Emergency Radiology最新文献

{"title":"Sinonasal NK/T-cell lymphoma - imaging features overlap with non-neoplastic etiologies.","authors":"Sneh Brahmbhatt, Jeremiah Daniel, Amit Agarwal, Vivek Gupta, Alok A Bhatt","doi":"10.1007/s10140-025-02350-5","DOIUrl":"10.1007/s10140-025-02350-5","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this retrospective study is to evaluate imaging features of sinonasal NK/T-cell lymphoma, potentially aiding early diagnosis and improving patient outcomes through timely biopsy evaluation and treatment.</p><p><strong>Materials & methods: </strong>This study was designed as a retrospective review. Imaging characteristics in a total of 28 patients with histology confirmed sinonasal NK/T-cell lymphoma were evaluated by two radiologists. Demographic data and clinical features were extracted from the electronic medical record.</p><p><strong>Results: </strong>Among 28 patients, 84.6% presented with nasal cavity involvement and 88.5% with an isoattenuating lesion on CT and 63.6% with T2 hypointensity on MRI. Notably, 57.7% showed osseous destruction and 27.3% had devascularized tissue, highlighting significant radiologic features that may overlap with non-neoplastic etiologies.</p><p><strong>Conclusion: </strong>Sinonasal NK/T-cell lymphoma should be in the differential diagnosis in patients presenting with chronic sinonasal symptoms and imaging findings of tissue necrosis, osseous destruction, and adjacent fat infiltration. Imaging features overlap with entities such as aggressive fungal sinusitis and granulomatosis with polyangiitis.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"487-493"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093333","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":"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":"645-652"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","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 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":"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":"653-661"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","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":"Diagnostic yield of an abbreviated MRI protocol in the evaluation of dizziness in the emergency department, a single institutional experience.","authors":"Faryal Shareef, Long Tu, Anish Neupane, Zaid Siddique, Rudra Joshi, Edward Melnick, Charles Wira, Amit Mahajan","doi":"10.1007/s10140-025-02349-y","DOIUrl":"10.1007/s10140-025-02349-y","url":null,"abstract":"<p><strong>Purpose: </strong>MRI is the preferred imaging modality for patients with acute dizziness when a central etiology is possible. Abbreviated protocols may improve access in urgent settings. This study assesses the diagnostic yield and utility of an abbreviated MRI protocol for patients presenting with dizziness to the emergency department (ED).</p><p><strong>Method: </strong>This retrospective study included 613 adult patients presenting to the ED with dizziness from August 1, 2019 to August 31, 2023. The protocol included 3 mm coronal and axial DWI, axial FLAIR, and SWI sequences, with a duration of approximately 11 min. MRI findings were categorized as negative or positive for intracranial pathology; etiology and location were recorded. Charts were reviewed for concurrent CTA during the ED visit, and findings were assessed for correlation with MRI results.</p><p><strong>Results: </strong>Of the 613 patients, clinically significant intracranial pathology was identified in 52 cases (8%), including 42 (7%) acute infarcts. Of these infarcts, 19 (45%) were infratentorial, 16 (38%) supratentorial, and 7 (17%) involved both regions. The cerebellum was the most common infratentorial site (38%), followed by the brainstem (24%). Infarcts ranged from 1-84 mm, with 48% measuring less than 1 cm. TOAST classification revealed strokes as cardioembolic (36%), large vessel (26%), cryptogenic (19%), and lacunar (19%). Statistical analysis showed no significant relationship between vertigo and infarct characteristics (P > 0.05).</p><p><strong>Conclusion: </strong>Abbreviated protocol MRI demonstrated a 8% diagnostic yield for detecting intracranial pathology and more often positive than concurrent CT/CTA in identifying acute findings. Supratentorial pathology can present with symptoms of dizziness as well. The abbreviated protocol offers a rapid, efficient diagnostic tool for urgent care settings and MRI identifies more acute findings than concurrent CT/CTA.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"559-568"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224760","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":"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":"663-668"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wide-Detector CT-Based optimized triple Rule-Out CT angiography for emergency chest pain: reducing contrast and radiation without compromising diagnostic quality.","authors":"Qiuhua Zhang, Kun Wang, Hong Ren","doi":"10.1007/s10140-025-02351-4","DOIUrl":"10.1007/s10140-025-02351-4","url":null,"abstract":"<p><strong>Background: </strong>The triple rule-out computed tomography angiography (TRO-CTA) has recently emerged as a technique that noninvasively evaluates the coronary arteries (CAs), the pulmonary arteries (PAs) and the thoracic aorta (TA).</p><p><strong>Objective: </strong>To evaluate the feasibility of an optimized scanning protocol to reduce the volume of iodine contrast media (ICM), injection rate, and radiation dose in patients undergoing TRO-CTA.</p><p><strong>Methods: </strong>Patients undergoing TRO-CTA were assigned to either group A or group B using a 16 cm wide-detector CT. Patients in group A were imaged with a traditional triple scanning protocol with a sequence of the PA, CAs, and TA. Patients in group B were imaged using the modified protocol with scanning sequence of PA, TA, and CAs, ICM of 55 ml, and injection rate of 4.5 mL/s. The image quality and effective radiation dose (ED) were compared.</p><p><strong>Results: </strong>There were no significant differences in basic information between groups A and B. Other than the left PA, RA, and RV, there were no significant differences in the CT attenuation values of relevant vascular structures between groups A and B. There were no significant differences in CNR values between the two groups except the LAD-D and LCX. The image quality scores were comparable between groups A and B except the CAs. However, there were significant differences between the two groups in ICM (p < 0.05), scanning time (p < 0.001) and ED (p = 0. 023).</p><p><strong>Conclusions: </strong>The optimized TRO-CTA scanning protocol can achieve less ICM and lower ED while maintaining image quality.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"551-558"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The subtype matters: unraveling the clinical impact of TBI variants among patients with isolated blunt head injury and skull fractures.","authors":"Heather X Rhodes-Lyons, Adel Elkbuli, Sarah E Johnson, David L McClure, Antonio Pepe","doi":"10.1007/s10140-025-02365-y","DOIUrl":"https://doi.org/10.1007/s10140-025-02365-y","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic Brain Injury (TBI) is a major cause of morbidity and mortality worldwide, with isolated blunt TBIs presenting unique clinical challenges. Despite extensive research, limited studies have examined how specific TBI subtypes, subdural hematoma (SDH), subarachnoid hemorrhage (SAH), epidural hemorrhage (EDH), diffuse axonal injury (DAI), and contusions-affect critical outcomes such as in-hospital mortality, ICU length of stay (LOS), and ventilation duration. Understanding these associations is essential for improving patient management and resource allocation.</p><p><strong>Objective: </strong>This study aims to assess the impact of TBI subtype and size on clinical outcomes, including in-hospital mortality, ICU LOS, and ventilation days, in adult patients with isolated blunt TBI and skull fractures.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using the ACS-TQIP-PUF (2017-2022). Logistic and linear regression models analyzed TBI subtype, size, demographics, comorbidities, and injury characteristics in patients aged ≥ 15 years with isolated blunt TBI and skull fractures. Polytrauma cases were excluded.</p><p><strong>Results: </strong>Among 64,111 patients, SDH > 8 mm had the highest association with in-hospital mortality (OR 4.89, p <.01). Larger SDH (> 8 mm), contusions (> 2 cm), and SAH correlated with extended ICU LOS, with DAI leading to the longest ICU stays (+ 5.73 days, p <.01) and ventilation days (+ 8.40 days, p <.01).</p><p><strong>Conclusion: </strong>TBI subtype and size significantly influence patient outcomes. SDH > 8 mm poses the highest mortality risk, while DAI results in prolonged ICU stays and ventilation. These findings highlight the need for targeted management strategies to optimize care for TBI patients.</p><p><strong>Levels of evidence: </strong>Level III, retrospective/epidemiological.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706733","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":"Letter to the Editor: Rapid abdominal MRI for appendicitis for evaluation of ovarian torsion in children.","authors":"Ahmet Gürkan Erdemir","doi":"10.1007/s10140-025-02371-0","DOIUrl":"https://doi.org/10.1007/s10140-025-02371-0","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658738","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":"Deep learning reconstruction enhances image quality in contrast-enhanced CT venography for deep vein thrombosis.","authors":"Yusuke Asari, Koichiro Yasaka, Joji Kurashima, Akira Katayama, Mariko Kurokawa, Osamu Abe","doi":"10.1007/s10140-025-02366-x","DOIUrl":"https://doi.org/10.1007/s10140-025-02366-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate and compare the diagnostic performance and image quality of deep learning reconstruction (DLR) with hybrid iterative reconstruction (Hybrid IR) and filtered back projection (FBP) in contrast-enhanced CT venography for deep vein thrombosis (DVT).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 51 patients who underwent lower limb CT venography, including 20 with DVT lesions and 31 without DVT lesions. CT images were reconstructed using DLR, Hybrid IR, and FBP. Quantitative image quality metrics, such as contrast-to-noise ratio (CNR) and image noise, were measured. Three radiologists independently assessed DVT lesion detection, depiction of DVT lesions and normal structures, subjective image noise, artifacts, and overall image quality using scoring systems. Diagnostic performance was evaluated using sensitivity and area under the receiver operating characteristic curve (AUC). The paired t-test and Wilcoxon signed-rank test compared the results for continuous variables and ordinal scales, respectively, between DLR and Hybrid IR as well as between DLR and FBP.</p><p><strong>Results: </strong>DLR significantly improved CNR and reduced image noise compared to Hybrid IR and FBP (p < 0.001). AUC and sensitivity for DVT detection were not statistically different across reconstruction methods. Two readers reported improved lesion visualization with DLR. DLR was also rated superior in image quality, normal structure depiction, and noise suppression by all readers (p < 0.001).</p><p><strong>Conclusions: </strong>DLR enhances image quality and anatomical clarity in CT venography. These findings support the utility of DLR in improving diagnostic confidence and image interpretability in DVT assessment.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658737","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":"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}