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Emergency Radiology

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https://www.readbyqxmd.com/read/29752651/emergency-ct-for-assessment-and-management-of-blunt-traumatic-splenic-injuries-at-a-level-1-trauma-center-13-year-study
#1
Sergio Margari, Fernanda Garozzo Velloni, Massimo Tonolini, Ettore Colombo, Diana Artioli, Niccolò Ettore Allievi, Fabrizio Sammartano, Osvaldo Chiara, Angelo Vanzulli
PURPOSE: To determine the relationship between multidetector computed tomography (MDCT) findings, management strategies, and ultimate clinical outcomes in patients with splenic injuries secondary to blunt trauma. MATERIALS AND METHODS: This Institutional Review Board-approved study collected 351 consecutive patients admitted at the Emergency Department (ED) of a Level I Trauma Center with blunt splenic trauma between October 2002 and November 2015. Their MDCT studies were retrospectively and independently reviewed by two radiologists to grade splenic injuries according to the American Association for the Surgery of Trauma (AAST) organ injury scale (OIS) and to detect intraparenchymal (type A) or extraparenchymal (type B) active bleeding and/or contained vascular injuries (CVI)...
May 12, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29749576/clinical-outcomes-after-magnetic-resonance-angiography-mra-versus-computed-tomographic-angiography-cta-for-pulmonary-embolism-evaluation
#2
Michael D Repplinger, Scott K Nagle, John B Harringa, Aimee T Broman, Christopher R Lindholm, Christopher J François, Thomas M Grist, Scott B Reeder, Mark L Schiebler
PURPOSE: To compare patient outcomes following magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) ordered for suspected pulmonary embolism (PE). METHODS: In this IRB-approved, single-center, retrospective, case-control study, we reviewed the medical records of all patients evaluated for PE with MRA during a 5-year period along with age- and sex-matched controls evaluated with CTA. Only the first instance of PE evaluation during the study period was included...
May 10, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29752650/traumatic-knee-injury-correlation-of-radiographic-effusion-size-with-the-presence-of-internal-derangement-on-magnetic-resonance-imaging
#3
Nathan D Cecava, Shane Dieckman, Kevin P Banks, Liem T Mansfield
PURPOSE: Traumatic knee injury is a common clinical presentation. However, knee internal derangement often goes undiagnosed on physical exam. The authors hypothesize that patients with suprapatellar joint effusion greater than 10 mm anteroposterior diameter on lateral radiograph have a high likelihood of knee internal derangement on magnetic resonance imaging. MATERIALS AND METHODS: A retrospective review of knee radiographs and magnetic resonance imaging in 198 patients age 18-40 years with acute knee injury was performed...
May 8, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29732520/sonographic-evaluation-of-peripheral-nerve-pathology-in-the-emergency-setting
#4
Shane Mallon, Vladimir Starcevic, Matthew Rheinboldt, Andrew Petraszko
High-resolution sonography has a growing role in both the diagnosis and management of traumatic and atraumatic peripheral nerve pathology. Sonography not only affords a cost-effective and time-efficient approach to interrogating long segments of peripheral nerves but also possesses unique advantages in terms of its dynamic, real-time nature with few clinical contraindications and limitations. In this review, we will initially discuss imaging techniques and characteristics of normal neural sonohistology, then address specific features and pitfalls pertaining to the spectrum of post-traumatic peripheral nerve injury...
May 7, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29732519/comprehensive-assessment-of-takotsubo-cardiomyopathy-by-cardiac-computed-tomography
#5
Daisuke Sueta, Seitaro Oda, Yasuhiro Izumiya, Koichi Kaikita, Masafumi Kidoh, Daisuke Utsunomiya, Yasuyuki Yamashita, Kenichi Tsujita
Cardiac computed tomography (CT) now plays an important role in emergency settings because of its accessibility and fast acquisition time, which cardiac magnetic resonance imaging (CMR) cannot match. Although cardiac CT was originally conceived for the assessment of the coronary artery tree, it has evolved to embrace several non-coronary applications. These include myocardial assessment, resulting in myocardial characterization comparable with that of CMR and cardiac CT for late enhancement imaging. In this report, we describe a patient with takotsubo cardiomyopathy who underwent a comprehensive assessment using cardiac CT...
May 7, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29700647/blunt-bowel-and-mesenteric-trauma-role-of-clinical-signs-along-with-ct-findings-in-patients-management
#6
Maria Cristina Firetto, Francesco Sala, Marcello Petrini, Alessandro A Lemos, Tiberio Canini, Stefano Magnone, Gianluca Fornoni, Ivan Cortinovis, Sandro Sironi, Pietro R Biondetti
BACKGROUND: Bowel and/or mesentery injuries represent the third most common injury among patients with blunt abdominal trauma. Delayed diagnosis increases morbidity and mortality. The aim of our study was to evaluate the role of clinical signs along with CT findings as predictors of early surgical repair. MATERIAL AND METHODS: Between March 2014 and February 2017, charts and CT scans of consecutive patients treated for blunt abdominal trauma in two different trauma centers were reread by two experienced radiologists...
April 27, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29679169/the-utility-of-scrotal-ultrasonography-in-the-emergent-setting-beyond-epididymitis-versus-torsion
#7
Christopher R McAdams, Andrew J Del Gaizo
Scrotal pain is a common acute presentation for medical care. Testicular torsion and epididymo-orchitis are two diagnoses for which early detection is critical and their sonographic imaging features have been thoroughly described in the radiologic literature. Other important conditions for which radiologists must be aware have received less attention. This article will highlight key traumatic and non-traumatic causes of acute scrotal pain other than testicular torsion and epididymo-orchitis that may present in the emergency department setting...
April 21, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29675722/contrast-enhanced-or-noncontrast-ct-for-renal-colic-utilizing-urinalysis-and-patient-history-of-urolithiasis-to-decide
#8
Vishal Desai, Mougnyan Cox, Sandeep Deshmukh, Christopher G Roth
PURPOSE: In the emergency setting, flank pain commonly leads to a noncontrast CT despite a significant percentage of patients having alternative diagnoses, often difficult to characterize without contrast. We investigated the combined utility of urinalysis and history of urolithiasis in identifying patients who are unlikely to have urolithiasis and may benefit from a contrast-enhanced study. METHODS: Retrospective review of 350 patients from May 2013 to May 2016 was performed for patients in the emergency department with renal colic that underwent noncontrast CT and urinalysis testing...
April 20, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29623485/imaging-of-neurovascular-emergencies-in-pregnancy-and-puerperium
#9
Kajari Bhattacharya, Hima Pendharkar
Acute neurovascular events, though rare, can complicate pregnancy and postpartum period. It is important to be aware of these clinical conditions for reducing maternal and fetal morbidity and mortality. In this review, we present a few important neurovascular emergencies and their imaging manifestations by various imaging modalities-computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA)-which presented at our institution in the peripartum period.
April 6, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29619644/road-traffic-accidents-a-pictorial-review
#10
Sanaa Kissi, L Fournier, N How Kit
Road traffic accidents are still a major cause of morbidity and mortality. With well-established whole-body CT protocols in trauma, radiologists are an integral part of trauma diagnosis and management teams. Five well-recognized traumatic syndromes (seat belt syndrome, handlebar syndrome, scapulothoracic dissociation, dashboard syndrome, and brake pedal injury) with their frequent associated complications should be diagnosed precociously according to the accident mechanism to avoid diagnostic delays and poor prognosis even if the circumstances seem minor...
April 4, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29603036/is-elevated-body-mass-index-protective-against-cervical-spine-injury-in-adults
#11
Nicholas M Beckmann, Chunyan Cai, Susanna C Spence, Mark L Prasarn, O Clark West
PURPOSE: Correlate body mass index (BMI) with incidence and type of cervical spine injury seen on CT in adult patients presenting with blunt trauma. MATERIALS AND METHODS: Retrospective chart review of all adult blunt trauma patients who had a cervical spine CT performed at our level 1 trauma center during an approximately 3-year period. RESULTS: A statistically significant (p = 0.01) difference in cervical spine injury incidence was present between different BMI groups...
March 30, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29594817/highlights-from-the-scientific-and-educational-abstracts-presented-at-the-aser-2017-annual-scientific-meeting-and-postgraduate-course
#12
Sudheer Balakrishnan
The annual meeting of the American Society of Emergency Radiology (ASER) took place in Toronto, Canada, on September 6 through September 9, 2017. Attendees represented the USA as well as international emergency radiology communities, including those from academic, private practice, and teleradiology settings. There were several "members in training" in attendance as well. The meeting again featured the "Trauma Head to Toe" 2-day didactic course, highlighting various important topics on imaging of traumatic injuries...
March 29, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29594895/clinical-implications-of-ct-findings-in-mesenteric-venous-thrombosis-at-admission
#13
S Salim, O Ekberg, J Elf, M Zarrouk, A Gottsäter, S Acosta
PURPOSE: The main aim of this study was to evaluate the association of computed tomography (CT) findings at admission and bowel resection rate in patients with mesenteric venous thrombosis (MVT). It was hypothesized that abnormal intestinal findings on CT were associated with a higher bowel resection rate. METHODS: Retrospective study of MVT patients treated between 2004 and 2017. CT images at admission and at follow-up were scrutinized according to a predefined protocol...
March 28, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29569049/ct-for-evaluation-of-acute-pericardial-emergencies-in-the-ed
#14
Abhishek Chaturvedi, Daniel Vargas, Daniel Ocazionez
Acute pericardial emergencies may present with acute chest pain. Although complete diagnosis and physiological effects of acute pericardial disease may require a combination of different imaging, CT plays a critical role in identifying the cause of chest pain in the ED. Many of these pericardial diseases can be fatal unless emergent treatment is obtained. The presentation can often be non-specific and symptoms can be overlapping with other diseases originating in the thorax or abdomen. Optimizing the CT scan is imperative when acute pericardial disease is suspected from clinical examination or preliminary imaging...
March 22, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29546674/causes-of-pneumocephalus-and-when-to-be-concerned-about-it
#15
Alain Cunqueiro, Meir H Scheinfeld
Intracranial gas is commonly detected on neuroimaging. The recognition of this finding can at first blush be unsettling. Being able to localize this gas to a specific compartment: intraarterial, intravenous, intraparenchymal, subdural, epidural, subarachnoid and intraventricular, is the first step in determining the importance of the gas. Determination of the route of entry: through the skull, extension from a paranasal sinus or the mastoid air cells, via the spine, or trans-vascular, is the other important factor in determining potential consequences...
March 15, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29541957/reporting-of-ct-cervical-spine-after-office-hours-by-radiology-trainees-analysis-of-discrepancy-rates-and-radpeer-scores
#16
Yet Yen Yan, Jenn Nee Khoo, Tien Jin Tan, Joe Francis, Le Roy Chong, Elizabeth Hui-Ying Chan
PURPOSE: To review the errors made by radiology trainees in the reporting of cervical spine CTs (CCT) and to compare the discrepancy rates between the stages of training. METHODS: All CCTs reported by trainees after office hours between January 2015 and December 2015 were retrospectively reviewed by a team of five musculoskeletal consultants with experience ranging between 7 and 15 years. Discrepancies between the provisional report by the trainee and the findings by the musculoskeletal consultants were graded according to the RADPEER scoring system...
March 14, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29536277/clinical-impact-of-computed-tomography-in-the-emergency-department-in-nontraumatic-chest-and-abdominal-conditions
#17
Lorenzo Carlo Pescatori, Matteo Brambati, Carmelo Messina, Giovanni Mauri, Giovanni Di Leo, Enzo Silvestri, Francesco Sardanelli, Luca Maria Sconfienza
AIM: To evaluate the clinical impact of CT scan in modifying the clinical management in patients referred to the emergency department. METHODS: We prospectively evaluated 300 patients (177 males, 63 ± 18 years old) admitted in the emergency department (ED) of a single institution, who underwent a CT examination for thoracic and/or abdominal complains. Demographic and clinical data were collected. Hypothesized outcome prior to CT scan and final management (i...
March 13, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29536276/to-reduce-routine-computed-tomographic-angiography-for-thoracic-aortic-injury-assessment-in-level-ii-blunt-trauma-patients-using-three-mediastinal-signs-on-the-initial-chest-radiograph-a-preliminary-report
#18
John H Harris, William H Harris, Sanjay Jain, A Y Ferguson, David A Hill, Amy M Trahan
PURPOSE: CTA is routinely ordered on level II blunt thoraco-abdominally injured patients for assessment of injury to the thoracic aorta. The vast majority of such assessments are negative. The question being asked is, Does the accurate interpretation of the three mediastinal signs permit reliable determination of which patients need CTA for aortic assessment? The purpose of this investigation was to evaluate the role of three specifically selected mediastinal anatomic signs on the initial supine chest radiograph (CXR) of adult level II blunt thoraco-abdominally injured patients for the presence or absence of a mediastinal hematoma...
March 13, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29536275/are-all-urgent-nephrostomies-that-urgent
#19
Daniel Koh, Kenneth K Lau, Evonne Teoh
PURPOSE: To investigate if the presence of systemic inflammatory response syndrome (SIRS) in patients with urinary tract obstruction at time of presentation to the emergency department correlates with a subsequent positive urine culture and to determine if it could be used as a tool to predict the urgency of a percutaneous nephrostomy (PCN). The secondary aim of the study was to assess the incidence of in-hour and after-hour emergent PCNs performed in a tertiary center which has both interventional radiological and urological expertise...
March 13, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29502287/breast-care-problems-on-call-training-residents-to-manage-effectively
#20
Lin H Bailey, Deborah O Jeffries, Jason J Bailey, Renee W Pinsky, Janet E Bailey, Bin Nan, Tianwen Ma, Katherine A Klein
PURPOSE: Our aim was to assess and address the challenges radiology residents face when managing breast imaging emergencies on call and to determine if targeted educational interventions improved resident confidence and knowledge. METHODS: We created surveys to determine resident comfort level with and knowledge of appropriate management of breast imaging emergencies. We also created structured educational interventions to improve resident confidence and knowledge...
March 3, 2018: Emergency Radiology
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