Emergency Radiology最新文献_第4页

Establishment of the first National diagnostic reference levels by clinical indication for adult head computed tomography in morocco: A baseline study. 通过摩洛哥成人头部计算机断层扫描临床指征建立首个国家诊断参考水平：一项基线研究。

IF 1.3

Emergency Radiology Pub Date : 2025-09-17 DOI: 10.1007/s10140-025-02382-x

Youssef Madkouri, Hamza Sekkat, Abdellah Khallouqi

{"title":"Establishment of the first National diagnostic reference levels by clinical indication for adult head computed tomography in morocco: A baseline study.","authors":"Youssef Madkouri, Hamza Sekkat, Abdellah Khallouqi","doi":"10.1007/s10140-025-02382-x","DOIUrl":"https://doi.org/10.1007/s10140-025-02382-x","url":null,"abstract":"Purpose: The widespread and growing use of computed tomography (CT) in emergency care across Morocco has raised critical concerns about radiation safety, particularly in the absence of national Diagnostic Reference Levels (DRLs). Without DRLs tailored to specific clinical indications, it becomes difficult to identify unjustified dose variations and ensure safe practices. This study aims to establish Morocco's first national, clinical indication-based DRLs for adult head CT examinations, promoting radiation dose optimization and alignment with international safety standards.Methods: A retrospective multicenter analysis was performed on 1,299 adult head CT examinations across 20 Moroccan hospitals. Clinical indications were categorized into seven groups: stroke, acute neurological symptoms, post-contrast imaging (tumor/abscess), CT angiography, oncology planning, sinus and temporal bone imaging. Key parameters and dose metrics were extracted and the 75th percentile (third quartile) of volumetric CT dose index (CTDIvol) and dose-length product (DLP) distribution per indication was used to propose DRLs.Results: DLP varied significantly across protocols (highest: oncology [1794.8 ± 128.8 mGy·cm]; lowest: temporal bone [398.4 ± 20.3 mGy·cm]). Geographic disparities emerged, with Agadir (2211 mGy·cm) and Al Hoceima (2204 mGy·cm) showing the highest doses versus Dakhla (790 mGy·cm). Stroke DLPs (880.7 ± 70.5 mGy·cm) were lower than some international benchmarks, reflecting protocol and regional differences in Moroccan practice.Conclusion: The study establishes the first set of national, indication-specific DRLs for adult head CT. These benchmarks provide a foundational tool for dose optimization, helping radiology departments evaluate current practices, reduce unnecessary exposure and promote compliance with international guidelines.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074539","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

Chest CT as a diagnostic tool for COVID-19 in resource-limited Countries : Diagnostic accuracy of chest CT for COVID-19 pneumonia in a resource-limited Gaza cohort: a retrospective study of 252 patients. 在资源有限的国家，胸部CT作为COVID-19的诊断工具：在资源有限的加沙队列中，胸部CT对COVID-19肺炎的诊断准确性：一项252例患者的回顾性研究。

IF 1.3

Emergency Radiology Pub Date : 2025-09-17 DOI: 10.1007/s10140-025-02388-5

Deniz Esin Tekcan Sanli, Ahmet Necati Sanli

引用次数: 0

Imaging requests for acute abdominal pain in the emergency department: a retrospective cross-sectional study. 急诊科急性腹痛影像学要求：一项回顾性横断面研究。

IF 1.3

Emergency Radiology Pub Date : 2025-09-17 DOI: 10.1007/s10140-025-02385-8

Esteban Vasquez, Andrea Torres, Belén Báez, Lía Rodríguez, Diego Cienfuegos, Marcelo Castro

{"title":"Imaging requests for acute abdominal pain in the emergency department: a retrospective cross-sectional study.","authors":"Esteban Vasquez, Andrea Torres, Belén Báez, Lía Rodríguez, Diego Cienfuegos, Marcelo Castro","doi":"10.1007/s10140-025-02385-8","DOIUrl":"https://doi.org/10.1007/s10140-025-02385-8","url":null,"abstract":"Purpose: To evaluate whether the appropriateness of imaging requests (AIR) for acute abdominal pain (AAP) in two private hospitals in Santiago (2023) was associated with higher diagnostic yield, and to explore predictors through a multivariable model.Methods: A retrospective cross-sectional study included patients aged ≥ 15 years presenting with AAP who underwent US, CT, or MRI. AIR was classified according to the ACR Appropriateness Criteria, and radiology reports were categorized as confirmatory or normal. A multivariable logistic regression model, incorporating interactions between AIR, imaging modality, and age, was applied to identify predictors of diagnostic yield.Results: A total of 189 imaging studies were analyzed (75 US, 62 CT, 52 MRI). Overall, 57.7% of requests were appropriate. Confirmatory findings occurred in 66.1% of cases, significantly more frequent in appropriate requests (84.4%) than in inappropriate ones (41.3%; p < 0.01). Inappropriateness reduced diagnostic yield from 78.3% to 17.4% in US and from 91.5% to 25.9% in CT, with no significant difference for MRI (86% vs. 81.3%). Older age was independently associated with higher probabilities of confirmatory findings. Epigastric pain and acute gastroenteritis were disproportionately linked to overuse, while hepatobiliary conditions showed predominantly appropriate use. The model demonstrated high discriminatory performance (AUC = 0.88).Conclusion: Adherence to ACR criteria was strongly associated with improved diagnostic yield in AAP, particularly for CT and US. Age and local epidemiology, including high biliary disease prevalence, influenced modality performance. These findings support context-sensitive decision-support tools and prospective studies to refine imaging strategies and enhance patient safety in emergency care.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074547","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

Resolution of traumatic adrenal hemorrhage on CT: impact of follow-up timing and initial hematoma size. 外伤性肾上腺出血的CT诊断：随访时间和初始血肿大小的影响。

IF 1.3

Emergency Radiology Pub Date : 2025-09-16 DOI: 10.1007/s10140-025-02396-5

Harry Yip, Maryam Shekarfaroush, Demi Markakis, Humza Tufail, Adil Zia, Jan Gerstenmaier, Bruno Di Muzio

{"title":"Resolution of traumatic adrenal hemorrhage on CT: impact of follow-up timing and initial hematoma size.","authors":"Harry Yip, Maryam Shekarfaroush, Demi Markakis, Humza Tufail, Adil Zia, Jan Gerstenmaier, Bruno Di Muzio","doi":"10.1007/s10140-025-02396-5","DOIUrl":"https://doi.org/10.1007/s10140-025-02396-5","url":null,"abstract":"Purpose: Traumatic adrenal gland hemorrhage (TAH) is an uncommon injury which can be managed conservatively in most cases. There are limited studies assessing the interval follow-up and resolution of conservatively managed TAH. The aim of our study was to evaluate the relationship between resolution of TAH, follow-up imaging interval and initial hematoma size. A key objective was to assess the incidence of underlying adrenal masses that may mimic or contribute to hemorrhage.Methods: Single centre retrospective cross-sectional study of all trauma patients with radiologically reported adrenal hemorrhage from January 1, 2009 to January 1, 2025. Patients were identified through radiology database search, with demographic, imaging and hematoma data collected to analyse associations between resolution, follow-up timing and initial hematoma size.Results: Of the 246 patients identified, 125 (51%) underwent at least 1 follow-up CT. The first follow-up occurred at a mean interval of 66.9 days; At this time, 60 patients (48%) showed complete resolution, 53 (42%) showed partial resolution and 12 (10%) demonstrated persistent hemorrhage. An underlying adrenal lesion was identified in 1% of patients. There were statistically significant associations between follow-up imaging time interval and hematoma resolution (p = 0.0025), and between the initial hematoma size and the resolution outcome (p < 0.000001).Conclusion: Complete resolution of TAH occurred more frequently in patients with follow-up imaging at ≥ 30 days post injury. Hematomas measuring < 27 mm on initial imaging were more likely to resolve completely. Underlying adrenal lesions were rare. These findings may assist trauma centres in refining follow-up imaging strategies for conservatively managed TAH.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069255","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

Systematic approach to the post-Whipple CT: clinical cases and problem-solving strategies. 惠普尔后CT的系统方法：临床病例和解决问题的策略。

IF 1.3

Emergency Radiology Pub Date : 2025-09-08 DOI: 10.1007/s10140-025-02379-6

Ceylan Colak, Ahmad Parvinian, Vamshi Mugu, Kelly Horst, Rebecca Hibbert, James Boyum, Christoph Wald, Alex Chan

引用次数: 0

Afterhours diagnostic radiology in the USA: radiologists' views on imaging volumes, compensation, work-from-home, and compensatory time-off. 美国的下班后诊断放射学：放射科医生对成像量、补偿、在家工作和补偿休假的看法。

IF 1.3

Emergency Radiology Pub Date : 2025-09-04 DOI: 10.1007/s10140-025-02381-y

Yelim Lee, Tarek Hanna, Thomas Ptak, Mary Jo Tarrant, Dominick Parris, David Markovich, Eric Friedberg, Eric Rubin, Mark Alson, Suzanne Chong

{"title":"Afterhours diagnostic radiology in the USA: radiologists' views on imaging volumes, compensation, work-from-home, and compensatory time-off.","authors":"Yelim Lee, Tarek Hanna, Thomas Ptak, Mary Jo Tarrant, Dominick Parris, David Markovich, Eric Friedberg, Eric Rubin, Mark Alson, Suzanne Chong","doi":"10.1007/s10140-025-02381-y","DOIUrl":"https://doi.org/10.1007/s10140-025-02381-y","url":null,"abstract":"Purpose: To understand the afterhours radiology workforce and views towards imaging volumes, compensation, overnight challenges, and work-from-home. METHODS: Survey questions focusing on the afterhours radiology workforce were created. The survey was administered by the American College of Radiology (ACR) and the data analysis performed by the ACR in partnership with an independent market research agency. The confidence level was set at 95%, with an error rate of +/- 2.2%. RESULTS: A total of 1109 out of 1844 (60.1%) survey participants responded to the afterhours survey. A majority of respondents (56%) had worked an afterhours shift while a minority had worked a late-evening (18%) or overnight shift (13%). Irrespective of practice type, the majority of radiologists thought afterhours volumes were not manageable, and afterhours compensation was not equitable. Less than half of those who worked overnight shifts believed they were given adequate compensatory time-off for recovery. The majority of respondents supported work-from-home for afterhours shifts.Conclusions: As the largest survey to date on after-hours radiology, these findings should be carefully considered by practices aiming to successfully recruit and retain radiologists in this critical niche.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991372","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

Global diagnostic accuracy and prognostic value of non-contrast CT in acute traumatic brain injury: a systematic review and meta-analysis. 非对比CT在急性创伤性脑损伤中的整体诊断准确性和预后价值：一项系统回顾和荟萃分析。

IF 1.3

Emergency Radiology Pub Date : 2025-08-29 DOI: 10.1007/s10140-025-02380-z

Sabzar Ahmad Bhat, Mamta Panda, Dolly Anil Sharma, Lalit Kumar Gupta

{"title":"Global diagnostic accuracy and prognostic value of non-contrast CT in acute traumatic brain injury: a systematic review and meta-analysis.","authors":"Sabzar Ahmad Bhat, Mamta Panda, Dolly Anil Sharma, Lalit Kumar Gupta","doi":"10.1007/s10140-025-02380-z","DOIUrl":"https://doi.org/10.1007/s10140-025-02380-z","url":null,"abstract":"Background: Traumatic brain injury (TBI) is a global health challenge associated with high morbidity and mortality. Non-contrast computed tomography (NCCT) remains the first-line imaging modality due to its accessibility and speed, yet its diagnostic and prognostic utility across diverse populations remains underexplored.Purpose: To systematically evaluate and quantify the diagnostic accuracy and prognostic value of NCCT in acute TBI patients worldwide.Evidence acquisition: Following PRISMA 2020 guidelines, a systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Scopus up to April 2025. Studies assessing the diagnostic or prognostic performance of NCCT in acute TBI were included. QUADAS-2 was used for quality assessment. Meta-analyses were performed using random-effects models.Evidence synthesis: Out of 2,132 articles screened, 41 studies met inclusion criteria, encompassing over 76,000 patients. The pooled sensitivity and specificity for NCCT detecting intracranial hemorrhage were 0.92 (95% CI: 0.89-0.95) and 0.87 (95% CI: 0.82-0.91), respectively. Prognostically, features like midline shift > 5 mm and compressed basal cisterns showed a significant association with in-hospital mortality (OR: 3.6, 95% CI: 2.4-5.1). Subgroup analyses by age, GCS, and scan timing confirmed robust diagnostic consistency.Conclusion: NCCT demonstrates high diagnostic accuracy in detecting intracranial hemorrhage and offers substantial prognostic insights in acute TBI. It remains a cornerstone imaging tool, particularly valuable in time-sensitive emergency settings.Clinical impact: NCCT should be prioritized in emergency protocols for early diagnosis and risk stratification in TBI, particularly in resource-constrained environments lacking advanced neuroimaging.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946909","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

The role of ventilation/perfusion scintigraphy in distinguishing acute from chronic pulmonary embolism. 通气/灌注显像在区分急性和慢性肺栓塞中的作用。

IF 1.3

Emergency Radiology Pub Date : 2025-08-07 DOI: 10.1007/s10140-025-02377-8

Hamdi Afşin, Emine Afşin

{"title":"The role of ventilation/perfusion scintigraphy in distinguishing acute from chronic pulmonary embolism.","authors":"Hamdi Afşin, Emine Afşin","doi":"10.1007/s10140-025-02377-8","DOIUrl":"https://doi.org/10.1007/s10140-025-02377-8","url":null,"abstract":"Background: In this study, we examined the potential role of V/Q scintigraphy in distinguishing acute PE (APE) from chronic PE (CPE).Materials and methods: From 2020 to 2023, 36 patients diagnosed with APE and 24 patients diagnosed with CPE were included in the study. Location (segmental, subsegmental, lobar), number and appearance (wedge/patch) of mismatch perfusion defects on V/Q scintigraphy were recorded, and data were compared between the two groups.Results: The number of mismatch segmental defects on V/Q scintigraphy was higher in the APE group (p = 0.042). The number of wedge-shaped defects was higher in the APE group (p = 0.003), while patchy defects were more common in the CPE group (p < 0.001). A negative correlation (p = 0.002) was observed between CPE and the number of wedges, whereas a positive correlation (p < 0.001) was found between CPE and the number of patches. Pulse oxygen saturation negatively correlated with the number of patches (p = 0.012). A negative correlation also existed between the number of mismatch segmental defects and CPE (p = 0.041). APE was indicated when the number of wedges was ≥1.5 (75% sensitivity,62% specificity, p = 0.03), while CPE was indicated when the number of patches was ≥0.5 (88% sensitivity, 61% specificity, p < 0.001). Patchy defects were found to be an independent risk factor for CPE (p = 0.008, OR: 2.1, 95% CI: 1.2-3.7).Conclusion: Patchy defects serve as an independent risk factor for CPE and correlate with the severity of hypoxemia.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793797","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

Promising initial evaluation: the Shock Thyroid Imaging Score (STIS) could predict mortality in hemodynamically unstable trauma patients. 有希望的初步评估：休克甲状腺成像评分（STIS）可以预测血流动力学不稳定的创伤患者的死亡率。

IF 1.3

Emergency Radiology Pub Date : 2025-08-01 Epub Date: 2025-06-14 DOI: 10.1007/s10140-025-02356-z

Matthew C Mueller, Jacques du Plessis, Abdelazim M E Mohammed, Rawan Abu Mughli, Michael E O'Keeffe, Sadia R Qamar, Jason A Robins, Chantelle Q Y Lin, Pascal N Tyrrell, Ferco H Berger

引用次数: 0

Emergency interventions for massive haemoptysis: a pictorial overview of life-saving endovascular procedures. 大咯血的紧急干预：挽救生命的血管内手术的图片概述。

IF 1.3

Emergency Radiology Pub Date : 2025-08-01 Epub Date: 2025-06-18 DOI: 10.1007/s10140-025-02361-2

Yugandhar Samireddypalle, Mithilesh Arumulla, A Rahul, P Karthickpriya, A Prudhvinath Reddy, Vikram Damaraju, Adimulam Ganga Ravindra, K S Amitha Vikrama

{"title":"Emergency interventions for massive haemoptysis: a pictorial overview of life-saving endovascular procedures.","authors":"Yugandhar Samireddypalle, Mithilesh Arumulla, A Rahul, P Karthickpriya, A Prudhvinath Reddy, Vikram Damaraju, Adimulam Ganga Ravindra, K S Amitha Vikrama","doi":"10.1007/s10140-025-02361-2","DOIUrl":"10.1007/s10140-025-02361-2","url":null,"abstract":"Massive haemoptysis is a medical emergency with high mortality if not promptly addressed. This pictorial essay aims to guide clinicians through the selection and execution of life-saving endovascular interventions tailored to the underlying vascular etiology. Emphasis is placed on clinical presentation, imaging clues, and procedural decision-making to enhance understanding among trainees and practicing radiologists. We present a curated series of cases of life-threatening haemoptysis managed with bronchial artery embolization (BAE), pulmonary artery embolization (PAE), embolization of acquired aortopulmonary collaterals (APCs), and thoracic endovascular aortic repair (TEVAR). Each case is dissected to highlight the clinical scenario, angiographic findings, interventional technique, and outcome. Endovascular management of haemoptysis should be guided by the underlying etiology and vascular anatomy. A structured approach to imaging interpretation, selective angiography, and tailored endovascular management can drastically reduce mortality. This educational overview bridges the gap between diagnosis and intervention, reinforcing practical decision-making in pulmonary vascular emergencies.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"635-644"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0