need-an-mri-in-every-case
#8
Charles G Colip, Mina Lotfi, Karen Buch, Nagaraj Holalkere, Bindu N Setty
PURPOSE: Spinal MRI is the exam of choice for the workup of patients with suspected spinal infection. In this retrospective study, we assess the value of obtaining contrast-enhanced spinal MRI for patients presenting to the emergency department (ED) with acute back pain and a history of intravenous drug use (IVDU). METHODS: A retrospective IRB-approved, HIPAA compliant review of the imaging findings, reports and electronic charts of 167 consecutive IV drug-using patients (M/F = 96:71, mean age = 40 years) that presented to the ED with acute back pain over a 55-month period and underwent contrast-enhanced spinal MRI within 24 h...
January 3, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29282579/accuracy-of-outside-radiologists-reports-of-computed-tomography-exams-of-emergently-transferred-patients
#9
Jeffrey D Robinson, Ken F Linnau, Daniel S Hippe, Kellie L Sheehan, Joel A Gross
PURPOSE: Growing numbers of patient with advanced imaging being transferred to trauma centers has resulted in increased numbers of outside CT scans received at trauma centers. This study examines the degree of agreement between community radiologists' interpretations of the CT scans of transferred patients and trauma center radiologists' reinterpretation. METHODS: All CT scans of emergency transfer patients received over a 1 month period were reviewed by an emergency radiologist...
December 27, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29249008/secondary-imaging-for-suspected-appendicitis-after-equivocal-ultrasound-time-to-disposition-of-mri-compared-to-ct
#10
James F Martin, David J Mathison, Paul C Mullan, Hansel J Otero
PURPOSE: The purpose of this study was to compare MRI to CT as a secondary imaging modality for children age 5 years and older with suspected appendicitis after an equivocal abdominal ultrasound in terms of (1) the time to ED disposition decision, (2) surgery consultation rate, and (3) imaging test accuracy. METHODS: We retrospectively studied children with suspected appendicitis and equivocal ultrasound results who underwent MR or CT as secondary imaging in a pediatric emergency department over two-consecutive 9-month periods...
December 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29247394/dose-monitoring-in-pediatric-and-young-adult-head-and-cervical-spine-ct-studies-at-two-emergency-duty-departments
#11
Hannele Niiniviita, Timo Kiljunen, Minna Huuskonen, Simo Teperi, Jarmo Kulmala
PURPOSE: As the number of pediatric computed tomography (CT) imaging is increasing, there is a need for real-time radiation dose monitoring and evaluation of the imaging protocols. The aim of this study was to present the imaging data, patient doses, and observations of pediatric and young adult trauma-and routine head CT and cervical spine CT collected by a dose monitoring software. METHODS: Patient age, study date, imaging parameters, and patient dose as volume CT dose index (CTDIvol) and dose length product (DLP) were collected from two emergency departments' CT scanners for 2-year period...
December 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29185082/multi-energy-spectral-ct-adding-value-in-emergency-body-imaging
#12
Gopal V Punjabi
Most vendors offer scanners capable of dual- or multi-energy computed tomography (CT) imaging. Advantages of multi-energy CT scanning include superior tissue characterization, detection of subtle iodine uptake differences, and opportunities to reduce contrast dose. However, utilization of this technology in the emergency department (ED) remains low. The purpose of this pictorial essay is to illustrate the value of multi-energy CT scanning in emergency body imaging.
November 28, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29159577/core-curriculum-case-illustration-a-rare-case-of-an-isolated-fallopian-tube-torsion
#13
Nehal Mohamed Ibrahim Saloum, Hayley Wurtz Hunt, Shaimaa Abdelhassib Fadl
This is the 46th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.erad.org/page/CCIP_TOC .
November 21, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29147883/clinical-and-radiological-diagnosis-of-gallstone-ileus-a-mini-review
#14
Liisa Chang, Minna Chang, Hanna M Chang, Aina I Chang, Fuju Chang
Gallstone ileus is a rare cause of bowel obstruction, which mainly affects the elderly population. The associated mortality is estimated to be up to 30%. The presentation of gallstone ileus is notoriously non-specific, and this often contributes to the delay in diagnosis. The diagnosis of gallstone ileus relies on a radiological approach, and herein we discuss the benefits and drawbacks of the use of different modalities of radiological imaging: plain abdominal films, computed tomography, magnetic resonance imaging, and ultrasound scanning...
November 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29143222/quantitative-analysis-of-the-level-of-readability-of-online-emergency-radiology-based-patient-education-resources
#15
David R Hansberry, Michael D'Angelo, Michael D White, Arpan V Prabhu, Mougnyan Cox, Nitin Agarwal, Sandeep Deshmukh
PURPOSE: The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. METHODS: Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales...
November 15, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29119408/pilot-study-of-a-new-comprehensive-radiology-report-categorization-radcat-system-in-the-emergency-department
#16
David W Swenson, Grayson L Baird, David C Portelli, Martha B Mainiero, Jonathan S Movson
PURPOSE: The purpose of this study was to describe a new, broadly applicable radiology report categorization (RADCAT) system that was developed collaboratively between radiologists and emergency department (ED) physicians, and to establish its usability and performance by interobserver variation. METHODS: In collaboration with our ED colleagues, we developed the RADCAT system for all imaging studies performed in our level-1 trauma center, including five categories that span the spectrum of normal through emergent life-threatening findings...
November 8, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28921009/radiation-overexposure-from-repeated-ct-scans-in-young-adults-with-acute-abdominal-pain
#17
Massimo Tonolini, Elena Valconi, Angelo Vanzulli, Roberto Bianco
PURPOSE: The purpose of this study is to assess the dose of ionizing radiation caused by repeated CT scans performed to investigate non-traumatic acute abdominal conditions in young adults. METHODS: Over 26 months, we collected a cohort of patients aged 18 to 45 years who were subject to at least one urgent contrast-enhanced abdomen/pelvis CT. Patients affected with urolithiasis, HIV infection, tumors, and vascular and chronic inflammatory bowel diseases were excluded...
February 2018: Emergency Radiology
https://www.readbyqxmd.com/read/28831608/infectious-and-inflammatory-diseases-of-the-central-nervous-system-the-spectrum-of-imaging-findings-and-differential-diagnosis
#18
REVIEW
Joseph M Rozell, Edward Mtui, Yu-Ning Pan, Shan Li
The infectious and inflammatory diseases of the central nervous system (CNS) including the brain and spine can present with a wide spectrum of clinical symptoms, locations, and appearance. The purpose of this exhibit is to review the different patterns of their presentations, to illustrate their imaging characteristics and techniques, and to discuss their clinical features and pathology so that the correct diagnosis can be made and prompt intervention can be initiated on a timely fashion.
December 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28801805/pulmonary-cta-in-sickle-cell-patients-quantitative-assessment-of-enhancement-quality
#19
Jeff Jensen, Tony Lin, Elliot K Fishman, Pamela T Johnson
PURPOSE: The purpose of this study was to validate the observation that pulmonary artery (PA) enhancement is often decreased in sickle cell disease (SCD) patients imaged with MDCT for suspected pulmonary embolism and determine whether contrast infusion parameters are accountable for lower enhancement levels. MATERIALS AND METHODS: Retrospective comparison of 35 adult SCD patients imaged for suspected pulmonary embolism (PE) in our emergency department using 128-slice dual source MDCT scanner to 34 age and weight matched adult controls...
December 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28786040/abdominal-and-pelvic-ct-scan-interpretation-of-emergency-medicine-physicians-compared-with-radiologists-report-and-its-impact-on-patients-outcome
#20
Shahram Bagheri-Hariri, Niloofar Ayoobi-Yazdi, Mo Afkar, Shervin Farahmand, Mona Arbab, Neda Shahlafar, Hamed Basirghafoori, Seyedhosien Seyedhoseini-Davarani, Mojtaba Sedaghat, Atoosa Akhgar
PURPOSE: In this study, the impact of contrast-enhanced abdominopelvic CT scan interpretations by emergency medicine team on patients' morbidity and mortality was evaluated and their interpretations were compared to radiologists' reports. METHODS: During a 3-month period, all patients who had undergone a contrast-enhanced abdominopelvic CT scan at the emergency department enrolled in this study. All CT scans were interpreted blindly by the emergency medicine (ED) attending physicians and the patients were treated accordingly...
December 2017: Emergency Radiology
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