Emergency Radiology最新文献

{"title":"Radiology resident competency in orthopedic trauma detection in simulated on-call scenarios.","authors":"John Ramos Rivas, Kevin Pierre, Abheek Raviprasad, Arman Mahmood, Olivia Scheuermann, Bruce Steinberg, Roberta Slater, Christopher Sistrom, Otgonbayar Batmunh, Priya Sharma, Ivan Davis, Anthony Mancuso, Dhanashree Rajderkar","doi":"10.1007/s10140-024-02309-y","DOIUrl":"10.1007/s10140-024-02309-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate radiology residents' ability to accurately identify three specific types of orthopedic trauma using radiographic imaging within a simulated on-call environment.</p><p><strong>Methods: </strong>We utilized the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM) to assess residents' preparedness for independent radiology call. The simulation included 65 cases, with three focusing on orthopedic trauma: sacral ala, femoral neck, and pediatric tibial/Toddler's fractures. Faculty graded residents' responses using a standardized 10-point rubric and categorized errors as observational (failing to identify key findings) or interpretive (incorrect conclusions despite correct identification of findings).</p><p><strong>Results: </strong>321 residents evaluated sacral ala fracture radiographs and received an average score of 1.29/10, with 8.71 points lost to observational errors. Only 6% produced effective reports (scores ≥ 7), while 80% made critical errors (scores < 2). For femoral neck fracture CT images (n = 316 residents), the average score was 2.48/10, with 6.71 points lost to observational errors. 25% produced effective reports, and 66% made critical errors. Pediatric tibial/Toddler's fracture radiographs (n = 197 residents) yielded an average score of 2.94/10, with 6.60 points lost to observational errors. 29% generated effective reports, while 71% made critical errors.</p><p><strong>Conclusion: </strong>Radiology residents demonstrated significant difficulty in identifying these orthopedic trauma cases, with errors primarily attributed to observational deficiencies. These findings suggest a need for targeted educational interventions in radiology residency programs to improve the identification of these fractures.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"387-394"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946562","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":"CT of the esophagus in the ER: what you need to know and what you need to remember.","authors":"Mohammad Yasrab, Charles K Crawford, Linda C Chu, Satomi Kawamoto, Elliot K Fishman","doi":"10.1007/s10140-025-02339-0","DOIUrl":"10.1007/s10140-025-02339-0","url":null,"abstract":"<p><p>Computed tomography (CT) imaging is a crucial diagnostic tool in the emergency department (ED) for evaluating non-traumatic esophageal conditions. Advanced imaging techniques such as multidetector CT (MDCT) quickly provide detailed 3D images with high spatial resolution, making it ideal for rapid assessment of a variety of esophageal pathologies. This pictorial essay presents 10 illustrative cases to highlight the clinical applications of MDCT and its critical role in diagnosing conditions like perforation, foreign body impaction, inflammatory or infectious esophagitis, achalasia, fistulae, and neoplasms. Optimized CT protocols, such as contrast-enhanced imaging and advanced postprocessing techniques like maximum intensity projection (MIP) images and volumetric rendering technique (VRT), in addition to 3D cinematic rendering, are crucial in improving diagnostic accuracy and enhancing visualization of anatomical structures. The cases presented emphasize the importance of early detection and timely management of esophageal conditions, as small delays can lead to significantly increased morbidity and mortality. Ultimately, a multidisciplinary approach that coordinates clinical, radiological, and pathological evaluations ensures appropriate management and improved patient outcomes in esophageal emergencies.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"447-455"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973290","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 reverse halo sign in emergency chest CT: A diagnostic guide across diverse pulmonary conditions.","authors":"Furkan Ufuk, Iclal Ocak, Lydia Chelala, Luis Landeras","doi":"10.1007/s10140-025-02337-2","DOIUrl":"10.1007/s10140-025-02337-2","url":null,"abstract":"<p><p>The atoll sign, also known as the reverse halo sign (RHS), is defined by a central ground-glass opacity encircled by a rim of consolidation. Originally described in the context of organizing pneumonia, it is now recognized across a spectrum of conditions-including infectious, inflammatory, vascular, malignant, and traumatic pathologies. This pictorial essay examines the various clinical scenarios in which the RHS is observed on emergency CT, highlighting its crucial role in differential diagnosis and patient management.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"435-445"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977615","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 hypoattenuating berry sign: a reliable marker for ruptured aneurysms in subarachnoid hemorrhage patients with multiple aneurysms.","authors":"Zhong-Qing Huang, Wan-Qin Sun, Hui-Fang Li, Shu-Feng Cai, Gang Xiao, Xin-Wei Zhou","doi":"10.1007/s10140-025-02317-6","DOIUrl":"10.1007/s10140-025-02317-6","url":null,"abstract":"<p><strong>Background and purpose: </strong>Non-enhanced computed tomography (NECT) and computed tomography angiography (CTA) are useful for detecting aneurysmal subarachnoid hemorrhage (SAH) but challenging to identify ruptured aneurysms in cases of multiple aneurysms. We aimed to determine if the hypoattenuating berry sign (HBS) can identify ruptured aneurysms in SAH patients with multiple aneurysms.</p><p><strong>Methods: </strong>Patients who had multiple aneurysms and underwent NECT were retrospectively recruited. The HBS, blood score, size and location of aneurysm were independently analyzed. The attenuation value of HBS and surrounding SAH were recorded. The independent factors of HBS in determination of ruptured aneurysms were analyzed using multivariable logistic regression.</p><p><strong>Results: </strong>Fifty-three patients (mean age 64.2 ± 10.9 years, 83.0% female) with 112 aneurysms were enrolled. In the univariate analysis, aneurysm size, aneurysm status (ruptured), and blood score were significantly correlated with the occurrence of HBS. In the multivariate analysis, only aneurysm status showed a significant association with HBS. Aneurysms with HBS were larger than those without (6.8 ± 4.2 mm versus 4.2 ± 1.2 mm, P < 0.001), and those measured via NECT were larger than those measured via DSA (7.2 ± 3.8 mm vs. 6.8 ± 4.2 mm, P < 0.001). HBS was found in 51.8% of all aneurysms and in 87.7% of ruptured aneurysms on NECT. Raters had high agreement on aneurysm size (ICC = 0.829), HBS presence (kappa = 0.928), and blood score (kappa = 0.780).</p><p><strong>Conclusions: </strong>The HBS can be used to detect ruptured aneurysm in patient with SAH and multiple aneurysms.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"361-368"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398577","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":"Exploring knowledge, attitude and confidence in point-of-care ultrasound among emergency physicians and radiologists in Jordan: a cross-sectional study.","authors":"Maryam Yagbeh, Alaa O Oteir, Maram Alakhras, Zainab Alqudah, Liqaa Rafee, Asmaa Al-Mnayyis, Rasha Buhumaid, Brett Williams","doi":"10.1007/s10140-025-02340-7","DOIUrl":"10.1007/s10140-025-02340-7","url":null,"abstract":"<p><strong>Objective: </strong>This study explored POCUS knowledge, attitudes, confidence, barriers, enablers, and their associated factors among radiologists and emergency physicians in Jordan.</p><p><strong>Methods: </strong>A cross-sectional questionnaire-based study covered five sections: socio-demographics, knowledge, attitude, confidence, and barriers and enablers. Summary statistics, correlation, and regression analyses were performed.</p><p><strong>Results: </strong>A total of 164 physicians participated, with an average age of 33.8 (± 7.69) years; 52.4% were radiologists and 47.6% were emergency physicians. Participants exhibited good knowledge, attitudes, and confidence. Higher attitude scores (β = 0.28; p < 0.001) and having a POCUS machine (β = 1.70; p = 0.01) were associated with higher knowledge. Higher knowledge (β = 0.64; p < 0.001) predicted better attitudes, while attitude (β = 0.21; p = 0.01), specialty radiologist (β = 8.5; p < 0.001), age (β = 0.23; p < 0.001), and number of monthly scans (β = 0.01; p = 0.01) predicted confidence.</p><p><strong>Conclusion: </strong>Radiologists and emergency physicians in Jordan demonstrated good POCUS knowledge, attitudes, and confidence. Specialty and usage frequency influenced these factors. Future studies should explore training effects on skill acquisition. The study found different factors that are associated with knowledge, attitude, and confidence levels such as specialty, frequency of using POCUS, and the levels of knowledge, attitude and confidence. Future studies, including large prospective studies and/or experimental studies that examine the effect of training on skill acquisition among various healthcare professionals are warranted.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"319-327"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969094","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":"10.1007/s10140-025-02335-4","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"483-484"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","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":"Imaging of tracheobronchial and laryngeal injuries.","authors":"Tanche Jimmy Wang, Ismail Ali, Shamir Rai, Nicolas Murray","doi":"10.1007/s10140-025-02334-5","DOIUrl":"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":"457-461"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","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":"Sonographic diagnosis of testicular loss or atrophy after incarcerated inguinal hernia in pediatric patients.","authors":"Takahiro Hosokawa, Yumiko Sato, Yutaka Tanami, Kyoichi Deie, Shinsuke Yoshizawa, Kensuke Ohashi, Hiroshi Kawashima, Eiji Oguma","doi":"10.1007/s10140-025-02338-1","DOIUrl":"10.1007/s10140-025-02338-1","url":null,"abstract":"<p><strong>Purpose: </strong>Incarcerated inguinal hernia is a common condition in pediatric patients presenting to the emergency department. In addition to causing intestinal obstruction, it can lead to acute testicular venous occlusion, necessitating urgent intervention. This study aimed to demonstrate the utility of ultrasonography in predicting testicular loss/atrophy associated with incarcerated inguinal hernia in pediatric patients.</p><p><strong>Methods: </strong>This study enrolled 58 patients with incarcerated inguinal hernia. Pre- and post-reduction sonographic findings, including the vascularity, enlargement, and echogenicity of the affected testis, were compared between patients with and without testicular loss/atrophy using Fisher's exact and Mann-Whitney U tests. The imaging studies were reviewed by two radiologists blinded to clinical information and other imaging findings, with discrepancies resolved by consensus.</p><p><strong>Results: </strong>All pre- and post-reduction sonographic findings were significantly different between the patients with and without testicular loss/atrophy, including vascularity (evaluated in 32 patients post-reduction; present/absent in 0/3 vs. 24/5), enlargement (evaluated in 50 patients; present/absent in 2/1 vs. 4/43), and echogenicity (evaluated in 50 patients; normal/abnormal in 0/3 vs. 47/0). The differences observed post-reduction were significant in terms of vascularity (evaluated in 38; present/absent in 0/3 vs. 30/5), enlargement (evaluated in 57 patients; present/absent in 2/1 vs. 1/53), and echogenicity (evaluated in 57 patients; normal/abnormal in 0/3 vs. 54/0).</p><p><strong>Conclusions: </strong>The vascularity, enlargement, and echogenicity within the affected testes on the ipsilateral side of the incarcerated inguinal hernia are useful sonographic findings for predicting testicular loss/atrophy. Therefore, ultrasonologist should evaluate the testicular condition in cases of an incarcerated inguinal hernia.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"309-317"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962801","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":"Point-of-care lung ultrasound - a rapid and reliable diagnostic tool for emergency physicians treating patients with acute dyspnea in high-volume emergency departments.","authors":"Irina Ciumanghel, Eliza Barbuta, Adi-Ionut Ciumanghel, Iulian Buzincu, Gabriela Grigorasi, Diana Cimpoesu","doi":"10.1007/s10140-025-02343-4","DOIUrl":"10.1007/s10140-025-02343-4","url":null,"abstract":"<p><strong>Purpose: </strong>Acute dyspnea is a common presenting symptom in the Emergency Department (ED). The study aims to assess the concordance between emergency physician diagnosis (i.e., initial rapid assessment at ED admission including point-of-care lung ultrasound - PoC-LUS) and attending physician diagnosis (i.e., hospital admission diagnosis which also includes CT scans) in patients presenting with dyspnea.</p><p><strong>Method: </strong>We performed a prospective pilot observational study in the ED of tertiary care university hospital between 31.01.2022 and 03.09.2024. We included dyspneic patients presented when the physician involved in the study was on call.</p><p><strong>Results: </strong>A total of 103 patients were included (mean age, 70±16.1 years). An excellent agreement was found between emergency physician and attending physician diagnosis for all etiologies of dyspnea: pleural effusion (Cohen's kappa coefficient 1 for bilateral, 0.844 for right, 0.790 for left pleural effusion), pneumonia (κ = 0.979 for right, κ = 0.930 for left pneumonia), bronchopneumonia (κ = 0.912), acute pulmonary edema (κ = 1), chronic obstructive pulmonary disease exacerbation (κ = 0.904), pleuropulmonary tumors (k = 0.884), acute respiratory distress syndrome - ARDS (κ = 1), (p < 0.001 for all). The median(±SD) time needed to complete the emergency physician diagnosis was 16(±4) minutes and the median(±SD) time needed to complete the attending physician diagnosis was 480(±112) minutes.</p><p><strong>Conclusion: </strong>In patients presenting in the ED with dyspnea, PoC-LUS guided emergency physician diagnosis has a very good diagnosis performance. The time needed to complete the emergency physician diagnosis is much lower than the time needed to complete the attending physician diagnosis. Given its availability, PoC-LUS is a useful tool for the assessment of patients presenting with dyspnea.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"329-338"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962793","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":"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":"10.1007/s10140-025-02333-6","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"485"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","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}