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Emergency Radiology

Davide Ippolito, Andrea De Vito, Cammillo Talei Franzesi, Luca Riva, Anna Pecorelli, Rocco Corso, Andrea Crespi, Sandro Sironi
OBJECTIVES: To evaluate dose reduction and image quality of 80-kV CT pulmonary angiography (CTPA) reconstructed with knowledge model-based iterative reconstruction (IMR), and compared with 100-kV CTPA with hybrid iterative reconstruction (iDose4 ). MATERIALS AND METHODS: One hundred and fifty-one patients were prospectively investigated for pulmonary embolism; a study group of 76 patients underwent low-kV setting (80 kV, automated mAs) CTPA study, while a control group of 75 patients underwent standard CTPA protocol (100 kV; automated mAs); all patients were examined on 256 MDCT scanner (Philips iCTelite)...
November 10, 2018: Emergency Radiology
William A Mehan, Christopher J Stapleton, Scott B Raymond
PURPOSE: Neck CT angiography (CTA) is frequently performed in conjunction with head CTA in patients presenting with clinical signs and symptoms concerning for acute intracranial hemorrhage, despite relatively low appropriateness (ACR Appropriateness Criteria 2-6). This decision is sometimes justified by suggesting that CTA neck findings are useful in planning subsequent catheter angiography. METHODS: We investigated the value of neck CTA in patients with suspected acute intracranial hemorrhage by reviewing 220 head and neck CTAs performed in our emergency room over a 24-month period for the indication of hemorrhage or headache...
November 5, 2018: Emergency Radiology
Brian M Haas, Lewis D Hahn, Isabel Oliva
PURPOSE: Plain radiography of the cervical spine is used as a screening test for trauma patients. We evaluated the diagnostic yield of performing anteroposterior (AP), odontoid, and oblique views in addition to the lateral view in the current era when radiographs are performed only on low-risk patients. METHODS: All imaging reports from cervical spine radiography studies on patients aged 18 years and older in the emergency room of a major academic medical center between November 22, 2003, and January 17, 2012, were retrospectively reviewed...
November 1, 2018: Emergency Radiology
Jessica H Porembka, Lindsay Compton, Lena Omar, Pooja Sharma, Haley Clark, Richard Ahn, Ramapriya Ganti, Yin Xi, Jeffery Metzger, John R Leyendecker
PURPOSE: The purpose of this study is to (1) assess the diagnostic yield of ultrasounds performed in the emergency department for suspected breast abscess and determine the rates of reimaging, discordance, and emergent intervention in a large, busy safety net hospital and (2) determine clinical factors significantly associated with abscess as a way to improve patient selection for emergent breast ultrasounds. METHODS: A total of 581 consecutive breast ultrasounds performed in the emergency department for suspected abscess over 15 months were retrospectively reviewed for imaging, demographics, laboratory data, and physical exam findings...
October 30, 2018: Emergency Radiology
Cory J Ozimok, Vincent M Mellnick, Michael N Patlas
PURPOSE: There is controversy regarding the administration of oral and rectal contrast for CT performed to detect bowel injury in the context of penetrating torso trauma. Given the lack of published societal guidelines, our goal was to survey radiologists from the American Society of Emergency Radiology membership database to determine consensus on CT protocols for penetrating trauma. METHODS: With ethics board approval, an anonymous ten-question online survey was distributed via email to 589 radiologists in the American Society of Emergency Radiology (ASER) member database...
October 21, 2018: Emergency Radiology
Daniel Hillman, Matthew Rheinboldt, Andrew Petraszko
Acute osseous and soft tissue injuries to the hand and wrist are a common cause for ER visitation. Though diagnostic assessment has historically remained the province of conventional radiography, CT and MRI, sonography is gaining increasing acceptance and utilization. Offering multiple inherent advantages as an imaging modality, ultrasonic assessment has proven its utility in the evaluation of ligamentous and tendinous carpal and digital injuries as well as infection and inflammation. In this review, we will initially discuss sonographic technique and relevant normal anatomical features...
October 16, 2018: Emergency Radiology
Noam Gerber, Kelley Sookraj, Swapna Munnangi, L D George Angus, Vineet Lamba, Krishan Kumar, Brinda Doraiswamy
PURPOSE: To evaluate whether the emergency department usage of head computed tomography (CT) on pediatric patients with minor head trauma changed after publication of the Pediatric Emergency Care Applied Research Network (PECARN) head CT guidelines and to identify risk factors associated with performing head CT on patients without a PECARN guideline indication. METHODS: This retrospective study included 484 patients 18 years of age or younger who presented to the emergency department with head injury and a total Glasgow Coma Scale score ≥ 14 between September 2005 and July 2014...
September 27, 2018: Emergency Radiology
William Borror, Greg E Gaski, Scott Steenburg
PURPOSE: The objectives of this study were to calculate the total volumetric rate of abdominopelvic bleeding in patients with acute pelvic fractures and examine the relationships between the bleeding rate, patient outcomes, and required patient interventions. METHODS: This was a retrospective cohort study which included 29 patients from a 4-year period (May 2013 to May 2017). Patients with acute pelvic fractures and active bleeding detected on CT with two phases of imaging were included...
September 26, 2018: Emergency Radiology
Komal A Chughtai, Omar P Nemer, Alexander T Kessler, Alok A Bhatt
Craniotomy and craniectomy are widely performed emergent neurosurgical procedures and are the prescribed treatment for a variety of conditions from trauma to cancer. It is vital for the emergency radiologist to be aware of expected neuroimaging findings in post-craniotomy and craniectomy patients in order to avoid false positives. It is just as necessary to be familiar with postsurgical complications in these patients to avoid delay in lifesaving treatment. This article will review the commonly encountered normal and abnormal findings in post-craniotomy and craniectomy patients...
September 25, 2018: Emergency Radiology
Tze Phei Kee, Raphael Shih Zhu Yiin, Tien Jin Tan, Chin Kong Goh
The original version of this article contains an error. The author name Raphael Shih Zhu Yiin was incorrectly listed as Raphael Shih Zhu Yin. The correct spelling is presented above. The original article has been corrected.
September 25, 2018: Emergency Radiology
Omar Anjum, Helena Bleeker, Robert Ohle
INTRODUCTION: Computed tomographic pulmonary angiograms (CTPAs) are often ordered to evaluate pulmonary embolism (PE) in the emergency department (ED). The increase use of CTPA has led to an increase in incidental findings, often of low clinical significance. Our objectives were to (1) assess the prevalence and clinical significance of incidental findings identified in patients evaluated with CTPAs for PE in the ED, (2) evaluate follow-up investigations for these incidental findings, and (3) assess the utility of routine chest X-rays done prior to CTPA...
September 20, 2018: Emergency Radiology
Steven P Rowe, Linda C Chu, Stefan L Zimmerman, Elliot K Fishman
Mycotic aneurysms are uncommon but emergent conditions in which infection of a vessel leads to a contained rupture. Progression to frank rupture, thrombosis, distal embolization, and death can occur. The widespread availability of computed tomography (CT) and its ability to obtain high-resolution, contrast-enhanced, volumetric images rapidly has made it the modality of choice for evaluating mycotic aneurysms. Three-dimensional CT visualizations can provide important information to surgeons and interventionalists prior to attempting repair of these lesions...
September 19, 2018: Emergency Radiology
Tze Phei Kee, Raphael Shih Zhu Yiin, Tien Jin Tan, Chin Kong Goh
CT head has been increasingly performed in the Emergency Department for patients presented with trauma, acute neurological or psychological symptoms. Most of the emergency physicians and radiologists have undergone dedicated training and are capable of identifying and interpreting life-threatening cerebral pathologies. However, as most attention is directed to the brain, the extracerebral non-traumatic pathologies on CT head can easily be overlooked, and some of them harbour clinically significant pathologies...
September 15, 2018: Emergency Radiology
Frank Battaglia, Samad Shah, Sabeena Jalal, Kiran Khurshid, Nupur Verma, Savvas Nicolaou, Sravanthi Reddy, Susan John, Faisal Khosa
OBJECTIVE: This study is intended to better understand how academic productivity and career advancement differs between men and women emergency radiologists in academic practices. MATERIALS AND METHODS: Parameters of academic achievement were measured, including number of citations, number of publications, and h-index, while also collecting information on academic and leadership ranking among emergency radiologists in North America. RESULTS: In emergency radiology, there are significantly fewer women than men (22...
September 7, 2018: Emergency Radiology
Ronald J Zagoria
No abstract text is available yet for this article.
September 4, 2018: Emergency Radiology
Sinan Karacabey, Erkman Sanri, Bayram Metin, Fatih Erkoc, Sener Yildirim, Yavuz Selim Intepe, Sercan Yalcinli
PURPOSE: Modern lung ultrasound (US) is mainly applied not only in critical care, emergency medicine, and trauma surgery, but also in pulmonary and internal medicine. In some cases, pneumothorax (PTX) distinguishes with bullous diseases. In this study, we aimed to discuss the success of US on detecting PTX versus bullae. METHODS: We performed a prospective blinded study. Patients underwent thorax computed tomography (CT) if bullae or pneumothorax could not be differentiated from the chest radiography...
September 3, 2018: Emergency Radiology
Keith D Herr, Benjamin Risk, Tarek N Hanna
PURPOSE: (1) Evaluate radiology resident perception of emergency radiology (ER). (2) Identify potential barriers to pursuing fellowship training or a career in ER among radiology residents. MATERIALS AND METHODS: A 9-question digital survey was designed using Qualtrics Experience Management software (Qualtrics Inc., Provo, UT) and distributed to all US radiology residents via a multi-pronged distribution approach. RESULTS: Four hundred fifty-one residents responded out of an estimated national total of 4432 residents (10...
August 31, 2018: Emergency Radiology
Shaimaa A Fadl, Ken F Linnau, Manjiri K Dighe
Placental and periplacental bleeding are common etiologies for antepartum bleeding. Placental abruption complicates approximately 1% of pregnancies and is associated with increased maternal, fetal, and neonatal morbidity and mortality. This article reviews the normal placental appearance on ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) and then discusses the different morphological appearance of placental and periplacental hematomas along with their mimics. Hematomas are classified based on the location as retroplacental, marginal subchorionic, preplacental (subamniotic), or intraplacental...
August 29, 2018: Emergency Radiology
Scott D Steenburg, Tracy Spitzer, Amy Rhodes
PURPOSE: To describe our institutional experience with post-mortem computed tomography (PMCT) and its impact on decedent injury severity score (ISS) and to assess the adequacy of emergently placed support medical devices. METHODS: Over a 5-year period, patients who died at or soon after arrival and have physical exam findings inconsistent with death were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place...
August 29, 2018: Emergency Radiology
Eric T Foo, Vishal Kumar, Sujal M Nanavati, Eugene Huo, Mark W Wilson, Miles B Conrad
Management of splenic pseudoaneurysms in hemodynamically stable patients has shifted toward nonoperative management, including watchful waiting and endovascular embolization. Standard of treatment does not include percutaneous embolization for splenic pseudoaneurysm repair. In this case report, we document a successful percutaneous embolization of a post traumatic splenic pseudoaneurysm with thrombin. Percutaneous embolization of splenic pseudoaneurysms can be considered a viable technique in patients who fail endovascular embolization or have lesions inaccessible to endovascular repair...
August 28, 2018: Emergency Radiology
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