Emergency Radiology最新文献

{"title":"Response to the letter to the editor: rapid abdominal MRI for appendicitis for evaluation of ovarian torsion in children.","authors":"Sharon W Gould, Arabinda Choudhary","doi":"10.1007/s10140-025-02372-z","DOIUrl":"https://doi.org/10.1007/s10140-025-02372-z","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648854","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":"Preoperative intestine-to-liver CT ratio: useful predictor of resection in strangulated obstruction.","authors":"Seiichiro Fujishima, Hironori Tsujimoto, Yoshihisa Yaguchi, Hiroyuki Horiguchi, Keita Kouzu, Yusuke Ishibashi, Yujiro Itazaki, Takafumi Suzuki, Naoyuki Uehata, Risa Kariya, Asuma Ide, Hiroshi Shinmoto, Hideki Ueno","doi":"10.1007/s10140-025-02369-8","DOIUrl":"https://doi.org/10.1007/s10140-025-02369-8","url":null,"abstract":"<p><strong>Background: </strong>Prompt diagnosis of strangulated bowel obstruction (SBO) is critical because delayed recognition can lead to life-threatening complications. This study assessed whether the intestinal-to-liver CT attenuation value ratio-a comparison of ischemic bowel-wall enhancement to liver enhancement-can predict the need for intestinal resection in SBO patients.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 52 patients who underwent emergency surgery for suspected SBO from 2014 to 2021. Of these, 35 required intestinal resection due to irreversible ischemia (resection group), while 17 did not (no-resection group). Preoperative clinical and imaging findings were compared between groups.</p><p><strong>Results: </strong>The resection group had a longer time from onset to surgery (p = 0.034) and higher leukocyte counts (p = 0.037). CT values of the poorly enhanced intestinal wall and the intestinal-to-liver attenuation ratio were significantly lower in the resection group (p < 0.0001). Multivariate analysis identified time to surgery (OR 5.08; 95% CI 1.106-23.350; p = 0.037) and CT attenuation ratio (OR 15.50; 95% CI 2.622-91.686; p = 0.0025) as independent predictors of resection. When stratified by the median ratio cutoff (< 0.40 vs. ≥ 0.40), resection rates were 92% and 44%, respectively (p = 0.0001). Additionally, CT attenuation ratio had the diagnostic performance (AUROC 0.886; Youden index 0.736; sensitivity 97.1% and specificity 76.5%.) CONCLUSION: An intestinal-to-liver CT attenuation ratio below 0.40 is a strong predictor of intestinal ischemia requiring resection in SBO patients.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642113","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":"Distal radius fracture - Supination underestimates dorsal tilt in distal radius fracture radiographs: a case report.","authors":"Sebastian P L Clark, Maria Ilsø, Jens C Werlinrud, Benjamin S Rasmussen, Janni Jensen","doi":"10.1007/s10140-025-02367-w","DOIUrl":"https://doi.org/10.1007/s10140-025-02367-w","url":null,"abstract":"<p><p>Distal radius fractures are one of the most prevalent fracture types. Dorsal tilt of the articular surface of the distal radius as assessed on the lateral radiograph is often used in determining the correct treatment method. This report seeks to highlight the importance of correct forearm positioning when obtaining distal radius radiographs, and the effects of pronation and supination on dorsal tilt measurements of the radius. It presents a case of a 35-year-old male with a malaligned left-sided distal radius fracture sustained during a sports-related fall.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590710","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":"Identifying key CT features and clinical variables for predicting operative management of left ventricular assist device (LVAD) driveline infections.","authors":"Mahati Mokkarala, Aravinda Ganapathy, Yuktesh Kalidindi, Chelsea R Schmitt, Mark J Hoegger, Ryan G Short, Demetrios A Raptis, David H Ballard","doi":"10.1007/s10140-025-02363-0","DOIUrl":"https://doi.org/10.1007/s10140-025-02363-0","url":null,"abstract":"<p><strong>Purpose: </strong>Despite technical advancements in left ventricular assist devices (LVADs), driveline infections (DLIs) remain a common complication evaluated by CT. The purpose of this study was to assess CT imaging features and clinical variables associated with operative versus non-operative management of LVAD DLIs.</p><p><strong>Materials/methods: </strong>This study analyzed 129 patients with LVAD driveline infections evaluated using CT. Two radiologists assessed CT scans for superficial and deep soft tissue stranding and fluid collections. Logistic regression was used to identify predictors of operative management using imaging and clinical variables, guided by Akaike information criterion. Results were reported as odds ratios, and Interreader agreement was evaluated using Cohen's Kappa.</p><p><strong>Results: </strong>Operative management was performed in 46.8% of patients. Positive driveline cultures (94.8% vs. 43.5%, p < 0.001) and new antibiotic use (98.3% vs. 72.7%, p < 0.001) were strongly associated with operative intervention. Mild subcutaneous fat stranding was the most frequent CT finding (62.6% and 66.9% by Readers 1 and 2, respectively), whereas deep fluid collections were rare (4.8-5.6%). Clinical predictors of operative management included new antibiotic use (p = 0.036), positive cultures (p < 0.001), and LVAD type. The resulting model achieved an AUC of 0.851 and overall accuracy of 78.6%. The absence of superficial fat stranding on CT significantly predicted non-operative management (p < 0.001).</p><p><strong>Conclusion: </strong>Positive driveline cultures, recent antibiotic initiation, and absence of skin or subcutaneous fat stranding on CT were associated with non-operative management in LVAD-related driveline infections. Absence of superficial fat stranding on CT may help distinguish suspected driveline infections that are unlikely to require surgical intervention.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583413","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":"An imaging potpourri of uncommon traumatic scalp injuries.","authors":"Clara M Kerwin, Curtis HonShideler, Mohamad Abdalkader, Bindu N Setty","doi":"10.1007/s10140-025-02362-1","DOIUrl":"https://doi.org/10.1007/s10140-025-02362-1","url":null,"abstract":"<p><p>Among radiologists, the scalp is a frequently overlooked region, and the literature offers little guidance regarding the imaging spectrum of scalp abnormalities in acute trauma. The severity of scalp abnormalities on imaging can be a harbinger of significant intracranial trauma. In this pictorial essay, we discuss a myriad of traumatic scalp lesions that are infrequently encountered on imaging.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495225","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 hemoperitoneum: a practical radiologic review for emergency diagnosis.","authors":"Paula Buades-Ribas, Sandra Baleato-González, Roberto García-Figueiras","doi":"10.1007/s10140-025-02360-3","DOIUrl":"https://doi.org/10.1007/s10140-025-02360-3","url":null,"abstract":"<p><p>Spontaneous hemoperitoneum (SH) is defined as the presence of blood within the peritoneal cavity from a non-traumatic origin. The absence of clinical suspicion and its low frequency render it a challenging diagnosis in the emergency setting. As it is a potentially life-threatening condition, radiologists play a fundamental role in the identification and location of the source of bleed, both essential to be able to deliver the best care possible for the patient. This review article aims to facilitate a practical approach to SH: We will begin by reviewing key imaging modalities of significant value for the detection and characterization of SH. Relevant anatomy and important CT signs to know will be mentioned. We will summarize the potential causes of SH in order of frequency, with a brief mention of differential diagnoses to consider. Finally, we will illustrate this review with a collection of cases from our hospital to showcase relevant diagnoses to consider when facing a patient with SH, focusing on key imaging elements that should not be overlooked.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474257","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":"Predictors of diagnostic errors in computed tomography interpretation by emergency physicians leading to changes in clinical management in the emergency department.","authors":"Naoaki Shibata, Takafumi Yonemitsu, Nozomu Shima, Yuichi Miyake, Tomoya Fukui, Junya Fuchigami, Akira Ikoma, Tetsuo Sonomura, Shigeaki Inoue","doi":"10.1007/s10140-025-02357-y","DOIUrl":"https://doi.org/10.1007/s10140-025-02357-y","url":null,"abstract":"<p><strong>Purpose: </strong>The use of computed tomography (CT) in the emergency department (ED) has been increasing due to its diagnostic value for emergency physicians (EPs). This study aimed to determine the predictors of EP interpretation errors (IEs) on CT scans leading to change in clinical management (IECM) in both endogenous and exogenous ED visits.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included patients with consecutive ED visits initially managed by EPs at our institution over 6 months. Patients who did not undergo CT imaging and presented with cardiopulmonary arrest upon arrival were excluded. CT images were interpreted by emergency radiologists immediately after acquisition, and IEs were identified. The primary outcome was IECM, determined by reference to the clinical management decisions made by EPs. A multivariate analysis was performed to determine the independent predictors of IECM.</p><p><strong>Results: </strong>Among the 2,037 patients, 158 (8%) had IEs, whereas 52 (3%) had IECM. Multisite CT imaging was the strongest independent predictor for both IECM (OR: 2.25, 95% CI: 1.21-4.19, P = 0.011) and IEs (OR: 2.32, 95% CI: 1.61-3.36, P < 0.001). Other predictors of IECM were prolonged ED stay and night-time ED visits as clinical factors. Additional predictors of overall IEs were contrast-enhanced CT and abdominopelvic CT as radiological factors.</p><p><strong>Conclusion: </strong>Multisite CT imaging, which involve multiple organs and extensive diagnostic information, significantly increases the likelihood of misinterpretation, leading to change in clinical management by EPs.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474256","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":"Diagnostic accuracy of chest CT for COVID-19 pneumonia in a resource-limited Gaza cohort: a retrospective study of 252 patients.","authors":"Husam H Mansour, Noor Khairiah A Karim, Noor Diyana Osman, Rohayu Hami, Yasser S Alajerami","doi":"10.1007/s10140-025-02359-w","DOIUrl":"10.1007/s10140-025-02359-w","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the diagnostic accuracy of chest CT for COVID-19 pneumonia in resource-limited Gaza. It compared CT performance to RT-PCR and examined how CT severity scores and interobserver agreement influence diagnostic accuracy, reproducibility, and clinical utility for early detection and triage.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 252 consecutive patients diagnosed with COVID-19 pneumonia between September 2020 and June 2021 at three major governmental hospitals across the Gaza Strip. Chest CT scans were compared to RT-PCR as the gold standard for diagnosis. CT severity scores were calculated using a 25-point system, and interobserver agreement was assessed using kappa statistics. Sensitivity, specificity, and predictive values were calculated for various threshold levels.</p><p><strong>Results: </strong>Among the 252 patients included in the study, the mean age was 56.81 ± 11.34 years, with 113 males and 139 females. The diagnostic sensitivity of chest CT was 91.4%, with a specificity of 76.4%. The highest accuracy was observed with a severity score threshold of ≥ 15, with a Youden index of 0.630. Interobserver agreement was excellent (kappa = 0.87) for ground-glass opacities and consolidation. The NPV was 71.2%, indicating the need for supplementary RT-PCR testing in low-prevalence cases.</p><p><strong>Conclusion: </strong>Chest CT is a reliable diagnostic adjunct for COVID-19 pneumonia, especially in Gaza's severely resource-limited setting, where CT was more accessible than RT-PCR. A CT severity score threshold of ≥ 15 offers an optimal balance of sensitivity and specificity. These findings highlight the practical role of CT imaging in pandemic response in resource-constrained environments.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336324","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":"Emergency interventions for massive haemoptysis: a pictorial overview of life-saving endovascular procedures.","authors":"Yugandhar Samireddypalle, Mithilesh Arumulla, A Rahul, P Karthickpriya, A Prudhvinath Reddy, Vikram Damaraju, Adimulam Ganga Ravindra, K S Amitha Vikrama","doi":"10.1007/s10140-025-02361-2","DOIUrl":"https://doi.org/10.1007/s10140-025-02361-2","url":null,"abstract":"<p><p>Massive haemoptysis is a medical emergency with high mortality if not promptly addressed. This pictorial essay aims to guide clinicians through the selection and execution of life-saving endovascular interventions tailored to the underlying vascular etiology. Emphasis is placed on clinical presentation, imaging clues, and procedural decision-making to enhance understanding among trainees and practicing radiologists. We present a curated series of cases of life-threatening haemoptysis managed with bronchial artery embolization (BAE), pulmonary artery embolization (PAE), embolization of acquired aortopulmonary collaterals (APCs), and thoracic endovascular aortic repair (TEVAR). Each case is dissected to highlight the clinical scenario, angiographic findings, interventional technique, and outcome. Endovascular management of haemoptysis should be guided by the underlying etiology and vascular anatomy. A structured approach to imaging interpretation, selective angiography, and tailored endovascular management can drastically reduce mortality. This educational overview bridges the gap between diagnosis and intervention, reinforcing practical decision-making in pulmonary vascular emergencies.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324799","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":"Promising initial evaluation: the Shock Thyroid Imaging Score (STIS) could predict mortality in hemodynamically unstable trauma patients.","authors":"Matthew C Mueller, Jacques du Plessis, Abdelazim M E Mohammed, Rawan Abu Mughli, Michael E O'Keeffe, Sadia R Qamar, Jason A Robins, Chantelle Q Y Lin, Pascal N Tyrrell, Ferco H Berger","doi":"10.1007/s10140-025-02356-z","DOIUrl":"https://doi.org/10.1007/s10140-025-02356-z","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293549","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}