Emergency Radiology最新文献

{"title":"Computed tomography imaging findings in head injury victims of conflict in Northern Ethiopia treated at the University of Gondar comprehensive specialized hospital.","authors":"Abdulfatah Workicho Mustafa, Yonathan Gebrewold, Mehammed Adem Getnet, China Tolessa Sedi, Aman Edao Bime, Salhadin Mohammed","doi":"10.1007/s10140-025-02325-6","DOIUrl":"10.1007/s10140-025-02325-6","url":null,"abstract":"<p><strong>Background: </strong>Head injuries pose a major global health issue, especially among young adults in developing countries. Data on head trauma patterns in conflict situations is scarce, and computed tomography (CT) is the main imaging method for evaluating acute head injuries.</p><p><strong>Objectives: </strong>This study aimed to assess the CT scan patterns of traumatic head injury among northern Ethiopian victims of war who were treated at the University of Gondar Comprehensive Specialized Hospital during the armed conflict in 2020 and 2021.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 76 cases of traumatic head injury who underwent CT scans from November 1, 2020, to January 30, 2021, at the Department of Radiology. Data regarding age, sex, mechanism of injury, and CT scan findings were collected and analyzed.</p><p><strong>Results: </strong>A total of 76 patients were assessed, with 73 (96.1%) being males and a male-to-female ratio of 24:1. Ages ranged from 19 to 48 years, with the most affected group being ≤ 29 years (44 or 57.9%). Common head injury mechanisms included bullets (50%), blunt trauma (26%), and blasts (21%). Abnormal CT findings were noted in 60 cases (78.95%), with the most common findings being skull fractures (64.5%), cerebral contusions (33%), and metallic foreign bodies (36%). Scalp and brain hematoma, presence of soft tissue foreign body, pneumocephalus, and subfalcine herniation exhibited a statistically significant correlation with bullet injuries (p-value < 0.05).</p><p><strong>Conclusion: </strong>This study found a high rate of abnormal CT scans mainly involving young males as the primary victims of traumatic head injuries in war-affected areas of Northern Ethiopia. The leading causes were bullet injuries, with common CT scan findings including skull fractures and cerebral contusions, many requiring immediate intervention. The high rate of abnormal CT scans in these patients underscores the need to improve access to CT scans in conflict-affected areas.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"185-194"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572376","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":"Forecasting trends of rising emergency department chest imaging using machine learning.","authors":"Sishir Doddi, Oscar Salichs, Shruthi Karthika Varier, Ashish Khandelwal, Satheesh Krishna Jeyaraj, Sree Harsha Tirumani","doi":"10.1007/s10140-025-02328-3","DOIUrl":"10.1007/s10140-025-02328-3","url":null,"abstract":"<p><strong>Introduction: </strong>Imaging studies in the acute care setting, such as the emergency room, have been increasing. In this report, we use the Centers for Medicare and Medicaid services (CMS) database to assess trends in ED chest CT and chest CTA imaging in ED from 2010 to 2021. In addition, we forecast the utilization of these imaging modalities until 2030 to predict volume of studies using machine learning models.</p><p><strong>Methods: </strong>CMS data regarding volume of procedures from 2010 to 2021 for CPT Codes: Chest CT: 71,250, 71,260, 71,270; and Chest CTA 71,275 was obtained. IBM SPSS Statistical Software was used to assess compound annual growth rate (CAGR) to identify trends in ED center (ED) imaging. For predictive time series forecast, and autoregressive integrated moving average (ARIMA) model was constructed using R Studio statistical software. Ljung-Box test was used to check the model's residuals.</p><p><strong>Results: </strong>Chest CT imaging in the ED setting has steadily increased from 273,063 in 2010 to 540,047 in 2021. Chest CTA imaging also saw an increase from 175,554 in 2010 to 705,727 in 2021. ED Chest CT imaging has increased from 2010 to 2021 with a CAGR of 7.5% (p < 0.001). Similarly, chest CTA imaging has also increased during this period with an average CAGR or 13.0% (p < 0.001). The ARIMA model forecast for ED CT chest imaging predicts a continued increase in volume of CT imaging reaching 614,995 in 2024 and 760,851 in 2030. Chest CTA is predicted to have an even higher increase up to 850,320 in 2024 and 1,139,505 in 2030 assuming the trend observed over the past decade is consistent.</p><p><strong>Conclusion: </strong>From 2010 to 2021, we found an increasing trend in ED chest CT and CTA imaging with forecast predicting volume up to twice of volume in 2030 compared to a decade ago. Understanding the anticipated volumes of forthcoming ED imaging can aid in planning hospital infrastructure, personnel, and funding amongst other required healthcare resources. It is important to consider that while imaging holds a significant role in patient care, inappropriate utilization can result in unnecessary radiation exposure, prolonged wait times, and an increase in burden of healthcare resources.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"247-253"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584907","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":"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/s10140-025-02327-4","DOIUrl":"10.1007/s10140-025-02327-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>Ischemic strokes can cause vertigo, particularly when involving the posterior circulation of the brain. Prior research has suggested that thin-section (3 mm) axial or coronal DWI may improve the detection of ischemic stroke compared to thick (5 mm) DWI. However, relative sensitivity of differing thin DWI sequences is unknown. In this retrospective cohort study, we compare the sensitivity of thin coronal DWI and thin axial DWI in detection of brain ischemia.</p><p><strong>Materials and methods: </strong>Retrospective study at a single institution (2/18/2020-8/31/2023) of patients who presented to the emergency department with vertigo/dizziness and underwent an abbreviated MRI protocol (3 mm axial DWI, 3 mm coronal DWI, axial FLAIR, and axial SWI). For each case with an ischemic lesion, the visibility of infarct on thin axial and coronal DWIs was rated; location and size were also recorded. Visibility on either sequence was considered the reference standard. Sensitivity was compared with McNemar's test.</p><p><strong>Results: </strong>615 abbreviated MRI examinations were performed; 24/615 (3.9%) had an ischemic lesion (15 cerebral, 7 brainstem, 13 cerebellar). 24 of these MRI examinations with ischemic lesions were performed using 3 mm axial MRI and on 3T MRI. All lesions (24/24) were visible on thin axial DWI (100% sensitivity, 95% CI: 0.95-1.00). Fewer lesions (20/24) were seen on thin coronal DWI (83% sensitivity, 95% CI: 0.72-0.91). The difference in sensitivity was statistically significant (p = 0.0374). Lesions not visible on coronal DWI were 2-8 mm in size, the largest in the middle cerebellar peduncle.</p><p><strong>Conclusions: </strong>Thin coronal DWI may not improve additional diagnostic utility beyond thin axial DWI for the detection of ischemia in patients with dizziness. When designing protocols tailored for stroke detection (particularly in the posterior circulation), replacing conventional (5 mm) DWI with thin (3 mm) axial DWI may be preferable to adding a thin coronal sequence.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"225-231"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572378","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":"Transient enhancement of chronic subdural hematomas: a clinical report of a mimic of acute intracranial hemorrhage.","authors":"Boniface Yarabe, Evan G Stein","doi":"10.1007/s10140-025-02324-7","DOIUrl":"10.1007/s10140-025-02324-7","url":null,"abstract":"<p><strong>Background: </strong>The incidence of chronic subdural hematomas (cSDHs) is rising, leading to an increased reliance on imaging for diagnosis and management. CT imaging is commonly used in the evaluation of these patients, but transient enhancement of chronic subdural collections can mimic acute-on-chronic subdural hematomas, potentially leading to misdiagnosis.</p><p><strong>Objective: </strong>To describe cases of transient enhancement of cSDHs after contrast administration.</p><p><strong>Methods: </strong>A case series of three patients with pre-existing cSDHs was analyzed. One patient underwent middle meningeal artery embolization (MME), and two patients received contrast-enhanced CT (CECT) for other indications. Changes in subdural collection attenuation were assessed on serial imaging.</p><p><strong>Results: </strong>These three patients with cSDH demonstrated transient enhancement of their subdural collections, which could be mistaken for acute or acute-on-chronic hemorrhage. Recognition of this pattern is critical to avoid misinterpretation, unnecessary radiation exposure, excessive healthcare utilization, and potentially invasive procedures.</p><p><strong>Conclusion: </strong>Awareness of transient enhancement in chronic subdural collections on CECT is essential for accurate diagnosis. Differentiating this benign imaging artifact from true hemorrhage can prevent unnecessary interventions and optimize patient care.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"297-301"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522981","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: Hematuria in the ER patient: optimizing detection of upper tract urothelial cancer - A pictorial essay.","authors":"Mohammad Yasrab, Charles K Crawford, Linda C Chu, Satomi Kawamoto, Elliot K Fishman","doi":"10.1007/s10140-025-02313-w","DOIUrl":"10.1007/s10140-025-02313-w","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"307"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046003","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":"Tips and challenges for clinical use and interpretation of low field portable MRI in neuroimaging.","authors":"Yingming Amy Chen, Shobhit Mathur, Amy Lin, Edmond Knopp, Matthew S Rosen, Aditya Bharatha","doi":"10.1007/s10140-025-02323-8","DOIUrl":"10.1007/s10140-025-02323-8","url":null,"abstract":"<p><p>Low field portable MRI (LF pMRI) is a new imaging tool that holds promise in offering a safe, cost-effective, point-of-care imaging solution in neuroimaging. There are however unique interpretive challenges and operational factors and limitations in its implementation in clinical practice. This paper aims to provide a comprehensive guide on the tips and tricks of interpreting LF pMRI, specifically the Hyperfine Swoop® MRI system, which operates at 0.064 T and is currently the only FDA and Health Canada approved LF pMRI system. This paper explores the operational aspects and interpretation challenges of low-field MRI, such as patient positioning, protocol selection, and the appearance of artifacts and common pathologies. Using illustrative examples, we aim to guide current and future operators of LF pMRI to optimize performance, provide accurate diagnoses, and avoid common pitfalls.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"279-289"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457343","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 UTAMI score: a chest x-ray-based tool for predicting ICU admission in ARDS of pneumonia patients.","authors":"Utami Purbasari, Nurhayati Adnan Prihartono, Helda, Budhi Antariksa, Rusli Muljadi, Rahmad Mulyadi, Agnes Nina Eureka","doi":"10.1007/s10140-025-02315-8","DOIUrl":"10.1007/s10140-025-02315-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study proposes and evaluates the Universal Thorax ARDS Modification Index (UTAMI), a new method based on chest x-ray findings, for rapid ICU admission prediction in pneumonia with ARDS. Clinical and laboratory variables are analyzed to find potential predictors.</p><p><strong>Method: </strong>A cross-sectional study at Fatmawati Central General Hospital (2022-2023) compared the diagnostic accuracy of UTAMI method against the gold standard for ARDS diagnosis; Berlin Definition. We analyzed 318 patients' data that were hospitalized for pneumonia. Clinical and laboratory predictors of ARDS were also analyzed.</p><p><strong>Results: </strong>Neutrophil levels, CRP, D-dimer, oxygen saturation, and respiratory rate can predict ARDS diagnosis according to the Berlin Definition. The patient cohort showed that those with moderate-severe ARDS were admitted to the ICU. With ARDS categorized as ARDS requiring ICU admission (ARDS ICU) and ARDS not requiring ICU admission, the UTAMI method requires only history of coronary artery disease (CAD), CRP, and oxygen saturation as key predictors. CRP was a predictor in both the Berlin Definition (PR 1.28) and the UTAMI method (PR 1.71). In the AUROC test, the Berlin Definition distinguished moderate-severe ARDS with 81.2% accuracy using chest radiographs, clinical and laboratory values. The UTAMI method, based solely on chest radiographs achieved 79.6% accuracy, showing fair discrimination against the gold standard.</p><p><strong>Conclusion: </strong>UTAMI Score is a viable tool for predicting the risk of ARDS in pneumonia. Utilizing UTAMI method, ARDS can be predicted using only chest radiograph, making it easier for clinicians to be alerted earlier. Predicting ARDS ICU from UTAMI method requires only 3 variables; CAD comorbid, laboratory CRP and peripheral oxygen saturation.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"173-184"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476297","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":"Hematuria in the ER patient: optimizing detection of upper tract urothelial cancer - A pictorial essay.","authors":"Mohammad Yasrab, Charles K Crawford, Linda C Chu, Satomi Kawamoto, Elliot K Fishman","doi":"10.1007/s10140-024-02308-z","DOIUrl":"10.1007/s10140-024-02308-z","url":null,"abstract":"<p><p>Upper tract urothelial carcinoma (UTUC) is a rare and challenging subset of the more frequently encountered urothelial carcinomas (UCs), comprising roughly 5-7% of all UCs and less than 10% of all renal tumors. Hematuria is a common presenting symptom in the emergency setting, often prompting imaging to rule out serious etiologies, with UTUC especially posing as a diagnostic challenge. These UTUC lesions of the kidney and ureter are often small, mimicking other pathologies, and are more aggressive than typical UC of the bladder, emphasizing the importance of timely and accurate diagnosis. Multidetector computed tomography urography (CTU) is the standard imaging modality for diagnosis, tumor staging, and surgical planning. Various postprocessing techniques like multiplanar reconstructions, maximal intensity projection (MIP) images, and 3D volumetric rendering technique (VRT) are crucial for accurate detection. In addition, 3D cinematic rendering (CR) is a novel technique that employs advanced illumination models, producing images with realistic shadows and increased surface detail, outperforming traditional VRT. We will review the distinctive imaging features between UTUC and infiltrating mimicking lesions on CTU in patients who presented with hematuria, in conjunction with advanced postprocessing techniques, ultimately improving diagnostic confidence and preoperative planning in the emergency context.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"267-277"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983082","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: Artificial intelligence in emergency and trauma radiology: ASER AI/ML expert panel Delphi consensus statement on research guidelines, practices, and priorities.","authors":"David Dreizin, Garvit Khatri, Pedro V Staziaki, Karen Buch, Mathias Unberath, Mohammed Mohammed, Aaron Sodickson, Bharti Khurana, Anjali Agrawal, James Stephen Spann, Nicholas Beckmann, Zachary DelProposto, Christina A LeBedis, Melissa Davis, Gabrielle Dickerson, Michael Lev","doi":"10.1007/s10140-025-02312-x","DOIUrl":"10.1007/s10140-025-02312-x","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"305-306"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002263","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":"Prognostication and integration of bedside lung ultrasound and computed tomography imaging findings with clinical features to Predict COVID-19 In-hospital mortality and ICU admission.","authors":"Mohammad Reza Maghsoudi, Amirhesam Alirezaei, Atena Soltanzadi, Sepehr Aghajanian, Arvin Naeimi, Ayad Bahadori Monfared, Fateme Mohammadifard, Mahmood Bakhtiyari","doi":"10.1007/s10140-025-02320-x","DOIUrl":"10.1007/s10140-025-02320-x","url":null,"abstract":"<p><strong>Introduction: </strong>Bedside lung ultrasound (LUS) and computed tomography (CT) imaging are valuable modalities in screening and diagnosis of pulmonary diseases. This study aims to investigate the prognostic value of integrating LUS and CT imaging findings with clinical features to predict poor outcomes upon ER admission in COVID-19.</p><p><strong>Methods: </strong>Patients visiting the study center with clinical presentation and laboratory findings compatible with COVID-19 between April 2020 to January 2022 were considered for this study. Several imaging findings (ground glass opacity, consolidation, atelectatic bands, mosaic attenuation, ARDS pattern, crazy paving, pleural thickening in CT and A-line, comet-tail artifact, confluent B-Line in BLUS, pleural thickening and Consolidation in both modalities) were evaluated, alongside clinical assessments upon admission, to assess their prognostic value. The top radiological, LUS findings, and clinical signs were integrated in a nomogram for predicting mortality.</p><p><strong>Results: </strong>A total of 1230 patients were included in the analyses. Among the findings, consolidation in BLUS and CT imaging, and absence of A-lines were associated with mortality. In addition to these findings, ground-glass opacities, atelectatic band, mosaic attenuation, crazy paving, and confluent B-line were also associated with ICU hospitalization. Although, the prognostic value of individual markers was poor and comparable (AUC < 0.65), the combined use of top clinical and imaging findings in the associated nomogram led to a high accuracy in predicting mortality (Area under curve: 87.3%).</p><p><strong>Conclusions: </strong>BLUS and CT imaging findings alone provide limited utility in stratifying patients for higher mortality and ICU admission risk and should not be used for risk stratification alone outside the context of each patient and their clinical presentations in suspected COVID-19 patients.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"255-266"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440238","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}