Emergency Radiology最新文献

{"title":"Imaging of tracheobronchial and laryngeal injuries.","authors":"Tanche Jimmy Wang, Ismail Ali, Shamir Rai, Nicolas Murray","doi":"10.1007/s10140-025-02334-5","DOIUrl":"https://doi.org/10.1007/s10140-025-02334-5","url":null,"abstract":"<p><p>Tracheobronchial and laryngeal injuries are relatively rare and may be life-threatening. Rapid diagnosis of these injuries is critical for the survival of patients. Findings of tracheobronchial and laryngeal injuries can be subtle. This pictorial essay reviews the imaging findings of tracheobronchial and laryngeal injuries.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting hemorrhagic transformation in acute ischemic stroke: a systematic review, meta-analysis, and methodological quality assessment of CT/MRI-based deep learning and radiomics models.","authors":"Mohsen Salimi, Pouria Vadipour, Amir Reza Bahadori, Shakiba Houshi, Ali Mirshamsi, Hossein Fatemian","doi":"10.1007/s10140-025-02336-3","DOIUrl":"https://doi.org/10.1007/s10140-025-02336-3","url":null,"abstract":"<p><p>Acute ischemic stroke (AIS) is a major cause of mortality and morbidity, with hemorrhagic transformation (HT) as a severe complication. Accurate prediction of HT is essential for optimizing treatment strategies. This review assesses the accuracy and utility of deep learning (DL) and radiomics in predicting HT through imaging, regarding clinical decision-making for AIS patients. A literature search was conducted across five databases (Pubmed, Scopus, Web of Science, Embase, IEEE) up to January 23, 2025. Studies involving DL or radiomics-based ML models for predicting HT in AIS patients were included. Data from training, validation, and clinical-combined models were extracted and analyzed separately. Pooled sensitivity, specificity, and AUC were calculated with a random-effects bivariate model. For the quality assessment of studies, the Methodological Radiomics Score (METRICS) and QUADAS-2 tool were used. 16 studies consisting of 3,083 individual participants were included in the meta-analysis. The pooled AUC for training cohorts was 0.87, sensitivity 0.80, and specificity 0.85. For validation cohorts, AUC was 0.87, sensitivity 0.81, and specificity 0.86. Clinical-combined models showed an AUC of 0.93, sensitivity 0.84, and specificity 0.89. Moderate to severe heterogeneity was noted and addressed. Deep-learning models outperformed radiomics models, while clinical-combined models outperformed deep learning-only and radiomics-only models. The average METRICS score was 62.85%. No publication bias was detected. DL and radiomics models showed great potential in predicting HT in AIS patients. However, addressing methodological issues-such as inconsistent reference standards and limited external validation-is essential for the clinical implementation of these models.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous rupture of solid pseudopapillary neoplasm (SPN) of the Pancreas - imaging insights and review of the literature.","authors":"Hajra Arshad, Linda C Chu, Elliot K Fishman, Satomi Kawamoto","doi":"10.1007/s10140-025-02332-7","DOIUrl":"https://doi.org/10.1007/s10140-025-02332-7","url":null,"abstract":"<p><p>Solid pseudopapillary neoplasm (SPN) of the pancreas, are rare low-grade malignant pancreatic tumors, most commonly occurring in young women during their second or third decade of life. They can present with vague abdominal symptoms like pain, discomfort, and nausea, or it can be incidentally discovered on imaging studies. There has been limited literature on ruptured SPN, which can be spontaneous or traumatic. In this paper, we present three cases of ruptured SPN, one traumatic and two spontaneous, to add to the scarcity of knowledge regarding this condition and its radiologic features, along with a detailed review of current literature.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic performance of automatic B-lines detection for evaluating pulmonary edema in the ER among novice POCUS practitioners.","authors":"Arosh S Perera Molligoda Arachchige, Niccolò Stomeo","doi":"10.1007/s10140-025-02335-4","DOIUrl":"https://doi.org/10.1007/s10140-025-02335-4","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Detectability of acute ischemic stroke with thin (3 mm) axial versus thin (3 mm) coronal diffusion-weighted imaging in patients presenting to the emergency department with acute dizziness.","authors":"Richard J Lozano, Faryal Shareef, Anish Neupane, Zaid Siddique, Rudra Joshi, Luca Pasquini, Long H Tu, Amit Mahajan","doi":"10.1007/s10140-025-02333-6","DOIUrl":"https://doi.org/10.1007/s10140-025-02333-6","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the letter to the editor: the diagnostic performance of automatic B-lines detection for evaluating pulmonary edema in the ER among novice POCUS practitioners.","authors":"Kamonwon Ienghong, Lap Woon Cheung, Dhanu Gaysonsiri, Korakot Apiratwarakul","doi":"10.1007/s10140-025-02331-8","DOIUrl":"https://doi.org/10.1007/s10140-025-02331-8","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overnight emergency radiologist coverage model with preserved resident autonomy: impact on report turnaround times and resident experience.","authors":"Rawan Abu Mughli, Deyvison T Baia Medeiros, Róisín MacDermott, Jacques du Plessis, Abdelazim M E Mohammed, Jason A Robins, Sadia R Qamar, Michael E O'Keeffe, Rajesh Bhayana, Masoom A Haider, Ferco H Berger","doi":"10.1007/s10140-025-02330-9","DOIUrl":"https://doi.org/10.1007/s10140-025-02330-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of overnight in-house emergency radiologist coverage on turnaround time (TAT) for emergent imaging of ED and inpatients, during the night and following morning, in a coverage model tailored to preserving resident autonomy.</p><p><strong>Methods: </strong>Retrospective analysis of TAT for all emergent imaging of ED and inpatients at an academic Level-1 trauma center from September 2015 to August 2019, two years before and after changing coverage model. Median and 90th percentile were assessed for overnight (22:00-07:00 h.) and morning (07:00-10:00 h.) emergent imaging TAT for both the 'First report' and 'Final report'. Statistical significance of TAT changes between study years was assessed with quantile regression. Trainee report volumes and their rotation evaluations were assessed.</p><p><strong>Results: </strong>128,433 emergent ED and inpatient imaging studies (82,482 overnight and 45,951 morning) were included; 40,136 CTs, 83,993 X-rays, 2018 US and 2286 MRIs. Imaging volumes increased over time. Except 90th percentile MRI First report TAT, all overnight TAT metrics statistically significantly improved with the new coverage model. For example, ED CT median Final report TAT decreased from 8.45 h to 1.38 h. Morning imaging showed statistically significant reduction for all TATs, except for MRI TATs and 90th percentile US Final report TAT. For example, ED CT median Final report TAT decreased from 1.56 h to 1.19 h. Absolute imaging volume reported by trainees increased by 14% in the 4-year period and weighted average rotation evaluation on a 5-point scale was 3.9 in the post-implementation cohort.</p><p><strong>Conclusion: </strong>Introduction of a tailored in-house overnight emergency radiologist coverage model can preserve resident autonomy and productivity while achieving statistically significant reduction of emergent imaging report turnaround time for emergent imaging overnight and the following morning. It may help mitigate ED overcrowding while preserving trainee educational experience.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the utility of chest x-rays for non-traumatic chest pain in Australia- a retrospective cohort study.","authors":"Alex Lin, Dinesh Varma, Biswadev Mitra","doi":"10.1007/s10140-025-02329-2","DOIUrl":"https://doi.org/10.1007/s10140-025-02329-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to quantify the proportion of chest x-rays (CXRs) for non-traumatic chest pain (NTCP) in the emergency department (ED) that were abnormal and assess the clinical significance of these abnormalities. We also aimed to explore the variables associated with abnormal and clinically significant abnormal CXRs, to predict a population where CXRs can be safely avoided.</p><p><strong>Methods: </strong>A single center retrospective cohort study was conducted including all adult patients presenting to a single ED with NTCP between 01 Jan 2022 and 31 Dec 2022. We categorized the CXRs into abnormal, or normal as reported by a radiologist. Abnormalities were categorized to be clinically significant based on potential or actual changes in patient management. The association of patient demographics, presenting vital signs, and clinical characteristics with clinically significant abnormalities were explored using multivariable logistic regression analysis.</p><p><strong>Results: </strong>There were 3,419 eligible patient encounters included for analysis. Of these, 746 (21.8%; 95%CI: 20.4-23.2%) CXRs had at least one abnormality detected. There were 218 (6.4%; 95%CI: 6.1-7.9%) CXRs deemed to have clinically significant abnormalities. Age categories of 50-64 years (aOR 1.64; 95%CI 1.04-2.60), and age > 64 years (aOR 2.32; 95%CI: 1.51-3.57), history of congestive heart failure (CHF) (aOR 1.86; 95%CI: 1.08-3.21), smoking (aOR 1.27; 95%CI: 1.04-1.57), hemoptysis (aOR 6.69; 95%CI: 1.92-23.33), diminished lung sounds (aOR 4.87; 95%CI:2.95-8.05), rales (aOR 4.49; 95%CI: 2.82-7.15), and abnormal oxygen saturations (aOR 1.98; 95%CI: 1.40-2.79) were associated with clinically significant abnormalities on CXRs. In the absence of these variables, 1.4% (95%CI: 0.6-2.6%) of CXRs were abnormal with clinical significance.</p><p><strong>Conclusions: </strong>CXRs have a relatively high yield of abnormalities among patients with NTCP. However, some CXRs could be safely avoided in the absence of variables associated with clinically significant abnormalities. Further validation of these clinical characteristics is required before translation to clinical practice.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of a new computed tomography severity score in hemorrhagic fever with renal syndrome.","authors":"Se Woo Kim, Cheong-Il Shin, Min Woo Kang, Min Cheol Kim, Donghwan Kim","doi":"10.1007/s10140-025-02322-9","DOIUrl":"https://doi.org/10.1007/s10140-025-02322-9","url":null,"abstract":"<p><strong>Purpose: </strong>To develop of a novel computed tomography (CT) severity score for hemorrhagic fever with renal syndrome (HFRS) and evaluate its correlation with disease severity and adverse outcomes.</p><p><strong>Methods: </strong>This retrospective study included 37 patients diagnosed with HFRS from January 2012 to December 2023 who had available clinical laboratory and abdominal CT data during the acute phase. The CT severity score (range 0-5) was based on perirenal fat stranding, pararenal fascia thickening, anterior pararenal space fat stranding, ascites, and pleural effusion. Correlations between the score and markers of inflammation, thrombocytopenia, proteinuria, and adverse outcomes-including nephrotic range proteinuria and renal replacement therapy (RRT)-were analyzed.</p><p><strong>Results: </strong>The CT severity score exhibited moderate to strong correlations with markers of inflammation (white blood cell count, ρ = 0.65, p < 0.001), thrombocytopenia (platelet count, ρ = -0.54, p < 0.001), and proteinuria (urine protein-to-creatinine ratio, ρ = 0.56, p < 0.001). Higher scores were associated with increased nephrotic range proteinuria in Chi-squared test for trend (p-for-trend = 0.001). A one-point increase in the score significantly increased odds of requiring RRT in logistic regression analysis (odds ratio: 9.89, p = 0.047). The score achieved an area under the receiver operating characteristics curve of 0.819 for predicting RRT.</p><p><strong>Conclusion: </strong>The CT severity score correlates well with disease severity and adverse outcomes in HFRS and can be assessed using noncontrast CT, making it a valuable prognostic tool in young male population. Further validation in diverse populations is warranted.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the utility of FDG PET/CT study in diagnosis of early acute appendicitis.","authors":"Saurabh Pallod, Rami Chatta, Ravanane Ramadosan, Hina Shah","doi":"10.1007/s10140-025-02314-9","DOIUrl":"https://doi.org/10.1007/s10140-025-02314-9","url":null,"abstract":"<p><p>Acute appendicitis is a common surgical emergency that can be challenging to diagnose due to its varied clinical presentations. Standard imaging methods include ultrasonography, computed tomography (CT), and Magnetic resonance imaging (MRI), but fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT), typically used for oncology, can incidentally detect appendicitis through increased radiotracer uptake associated with inflammation. The paper discusses two cases where acute appendicitis was identified during PET/CT scans conducted for cancer evaluations. In cancer patients, diagnosing appendicitis is difficult due to overlapping symptoms from chemotherapy, metastasis, or radiation effects. Clinicians and radiologists must remain vigilant for incidental appendicitis findings in PET/CT scans, as early diagnosis can prevent complications despite its rarity in oncology imaging.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}