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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 Yin, 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
Natalia Simanovsky, Omer Issachar, Benjamin Koplewitz, N Lev-Cohain, D Rekhtman, Nurith Hiller
PURPOSES: Early recurrent ileocolic intussusception (RICI) is a rare event. We aimed to estimate the rate of RICI and identify predisposing factors for early recurrence for children treated in a tertiary-care academic medical center. METHODS: Consecutive children who were diagnosed with ileocolic intussusception (ICI) during the years 2005-2015 and had successful enema reduction were included. Demographic, clinical, imaging, and laboratory data were recorded for analysis...
August 24, 2018: Emergency Radiology
Kamila A Skalski, Alexander T Kessler, Alok A Bhatt
Susceptibility-weighted imaging (SWI) plays a key role in an emergency setting. SWI takes the intrinsic properties of materials being scanned and creates a visual representation of their effects on the magnetic field, thereby differentiating a number of pathologies. Magnetic resonance imaging (MRI) is now more often used, especially when computed tomography (CT) is inconclusive or even negative. Often, clinicians prefer to obtain an MRI first. This article will review the various hemorrhagic and non-hemorrhagic causes of low signal on SWI...
August 22, 2018: Emergency Radiology
Elizabeth George, Ashish Khandelwal, Christopher Potter, Aaron Sodickson, Srinivasan Mukundan, Diego Nunez, Bharti Khurana
Cerebrovascular injury is increasingly identified in patients presenting after blunt trauma due to the implementation of screening criteria and advances in noninvasive angiographic imaging by CT. The variable latent time before onset of secondary stroke presents a window of opportunity for prevention, reinforcing the importance of detection of asymptomatic patients via screening. Furthermore, the high morbidity and mortality associated with secondary stroke makes it imperative that radiologists recognize these challenging injuries...
August 10, 2018: Emergency Radiology
Jacob C Mandell, Bharti Khurana
PURPOSE: To explore clinical applications of a novel conventional computed tomography (CT) color post-processing algorithm to increase conspicuity of nondisplaced trabecular fractures. MATERIALS AND METHODS: The algorithm was created in Adobe Photoshop and Adobe Extendscript, utilizing DICOM images from conventional CT as source images. A total of six representative cases were selected and processed. No statistical analyses were performed. RESULTS: A total of six cases are demonstrated, five with MRI correlation demonstrating corresponding fractures and bone marrow edema, including a case of sacral insufficiency fracture, two cases of vertebral body fracture, two cases of nondisplaced hip fracture, and a knee bone marrow edema lesion (without MRI correlate)...
August 9, 2018: Emergency Radiology
Eric A White, Matthew R Skalski, George R Matcuk, Nathanael Heckmann, Anderanik Tomasian, Jordan S Gross, Dakshesh B Patel
Intra-articular tongue-type fractures may develop skin breakdown and often require urgent surgical reduction and fixation. Recognition of the imaging findings, accurate interpretation, and timely communication may prevent devastating clinical outcomes including soft tissue coverage procedures and amputation. This article reviews the anatomy of the calcaneus, as well as the clinical presentation and imaging findings of intra-articular tongue-type fractures. Imaging interpretation and clinical management of these fractures are discussed...
July 30, 2018: Emergency Radiology
Matthew A Haber, Diego Nunez
The altered physiologic state of female patients during and just after pregnancy places them at an increased risk for several potentially life-threatening neurologic disorders. Swift diagnosis of such pathology and related complications is critical in order to reduce risk of morbidity and mortality to both the mother and the fetus. Neuroimaging plays an important role in the emergent diagnosis of pathology associated with pregnancy and puerperium, and it is critical for the radiologist to be cognizant of correlative imaging findings...
July 20, 2018: Emergency Radiology
Koichi Inukai, Shuhei Uehara, Yoshiteru Furuta, Masanao Miura
PURPOSE: The success rate of nonoperative management (NOM) of traumatic liver injury is approximately 90%. Although NOM has become the standard treatment when patients' vital signs are stable, open surgical hemostasis is often selected when these signs are unstable. At our hospital, we extensively use NOM along with transcatheter arterial embolization (TAE) to treat patients with severe abdominal trauma, as per our original protocol. We also apply NOM for severe liver injury with unstable hemodynamics...
July 19, 2018: Emergency Radiology
Babita Panigrahi, Blake C Jones, Steven P Rowe
Synthetic marijuana is a dangerous substance due to its potency, ever-changing composition, and unpredictable side effects. Recently, brodifacoum-contaminated synthetic marijuana has led to multiple deaths and morbidity throughout the USA from severe coagulopathy associated with use of this strain of the drug (brodifacoum is a rodenticide and potent Vitamin K antagonist/anticoagulant). We describe the clinical and radiologic findings in two patients who were diagnosed with, and treated for, ingestion of this new strain of synthetic marijuana...
July 18, 2018: Emergency Radiology
Jacob C Mandell, Tatiana C Rocha, Maria Alejandra Duran-Mendicuti, Nityanand P Miskin, Junzi Shi, Bharti Khurana
PURPOSE: The purpose of this study was to demonstrate the diagnostic performance and effect on reader confidence of a custom computed tomography (CT) color postprocessing algorithm for assessment of nondisplaced proximal femoral fractures. MATERIALS AND METHODS: Four radiologists, including two PGY-3 radiology residents and two emergency radiologists, independently interpreted 30 CT examinations of the hip and/or pelvis performed for trauma, consisting of a total of 15 cases positive for nondisplaced hip fracture and 15 age and sex-matched controls...
July 14, 2018: Emergency Radiology
Dong Wook Kim, Hee Mang Yoon, Jeong-Yong Lee, Jung Heon Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho
OBJECTIVE: To assess the diagnostic performance of CT for pediatric patients with suspected appendicitis in various clinical settings and the proportion of acute appendicitis on final diagnosis among equivocal CT findings. METHODS: MEDLINE and EMBASE databases were searched until October 21, 2017, for studies investigating diagnostic performance of CT for acute appendicitis in pediatric patients confirmed by histopathologic findings and/or clinical follow-up. Pooled estimates of sensitivity and specificity were calculated using a hierarchical logistic regression modeling...
July 12, 2018: Emergency Radiology
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