Emergency Radiology最新文献

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Exploring the role of CT scouts in expediting MRI in acute stroke. 探索 CT 侦察员在加快急性中风核磁共振成像中的作用。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-09-21 DOI: 10.1007/s10140-024-02282-6
Rahul B Singh, Ahmed K Ahmed, Gabriel M Virador, Yassine Alami Idrissi, Alok A Bhatt, Dhairya A Lakhani, Merrie W Oei, Neethu Gopal, Cameron Overfield, Colin Rowell, Dinesh Rao, Prasanna Vibhute, Robert E Watson, Sukhwinder J S Sandhu
{"title":"Exploring the role of CT scouts in expediting MRI in acute stroke.","authors":"Rahul B Singh, Ahmed K Ahmed, Gabriel M Virador, Yassine Alami Idrissi, Alok A Bhatt, Dhairya A Lakhani, Merrie W Oei, Neethu Gopal, Cameron Overfield, Colin Rowell, Dinesh Rao, Prasanna Vibhute, Robert E Watson, Sukhwinder J S Sandhu","doi":"10.1007/s10140-024-02282-6","DOIUrl":"10.1007/s10140-024-02282-6","url":null,"abstract":"<p><strong>Purpose: </strong>For acute stroke patients requiring MR examination and unable to provide a reliable history, screening for potentially MRI-incompatible objects (PMIOs) typically necessitates the use of plain-film radiographs (PFRs). However, using a whole body CT scout at the time of non-contrast head CT scans can preclude critical delays. Here, we aim to compare the effectiveness of PFRs and CT scouts in detecting PMIOs.</p><p><strong>Methods: </strong>A case-control study was conducted at a tertiary care institution, involving 408 imaging studies from 200 patients, half of which contained PMIOs. The diagnostic performances of CT scouts and PFRs were evaluated by six blinded readers, including two board-certified neuroradiologists, one neuroradiology fellow, and three radiology residents.</p><p><strong>Results: </strong>2448 interpretations from the 6 readers were analyzed. The diagnostic performance of combined CT scout images (full-body and regional) was not significantly different from that of PFRs for all six readers (p = 0.06). However, PFRs outperformed full-body CT scouts in PMIO detection (p = 0.01), with no significant differences observed between PFRs and regional CT scouts (p = 0.4). Notably, the diagnostic accuracy of the radiology residents was found to be equivalent to radiologists across all imaging techniques.</p><p><strong>Conclusion: </strong>Integrating CT scouts in acute stroke protocols may help expedite MRI screening. The scouts should include the head, neck, chest, upper arms, abdomen, pelvis, and thighs. Including radiology residents in the screening process for PMIOs may be an avenue for resource optimization in acute care settings.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"41-50"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282203","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}
引用次数: 0
Diagnostic performance of neural network algorithms in skull fracture detection on CT scans: a systematic review and meta-analysis. 神经网络算法在CT扫描颅骨骨折检测中的诊断性能:系统回顾和荟萃分析。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-12-16 DOI: 10.1007/s10140-024-02300-7
Guive Sharifi, Ramtin Hajibeygi, Seyed Ali Modares Zamani, Ahmed Mohamedbaqer Easa, Ashkan Bahrami, Reza Eshraghi, Maral Moafi, Mohammad Javad Ebrahimi, Mobina Fathi, Arshia Mirjafari, Janine S Chan, Irene Dixe de Oliveira Santo, Mahsa Asadi Anar, Omidvar Rezaei, Long H Tu
{"title":"Diagnostic performance of neural network algorithms in skull fracture detection on CT scans: a systematic review and meta-analysis.","authors":"Guive Sharifi, Ramtin Hajibeygi, Seyed Ali Modares Zamani, Ahmed Mohamedbaqer Easa, Ashkan Bahrami, Reza Eshraghi, Maral Moafi, Mohammad Javad Ebrahimi, Mobina Fathi, Arshia Mirjafari, Janine S Chan, Irene Dixe de Oliveira Santo, Mahsa Asadi Anar, Omidvar Rezaei, Long H Tu","doi":"10.1007/s10140-024-02300-7","DOIUrl":"10.1007/s10140-024-02300-7","url":null,"abstract":"<p><strong>Background and aim: </strong>The potential intricacy of skull fractures as well as the complexity of underlying anatomy poses diagnostic hurdles for radiologists evaluating computed tomography (CT) scans. The necessity for automated diagnostic tools has been brought to light by the shortage of radiologists and the growing demand for rapid and accurate fracture diagnosis. Convolutional Neural Networks (CNNs) are a potential new class of medical imaging technologies that use deep learning (DL) to improve diagnosis accuracy. The objective of this systematic review and meta-analysis is to assess how well CNN models diagnose skull fractures on CT images.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science were searched for studies published before February 2024 that used CNN models to detect skull fractures on CT scans. Meta-analyses were conducted for area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Egger's and Begg's tests were used to assess publication bias.</p><p><strong>Results: </strong>Meta-analysis was performed for 11 studies with 20,798 patients. Pooled average AUC for implementing pre-training for transfer learning in CNN models within their training model's architecture was 0.96 ± 0.02. The pooled averages of the studies' sensitivity and specificity were 1.0 and 0.93, respectively. The accuracy was obtained 0.92 ± 0.04. Studies showed heterogeneity, which was explained by differences in model topologies, training models, and validation techniques. There was no significant publication bias detected.</p><p><strong>Conclusion: </strong>CNN models perform well in identifying skull fractures on CT scans. Although there is considerable heterogeneity and possibly publication bias, the results suggest that CNNs have the potential to improve diagnostic accuracy in the imaging of acute skull trauma. To further enhance these models' practical applicability, future studies could concentrate on the utility of DL models in prospective clinical trials.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"97-111"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827714","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}
引用次数: 0
Quantitative ROI differences for assessment of occult intertrochanteric extension of greater trochanteric fractures on pelvis CT. 骨盆 CT 评估大转子间骨折隐匿性延伸的定量 ROI 差异。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-10-25 DOI: 10.1007/s10140-024-02293-3
Meghan A Moriarty, Dimitri G Stefanov, Michael S Brown, Daniel M Walz, Pamela J Walsh
{"title":"Quantitative ROI differences for assessment of occult intertrochanteric extension of greater trochanteric fractures on pelvis CT.","authors":"Meghan A Moriarty, Dimitri G Stefanov, Michael S Brown, Daniel M Walz, Pamela J Walsh","doi":"10.1007/s10140-024-02293-3","DOIUrl":"10.1007/s10140-024-02293-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if difference in Hounsfield Units (HU) of the medullary bone between the injured and non-injured femurs in patients with greater trochanteric fractures is associated with occult intertrochanteric (IT) extension.</p><p><strong>Methods: </strong>Retrospective review was performed of 81 patients (age range 54-102, 54 females and 27 males) who underwent CT and subsequent MRI after identification of a greater trochanteric fracture without evidence of IT extension on radiography and/or CT. Hounsfield units of the injured and non-injured femurs on CT were recorded at the level of the base of the greater trochanter centrally (ROI1) and the level of the upper border of the lesser trochanter posteromedially (ROI2). The difference between the injured and non-injured femur for each ROI1 and ROI2 were calculated. Absence or presence, and if present, extent of IT extension was assessed on MRI. Analysis was performed to determine if there is correlation of difference in density with presence, and extent of occult IT fractures.</p><p><strong>Results: </strong>81 cases met inclusion criteria, 14 (17%) had no IT extension, 11 (14%) had less than 50% IT extension and 56 (69%) had 50% or greater IT extension. There was statistical significance between presence and absence of IT extension between the injured and non-injured femur for ROI1 (HU) no IT extension median (IQR): 18.8(4-40), ROI1 (HU) present IT extension median (IQR): 65.5(46-90) p < .0001, and for ROI2 no IT extension median (IQR): 3(-8-25.5) and ROI2 present IT extension 51(40.5-76), p < .0001. There was statistical significance of the extent of IT extension: ROI1 less than 50% IT extension median (IQR): 37.5(27.5-57), ROI1 50% or greater IT extension median (IQR): 72.3(53.5-91.3), p < .0001, and for ROI2 less than 50% IT extension median (IQR): 17.5(8-49), and ROI2 50% or greater IT extension median (IQR): 55.8(45.3-81.5), p < .0001. A threshold ROI2 difference of 50 HU resulted in specificity of 92% and sensitivity 60.7% of for IT extension 50% or greater.</p><p><strong>Conclusion: </strong>Patients presenting with greater trochanteric fractures, an asymmetric increased density measured by ROI differences within the medullary space of the IT region between the injured and non-injured femur is associated with occult IT extension.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"13-22"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497217","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}
引用次数: 0
Diagnostic performance of ChatGPT in tibial plateau fracture in knee X-ray. ChatGPT在膝关节胫骨平台骨折的x线诊断价值。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-11-30 DOI: 10.1007/s10140-024-02298-y
Mohammadreza Mohammadi, Sara Parviz, Parinaz Parvaz, Mohammad Mahdi Pirmoradi, Mohammad Afzalimoghaddam, Hadi Mirfazaelian
{"title":"Diagnostic performance of ChatGPT in tibial plateau fracture in knee X-ray.","authors":"Mohammadreza Mohammadi, Sara Parviz, Parinaz Parvaz, Mohammad Mahdi Pirmoradi, Mohammad Afzalimoghaddam, Hadi Mirfazaelian","doi":"10.1007/s10140-024-02298-y","DOIUrl":"10.1007/s10140-024-02298-y","url":null,"abstract":"<p><strong>Purpose: </strong>Tibial plateau fractures are relatively common and require accurate diagnosis. Chat Generative Pre-Trained Transformer (ChatGPT) has emerged as a tool to improve medical diagnosis. This study aims to investigate the accuracy of this tool in diagnosing tibial plateau fractures.</p><p><strong>Methods: </strong>A secondary analysis was performed on 111 knee radiographs from emergency department patients, with 29 confirmed fractures by computed tomography (CT) imaging. The X-rays were reviewed by a board-certified emergency physician (EP) and radiologist and then analyzed by ChatGPT-4 and ChatGPT-4o. The diagnostic performances were compared using the area under the receiver operating characteristic curve (AUC). Sensitivity, specificity, and likelihood ratios were also calculated.</p><p><strong>Results: </strong>The results indicated a sensitivity and negative likelihood ratio of 58.6% (95% CI: 38.9 - 76.4%) and 0.4 (95% CI: 0.3-0.7) for the EP, 72.4% (95% CI: 52.7 - 87.2%) and 0.3 (95% CI: 0.2-0.6) for the radiologist, 27.5% (95% CI: 12.7 - 47.2%) and 0.7 (95% CI: 0.6-0.9) for ChatGPT-4, and 55.1% (95% CI: 35.6 - 73.5%) and 0.4 (95% CI: 0.3-0.7) for ChatGPT4o. The specificity and positive likelihood ratio were 85.3% (95% CI: 75.8 - 92.2%) and 4.0 (95% CI: 2.1-7.3) for the EP, 76.8% (95% CI: 66.2 - 85.4%) and 3.1 (95% CI: 1.9-4.9) for the radiologist, 95.1% (95% CI: 87.9 - 98.6%) and 5.6 (95% CI: 1.8-17.3) for ChatGPT-4, and 93.9% (95% CI: 86.3 - 97.9%) and 9.0 (95% CI: 3.6-22.4) for ChatGPT4o. The area under the receiver operating characteristic curve (AUC) was 0.72 (95% CI: 0.6-0.8) for the EP, 0.75 (95% CI: 0.6-0.8) for the radiologist, 0.61 (95% CI: 0.4-0.7) for ChatGPT-4, and 0.74 (95% CI: 0.6-0.8) for ChatGPT4-o. The EP and radiologist significantly outperformed ChatGPT-4 (P value = 0.02 and 0.01, respectively), whereas there was no significant difference between the EP, ChatGPT-4o, and radiologist.</p><p><strong>Conclusion: </strong>ChatGPT-4o matched the physicians' performance and also had the highest specificity. Similar to the physicians, ChatGPT chatbots were not suitable for ruling out the fracture.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"59-64"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754819","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}
引用次数: 0
Radiology resident proficiency in identifying misplaced lines, tubes, and devices: a simulation-based study using WIDI SIM. 放射科住院医师熟练识别错位的线、管和设备:使用WIDI SIM的模拟研究。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-12-06 DOI: 10.1007/s10140-024-02295-1
Alexandria Iakovidis, Kevin Pierre, Abheek Raviprasad, Isabella Carvalho, Alina Zankevich, Roberta Slater, Christopher Sistrom, Otgonbayar Batmunh, Priya Sharma, Anthony Mancuso, Dhanashree Rajderkar
{"title":"Radiology resident proficiency in identifying misplaced lines, tubes, and devices: a simulation-based study using WIDI SIM.","authors":"Alexandria Iakovidis, Kevin Pierre, Abheek Raviprasad, Isabella Carvalho, Alina Zankevich, Roberta Slater, Christopher Sistrom, Otgonbayar Batmunh, Priya Sharma, Anthony Mancuso, Dhanashree Rajderkar","doi":"10.1007/s10140-024-02295-1","DOIUrl":"10.1007/s10140-024-02295-1","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate placement of medical devices is crucial in critical care to prevent severe complications. This study aims to evaluate radiology residents' proficiency in identifying four specific critical misplacements of medical devices using the Wisdom in Diagnostic Imaging Simulation (WIDI SIM).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 1,102 responses from radiology residents who participated in the WIDI SIM between 2010 and 2022. The majority were first- and second-year residents from multiple institutions. The simulation presented four specific cases featuring misplacements of an endotracheal tube in the esophagus, an intrauterine device embedded in the myometrium, a peripherally inserted central catheter in the right internal jugular vein, and an umbilical venous catheter in the splenic vein. Residents provided free-text interpretations scored on a 0-10 scale by subspecialty radiologists. Errors were categorized as observational (failure to identify misplacement) or interpretive (misinterpretation of identified misplacement). Statistical analyses were performed using Kruskal-Wallis and Dunn's multiple comparisons tests.</p><p><strong>Results: </strong>Across all cases, residents' average scores did not meet the acceptable standard of 7 points. Observational errors were predominant, indicating a failure to recognize these specific device misplacements. Effective report rates were low: 58% for the endotracheal tube case, 35% for the intrauterine device, 19% for the peripherally inserted central catheter, and 25% for the umbilical venous catheter. Significant performance improvements were observed between first- and second-year residents in three of the four cases (p-values ranging from < 0.0001 to 0.0238), but overall proficiency remained suboptimal even among senior residents.</p><p><strong>Conclusion: </strong>This study reveals gaps in radiology residents' ability to identify these specific misplaced lines, tubes, and devices accurately. The consistent pattern of underperformance, primarily due to observational errors, suggests a need for targeted educational interventions to improve resident proficiency in this aspect of emergency radiology.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"73-78"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784575","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}
引用次数: 0
Correction to: Exploring the role of CT scouts in expediting MRI in acute stroke. 更正:探索 CT 侦察员在急性中风患者中加速 MRI 的作用。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 DOI: 10.1007/s10140-024-02301-6
Rahul B Singh, Ahmed K Ahmed, Gabriel M Virador, Yassine Alami Idrissi, Alok A Bhatt, Dhairya A Lakhani, Merrie W Oei, Neethu Gopal, Cameron Overfield, Colin Rowell, Dinesh Rao, Prasanna Vibhute, Robert E Watson, Sukhwinder J S Sandhu
{"title":"Correction to: Exploring the role of CT scouts in expediting MRI in acute stroke.","authors":"Rahul B Singh, Ahmed K Ahmed, Gabriel M Virador, Yassine Alami Idrissi, Alok A Bhatt, Dhairya A Lakhani, Merrie W Oei, Neethu Gopal, Cameron Overfield, Colin Rowell, Dinesh Rao, Prasanna Vibhute, Robert E Watson, Sukhwinder J S Sandhu","doi":"10.1007/s10140-024-02301-6","DOIUrl":"10.1007/s10140-024-02301-6","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"137"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715697","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}
引用次数: 0
Comparison of clinical and abdominal CT imaging findings in children evaluated for abusive and accidental abdominal trauma. 儿童虐待性和意外性腹部创伤的临床和腹部CT影像学表现的比较。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-12-21 DOI: 10.1007/s10140-024-02305-2
Boaz Karmazyn, Reid S Fisher, Doriann M Alcaide, Shannon L Thompson, Rebeca Santos, Gregory S Jennings, George J Eckert, Megan B Marine
{"title":"Comparison of clinical and abdominal CT imaging findings in children evaluated for abusive and accidental abdominal trauma.","authors":"Boaz Karmazyn, Reid S Fisher, Doriann M Alcaide, Shannon L Thompson, Rebeca Santos, Gregory S Jennings, George J Eckert, Megan B Marine","doi":"10.1007/s10140-024-02305-2","DOIUrl":"10.1007/s10140-024-02305-2","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of child abuse in children evaluated for a blunt abdominal trauma can be challenging due to overlapping types of injuries.</p><p><strong>Objective: </strong>Identify clinical characteristics and CT findings that differentiate children evaluated for accidental abdominal trauma (AcAT) and abusive abdominal trauma (AbAT).</p><p><strong>Materials and methods: </strong>Retrospective (1/2010 to 6/2024) study on children < 3 years-old who had an abdominal CT scan for AcAT or AbAT. Demographic, clinical, and imaging variables were compared between CT-positive child abuse, and accidental trauma.</p><p><strong>Results: </strong>Abdominal CT positive for trauma was found in 26.5% (82/309) children that were evaluated for AAT and in 28.8% (42/146) for AcAT. Children with positive CT for AbAT were significantly younger (average age 0.9 ± 0.9 versus 1.8 ± 0.9 years), and most (70.7%) were younger than one year old. Most children evaluated for AbAT with positive CT (70.7%) had an unknown cause of injury. The most common mechanism provided for abused children was low height fall (18/82, 22.0%) as compared with no low height fall in accidental trauma (p < 0.001). Rib fractures were identified on CT in 5049/82 children (61.059.8%) evaluated for AbAT as compared with 4/42 (9.5%) in children evaluated for AcAT (p < 0.001).</p><p><strong>Conclusion: </strong>In children evaluated for blunt abdominal trauma, presence of rib fractures should alert radiologists to the possibility of child abuse. Abused children were mostly younger than one year, with an unknown mechanism of injury or a fall from a low height.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"23-31"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871663","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}
引用次数: 0
Prognostic value of CT findings for conservative treatment failure in adhesive small bowel obstruction. CT 结果对粘连性小肠梗阻保守治疗失败的预后价值。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-07-29 DOI: 10.1007/s10140-024-02276-4
Elena Desiato, Ada Maria Antonella Lucia, Simone Giudici, Angela Ammirabile, Marco Francone, Ezio Lanza, Daniele Del Fabbro
{"title":"Prognostic value of CT findings for conservative treatment failure in adhesive small bowel obstruction.","authors":"Elena Desiato, Ada Maria Antonella Lucia, Simone Giudici, Angela Ammirabile, Marco Francone, Ezio Lanza, Daniele Del Fabbro","doi":"10.1007/s10140-024-02276-4","DOIUrl":"10.1007/s10140-024-02276-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify the radiological CT findings that are significantly correlated with the outcome of conservative management with oral water-soluble contrast medium in patients presenting with Adhesive Small Bowel Obstruction (ASBO) to the Emergency Room.</p><p><strong>Methods: </strong>In this retrospective single-center study, we considered all consecutive patients admitted to the ER from February 2019 to February 2023 for ASBO with an available contrast-enhanced CT scan performed at diagnosis and treated with conservative management. The investigated CT findings were type and location of transition zone, ASBO degree, fat notch sign, beak sign, small bowel feces sign, presence of peritoneal free fluid and pneumatosis intestinalis. Radiological parameters were analyzed using univariable and multivariable logistic regression to test the significant association between the CT parameters and the target.</p><p><strong>Results: </strong>Among the 106 included patients (median age 74.5 years), conservative treatment was effective in 59 (55.7%) and failed in 47 (44.3%), needing delayed surgery. In the failure group, there was a higher prevalence of patients who had previous ASBO episodes (p = 0.03), a greater proportion of females (p = 0.04) and a longer hospital stay (p < 0.001). At multivariable analysis, two CT findings were significantly correlated with failure of conservative treatment: fat notch sign (OR = 2.95; p = 0.04) and beak sign (OR = 3.42; p = 0.04).</p><p><strong>Conclusions: </strong>Two radiological signs correlate with failure of non-operative management in ASBO, suggesting their importance in surgical decision-making. Patients presenting with these signs are at higher risk of unsuccessful conservative treatment and may require undelayed surgical intervention.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"33-40"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787593","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}
引用次数: 0
Epiploic appendagitis on the vermiform appendix is often misdiagnosed as acute appendicitis. 蚓状阑尾的尾网膜阑尾炎常被误诊为急性阑尾炎。
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-12-11 DOI: 10.1007/s10140-024-02304-3
Akihiro Horibe, Juri Funasaka, Keisuke Hiroshima, Masanobu Kiriyama
{"title":"Epiploic appendagitis on the vermiform appendix is often misdiagnosed as acute appendicitis.","authors":"Akihiro Horibe, Juri Funasaka, Keisuke Hiroshima, Masanobu Kiriyama","doi":"10.1007/s10140-024-02304-3","DOIUrl":"10.1007/s10140-024-02304-3","url":null,"abstract":"<p><p>Epiploic appendagitis of the vermiform appendix is a rare cause of right lower abdominal pain that can mimic acute appendicitis and result in unnecessary surgery. Despite this, the condition can be managed with non-steroidal anti-inflammatory drugs alone. Due to the lack of characteristic physical or laboratory findings, accurate diagnosis by imaging is crucial. The aim of this case report is to emphasize this uncommon condition to prevent misdiagnosis and avoid unnecessary surgical interventions. A 57-year-old man presented with a 2-day history of abdominal pain and tenderness in the right abdominal region. Laboratory results were within the normal range. The surgeon diagnosed him as distal appendicitis or colonic diverticulitis and treated him with antibiotics, leading to improvement within several days. A subsequent review of the plain computed tomography images by the radiologist detected an oval fat density surrounded by a high-intensity rim and a high-density spot in the center at the tip of normal vermiform appendix. This led to a diagnosis of epiploic appendagitis on the vermiform appendix. Epiploic appendagitis is characterized by inflammation and ischemia resulting from torsion of the epiploic appendage. It can occur not only on the colon but also on the appendix. The imaging findings in this case were typical of epiploic appendagitis on the appendix. It is imperative for clinicians to be familiar with the clinical presentation and imaging findings of epiploic appendagitis on the appendix to ensure an accurate diagnosis, reduce unnecessary surgeries, thereby enhancing patient outcomes.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"131-135"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806478","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}
引用次数: 0
Correlation between adult trauma center status and radiology resident performance on trauma cases in the WIDI SIM exam. 成人创伤中心状态与WIDI SIM考试创伤病例放射学住院医师表现的相关性
IF 1.7
Emergency Radiology Pub Date : 2025-02-01 Epub Date: 2024-12-02 DOI: 10.1007/s10140-024-02302-5
Kevin Pierre, Abheek Raviprasad, Isabella Amador, Alexandria Iakovidis, Jay Talati, Christopher Sistrom, Roberta Slater, Linda Lanier, John Rees, Ivan Davis, Anthony Mancuso, Priya Sharma, Dhanashree Rajderkar
{"title":"Correlation between adult trauma center status and radiology resident performance on trauma cases in the WIDI SIM exam.","authors":"Kevin Pierre, Abheek Raviprasad, Isabella Amador, Alexandria Iakovidis, Jay Talati, Christopher Sistrom, Roberta Slater, Linda Lanier, John Rees, Ivan Davis, Anthony Mancuso, Priya Sharma, Dhanashree Rajderkar","doi":"10.1007/s10140-024-02302-5","DOIUrl":"10.1007/s10140-024-02302-5","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether adult trauma center status influences radiology resident performance on trauma cases in the Emergent/Critical Care Imaging SIMulation (WIDI SIM) exam.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed 29,290 WIDI SIM exam scores from 110 adult trauma cases across 55 radiology residency programs. Residents were categorized by training level-R1 (n = 17,801), R2 (n = 9,136), R3 (n = 1,826), R4 (n = 527)-and by their program's adult trauma center designation: Level 1 (n = 20,121), Level 2 (n = 1,870), Level 3 (n = 1,029), Level 4 (n = 487), and no trauma designation (n = 5,834). A Generalized Linear Mixed Model with a negative binomial distribution was used to evaluate the effect of trauma center status on resident performance, adjusting for resident level, imaging modality, and case specialty.</p><p><strong>Results: </strong>After adjusting for confounding variables, there was no statistically significant difference in resident scores based on adult trauma center status (p > 0.05 for all trauma levels compared to no trauma designation). Resident level significantly influenced performance, with higher-level residents scoring better than R1 residents (p < 0.001 for R2-R4). Imaging modality and case specialty also significantly affected scores. Residents performed better on MR, US, and XR modalities compared to CT (p ≤ 0.002), and scored lower on chest, cardiovascular, musculoskeletal, and neuro cases compared to abdominopelvic cases (p < 0.001).</p><p><strong>Conclusion: </strong>Adult trauma center status did not significantly impact radiology resident performance on trauma cases in the WIDI SIM exam. Resident training level, imaging modality, and case specialty were significant factors influencing performance. These findings suggest that resident education and exposure to diverse imaging modalities and specialties are more critical determinants of diagnostic accuracy than the trauma center designation of their training program.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1-5"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767409","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}
引用次数: 0
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