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Emergency CT imaging

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https://www.readbyqxmd.com/read/28441632/emergency-computed-tomography-in-patients-with-first-seizure
#1
Kaisa Kotisaari, Pekka Virtanen, Nina Forss, Daniel Strbian, Filip Scheperjans
PURPOSE: To determine the frequency of emergent imaging findings on head computed tomography (CT) in an adult population of first seizure (FS) patients presenting to an emergency department (ED); and to search for associations between clinical features and emergent imaging findings among these patients. METHODS: For this retrospective registry-based study, adult FS patients presenting to Helsinki University Hospital ED in 2006 were identified based on ICD-10 diagnosis...
April 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28441370/conventional-modalities-and-novel-emerging-imaging-techniques-for-musculoskeletal-tumors
#2
Meera Raghavan
BACKGROUND: Imaging of musculoskeletal tumors requires a multimodality approach and includes radiography, computed tomography (CT), and magnetic resonance imaging (MRI). METHODS: Topics related to primary bone and soft-tissue tumors are reviewed. The fundamental imaging principles are discussed as well as the applications of emerging imaging modalities. RESULTS: MRI is the preferred technique for the evaluation of musculoskeletal tumors, whereas other imaging modalities play a complementary role...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28440669/can-multiphase-dynamic-ct-angiography-provide-a-better-assessment-of-aortic-dissection-compared-with-the-standard-triphasic-protocol
#3
Chun-Yan Lu, Yi-Ke Diao, Ying-Qiang Guo, Xiao-Hui Zhang, Hong-Li Bai, Zhen-Lin Li
Background Acute aortic dissection (AD) is a life-threatening medical emergency. It has been debated whether the multiphase dynamic computed tomography angiography (CTA) protocol is superior to the standard triphasic protocol for revealing the characteristics of AD. Purpose To examine two multiphase dynamic protocols, Dynamic four-dimensional (4D) CTA using the shuttle mode and Flash 4D CTA using the high-pitch mode for the assessment of AD and to compare them with the standard triphasic protocol. Material and Methods A total of 54 consecutive patients were randomly and equally assigned to three groups and scanned with a second-generation DSCT scanner...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28437625/imaging-guided-synergetic-therapy-of-orthotopic-transplantation-tumor-by-superselectively-arterial-administration-of-microwave-induced-microcapsules
#4
Shunsong Tang, Changhui Fu, Longfei Tan, Tianlong Liu, Jingsong Mao, Xiangling Ren, Hongying Su, Dan Long, Qianqian Chai, Zhongbing Huang, Xudong Chen, Jingzhuo Wang, Jun Ren, Xianwei Meng
It is an ambitious target to improve overall Hepatocellular Carcinoma therapeutic effects. Recently, MW ablation has emerged as a powerful thermal ablation technique, affording favorable survival with excellent local tumor control. To achieve better therapeutic effects of MW ablation, MW sensitizers are prepared for enhanced MW ablation to preferentially heat tumor territory. However, it is still not practicable for treatment of the orthotopic transplantation tumor. Herein, biocompatible and degradable methoxy poly(ethylene glycol)-poly(lactic-co-glycolic acid) (mPEG-PLGA) microcapsules with hierarchical structure have been designed for microwave-induced tumor therapy...
April 14, 2017: Biomaterials
https://www.readbyqxmd.com/read/28435496/-choosing-wisely-imaging-recommendations-initial-implementation-in-new-england-emergency-departments
#5
Ali S Raja, Arjun Venkatesh, Nathan Mick, Cristopher P Zabbo, Kohei Hasegawa, Janice A Espinola, Jane C Bittner, Carlos A Camargo
INTRODUCTION: In June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to "reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations." However, it is unknown whether New England emergency departments (ED) have already implemented evidence-based interventions to improve adherence to ACEP Choosing Wisely recommendations related to imaging after their initial release in 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431590/delays-in-door-to-needle-time-for-acute-ischemic-stroke-in-the-emergency-department-a-comprehensive-stroke-center-experience
#6
Ashkan Mowla, Jordan Doyle, Navdeep S Lail, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Peyman Shirani, Marilou Ching, Annemarie Crumlish, Deborah A Steck, David Janicke, Elad I Levy, Robert N Sawyer
BACKGROUND: Current American Stroke Association guidelines recommend initiating intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) within 60min of patient arrival, given the benefits of IVT for AIS are time dependent. This study aimed to identify the delaying factors in door-to-needle time (DTN) in the emergency department of one of the largest comprehensive stroke centers in New York State. We also recommended measures to reduce the delays. METHODS: We retrospectively reviewed the medical charts of all AIS patients who received IVT in our emergency department patients between April 1, 2012 and December 31, 2015 to identify those with a DTN time of >60min...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28430540/demystifying-orbital-emergencies-a-pictorial-review
#7
Viet D Nguyen, Achint K Singh, Wilson B Altmeyer, Bundhit Tantiwongkosi
Imaging of the orbit plays an important role in the workup of orbital emergencies. Orbital imaging is particularly useful in the emergency department, where clinical history and physical examination may be limited or delayed until the exclusion or treatment of more life-threatening conditions. Cross-sectional orbital imaging with multidetector computed tomography (CT) and magnetic resonance (MR) imaging is commonly performed in addition to ultrasonography. In an emergent setting, CT is the preferred modality when evaluating for intraorbital foreign bodies, fractures, or calcifications within a mass lesion...
April 21, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28429379/retrospective-evaluation-of-thoracic-computed-tomography-findings-in-dogs-naturally-infected-by-angiostrongylus-vasorum
#8
Mark E Coia, Gawain Hammond, Daniel Chan, Randi Drees, David Walker, Kevin Murtagh, Janine Stone, Nicholas Bexfield, Lizzie Reeve, Jenny Helm
Angiostrongylus vasorum (A. vasorum) is an important emerging disease of canidae. Cardiorespiratory signs are common in affected dogs, therefore thoracic imaging is critical for diagnosing and monitoring disease. Descriptions of thoracic computed tomography (CT) findings in dogs naturally infected with A. vasorum are currently lacking. Aims of this multicenter, retrospective study were to describe thoracic CT findings in a group of dogs with confirmed disease, determine whether any changes were consistent among dogs, and propose standardized terms for describing thoracic CT findings...
April 20, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#9
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28417277/clandestine-charisma-of-the-charm-needles-a-radiologist-s-challenge
#10
Michael T Jurkiewicz, C C Tchoyoson Lim, Suyash Mohan
A 94-year-old Korean woman was seen in the Emergency Department after a fall. CT examination of the maxillofacial region found multiple small linear metallic densities in the subcutaneous soft tissues of the face. The appearance of these densities was unchanged when compared to a study performed 2 years prior; however, the imaging interpretations of these densities were markedly different. Additional imaging during the course of her hospital stay demonstrated numerous similar densities in the breasts, abdomen, hips, and legs-finally diagnosed as "charm needles...
April 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28416437/the-ct-based-fractal-analysis-of-trabecular-bone-structure-may-help-in-detecting-decreased-quality-of-bone-prior-to-urgent-spinal-procedures
#11
Marcin Czyz, Arion Kapinas, James Holton, Renata Pyzik, Bronek M Boszczyk, Nasir A Quraishi
BACKGROUND CONTEXT: To date no reliable method is available to determine the parameters of bone density based on the routine spinal CT in the emergency setup. We propose the use of fractal analysis to detect patients with poor quality of bone prior to urgent or semi-urgent spinal procedures. PURPOSE: To validate the hypothesis that the CT-based fractal analysis of the trabecular bone structure may help in detecting patients with poor quality of bone prior to urgent spinal procedures...
April 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#12
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414679/misses-opportunity-tof-diagnoses-in-4th-decade-of-life
#13
O Baniahmad, T Jarreau, A Johnson
CASE: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Physical examination was notable for central cyanosis, facial and lid edema, a II/VI holosystolic murmur across right chest radiating to entire right back hemithorax, decreased breath sounds at bases with pulmonary crackles, clubbing of fingers and edema of bilateral lower extremities...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413549/challenges-in-a-case-of-ophthalmic-artery-aneurysm-associated-with-abnormal-internal-carotid-arteries
#14
Eduard B Dinca, Felix Brehar, Andrei Giovani, Alexandru V Ciurea
Ophthalmic artery aneurysms account for 5% of all cerebral aneurysms and are an important cause of morbidity and mortality related to subarachnoid hemorrhage. The diagnosis is often made only when the aneurysm is large enough to become symptomatic. They remain technically challenging for both neurosurgeon and interventional radiologist. We present the case of a 62-year-old woman admitted for transient loss of consciousness, followed by generalized tonic-clonic seizures. Computed tomography (CT) showed a subarachnoid hemorrhage (SAH), clinically graded as Hunt and Hess III...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#15
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28402131/can-imaging-predict-subclinical-cortisol-secretion-in-patients-with-adrenal-adenomas-a-ct-predictive-score
#16
Cristina Mosconi, Valentina Vicennati, Dimitris Papadopoulos, Guido Di Dalmazi, Antonio M Morselli-Labate, Rita Golfieri, Renato Pasquali
OBJECTIVE: The aim of this study is to determine whether any correlation between CT findings and functional parameters exists to predict subclinical glucocorticoid secretion. MATERIALS AND METHODS: This is a retrospective database study of 55 patients with incidentally discovered adenomas, investigated through CT with an adrenal protocol, assessing diameters and attenuation values on the unenhanced and contrast-enhanced phases. Patients underwent blood cortisol and corticotropin evaluation and overnight dexamethasone suppression test (DST), in accordance with clinical recommendations...
April 12, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28401173/history-and-future-technical-innovation-in-positron-emission-tomography
#17
REVIEW
Terry Jones, David Townsend
Instrumentation for positron emission tomography (PET) imaging has experienced tremendous improvements in performance over the past 60 years since it was first conceived as a medical imaging modality. Spatial resolution has improved by a factor of 10 and sensitivity by a factor of 40 from the early designs in the 1970s to the high-performance scanners of today. Multimodality configurations have emerged that combine PET with computed tomography (CT) and, more recently, with MR. Whole-body scans for clinical purposes can now be acquired in under 10 min on a state-of-the-art PET/CT...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28398001/an-update-on-carbon-nanotube-enabled-x-ray-sources-for-biomedical-imaging
#18
REVIEW
Connor Puett, Christina Inscoe, Allison Hartman, Jabari Calliste, Dora K Franceschi, Jianping Lu, Otto Zhou, Yueh Z Lee
A new imaging technology has emerged that uses carbon nanotubes (CNT) as the electron emitter (cathode) for the X-ray tube. Since the performance of the CNT cathode is controlled by simple voltage manipulation, CNT-enabled X-ray sources are ideal for the repetitive imaging steps needed to capture three-dimensional information. As such, they have allowed the development of a gated micro-computed tomography (CT) scanner for small animal research as well as stationary tomosynthesis, an experimental technology for large field-of-view human imaging...
April 11, 2017: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/28393006/small-cell-lung-cancer-transformation-during-immunotherapy-with-nivolumab-a-case-report
#19
Takuma Imakita, Kohei Fujita, Osamu Kanai, Tsuyoshi Terashima, Tadashi Mio
We report a rare case of transformation of non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC), without epidermal growth factor receptor (EGFR) gene mutation, during immunotherapy treatment with nivolumab. A 75-year-old man was referred to our hospital following the observation of a 64 mm mass in a chest computed tomography (CT) scan. A transbronchial biopsy of the mass identified the pathological presence of poorly differentiated NSCLC, with no histological signs of SCLC. No mutations were identified in the EGFR gene...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28391603/embedded-clinical-decision-support-in-electronic-health-record-decreases-use-of-high-cost-imaging-in-the-emergency-department-embed-study
#20
Kelly Bookman, David West, Adit Ginde, Jennifer Wiler, Robert McIntyre, Andrew Hammes, Nichole Carlson, David Steinbruner, Matthew Solley, Richard Zane
OBJECTIVE: Evaluate the impact of evidence-based clinical decision support tools integrated directly into provider workflow in the electronic health record on utilization of CT brain, c-spine and pulmonary embolism (PE). METHODS: Validated, well accepted scoring tools for head injury, c-spine injury and pulmonary embolism were embedded into the electronic health record in a manner minimally disruptive to provider workflow. This was a longitudinal, before/after study in 5 emergency departments in a healthcare system with a common electronic health record...
April 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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