Emergency Radiology最新文献

{"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}

{"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}

{"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}

{"title":"Splenic artery embolization for variceal bleeding in portal hypertension: a systematic review and metanalysis.","authors":"Mohadese Ahmadzade, Shahram Akhlaghpoor, Hamidreza Rouientan, Sara Hassanzadeh, Hamed Ghorani, Mahsa Heidari-Foroozan, Mobina Fathi, Fakhroddin Alemi, Shadi Nouri, Kelly Trinh, Kei Yamada, Mohammad Ghasemi-Rad","doi":"10.1007/s10140-024-02299-x","DOIUrl":"10.1007/s10140-024-02299-x","url":null,"abstract":"<p><strong>Purpose: </strong>Splenic artery embolization (SAE) has emerged as a promising alternative for managing variceal bleeding secondary to portal hypertension (PH). This study aims to elucidate the significance of SAE in managing esophageal variceal bleeding in patients with PH, providing an overview of its efficacy, safety, and role in PH management.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA standards. EMBASE, PubMed, Scopus, and Web of Science databases were searched from inception until April 14, 2024. Original observational and clinical studies on SAE in managing variceal bleeding due to PH were included. Meta-analyses were performed using a random-effects model, and publication bias was assessed using regression and rank correlation tests for funnel plot asymmetry.</p><p><strong>Results: </strong>Eighteen studies met the inclusion criteria, encompassing 531 patients. The meta-analysis revealed a significant reduction in variceal bleeding post-SAE (RD = -0.86; 95% CI: -0.97, -0.75; p < 0.001). Complete resolution of varices was observed in 26% of patients (95% CI: 11%, 45%; p = 0.006), and 78% showed improvement in variceal grade (95% CI: 43%, 88%; p < 0.001). SAE significantly increased platelet counts (SMD = 1.15; 95% CI: 0.63, 1.68; p < 0.001). Common complications included post-embolization syndrome, and the overall complication rate was low.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis study supports the efficacy and safety of SAE in managing variceal bleeding due to PH, demonstrating significant reductions in bleeding, improvements in variceal grade, and increases in platelet counts.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"79-95"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686412","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 incidence of vascular injuries in patients with negative cervical computed tomography (CT) following blunt trauma.","authors":"Assala Aslan, Joseph Eskew, Spencer Zaheri, Ridge Arceneaux, Elizabeth Field, Elise Thibodeaux, Morgan Roque, Luis De Alba, Octavio Arevalo, Hugo Cuellar","doi":"10.1007/s10140-024-02310-5","DOIUrl":"https://doi.org/10.1007/s10140-024-02310-5","url":null,"abstract":"<p><strong>Introduction: </strong>Computed tomography (CT) angiography is commonly utilized to quickly identify vascular injuries caused by blunt cervical trauma. It is often conducted alongside a cervical spine CT, based on established criteria. This study assessed the prevalence of cervical vascular injuries identified via CT angiography (CTA) in patients who had negative findings on cervical CT scans.</p><p><strong>Materials and methods: </strong>A retrospective study was performed on patients who experienced blunt trauma from January 2020 to December 2022 and underwent both cervical CT and CTA. The sample size was determined using the formula: n = (Z^2 * P * (1 - P)) / E^2, assuming a 99% confidence interval, a 2% margin of error, and a proportion of 0.05.</p><p><strong>Results: </strong>A total of 1,165 patients presented with acute blunt trauma to the head and neck during the study period. Out of those, 800 patients (68.7%) had negative cervical CT scans and only 5 patients (0.6%) were found to have vascular injuries on CTA, with an average age of 44.2 years. Regarding the severity of the injuries, three were classified as grade I and two as grade II. On the other hand, of the 365 patients with positive cervical CT, 44 patients (12%) had vascular injury on CTA, including 16 patients (4.5%) with grades III and IV injuries.</p><p><strong>Conclusion: </strong>The findings of this study suggest that CTA in patients with negative cervical CT scans seldom reveals vascular injuries, with no injuries exceeding grade II. This highlights the selective utility of CTA in this patient group.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977687","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-08","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":"Occipital condyle fractures revisited.","authors":"Mahla Radmard, Armin Tafazolimoghadam, Akua Afrah Amoah, Dhairya A Lakhani, Tej D Azad, Ali Bydon, David M Yousem","doi":"10.1007/s10140-024-02303-4","DOIUrl":"https://doi.org/10.1007/s10140-024-02303-4","url":null,"abstract":"<p><strong>Purpose: </strong>Occipital condyle fractures (OCFs) are classified by the Anderson and Montesano system into Type I (comminuted, minimally displaced), Type II (stable, associated with basilar skull fractures), and Type III (unstable avulsion fractures). We retrospectively analyzed 24,986 cervical spine CT examinations of emergency department patients over five years to determine the incidence and characteristics of OCFs, mechanism of injury, and associated intracranial and cervical spine injuries.</p><p><strong>Methods and materials: </strong>The study was IRB-approved and HIPAA compliant. We retrospectively reviewed the CT brain and CT cervical spine reports performed from July 2018 to August 2023. Variables collected included age, sex, clinical presentation, coincident brain and cervical spine injuries, treatments, and OCF classifications.</p><p><strong>Results: </strong>Sixty-three of 24,986 patients (0.25%) had OCFs, predominantly male (41 males, 22 females), with an average age of 51.1 years; 22/63 (34.9%) occurred in asymptomatic patients. Concurrent injuries included cervical spine fractures (33.3%) at C1 and C2 and intracranial injuries (47.6%), mostly subarachnoid and subdural hemorrhages. OCFs were categorized into Anderson-Montesano Type I (9 cases), Type II (24 cases), and Type III (30 cases), with unstable Type III fractures more common in MVC victims; stable fractures had higher rates of intracranial injuries. There were no significant differences in morbidity, mortality, or concurrent cervical spine or chest/abdominal/pelvic findings between stable and unstable OCFs.</p><p><strong>Conclusion: </strong>The study highlights the importance of comprehensive imaging and evaluation in trauma cases to identify OCFs, even in asymptomatic patients, with a high rate of concurrent C1-2 and intracranial injuries.</p><p><strong>Clinical relevance/application: </strong>Being aware of occipital condyle fractures, types, and complications is important in the emergency radiology evaluation of trauma patients, especially given high rates of C1-2 fractures and intracranial bleeds.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779604","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":"Clinical prediction scale approach derived from a retrospective study to reduce the number of urgent, low-value cranial CT scans.","authors":"Juana María Plasencia-Martínez, Elena Otón-González, Marta Sánchez-Canales, Herminia Ortiz-Mayoral, Estefanía Cotillo-Ramos, Nuria Isabel Casado-Alarcón, Mónica Ballesta-Ruiz, Ramón Villaverde-González, José María García-Santos","doi":"10.1007/s10140-024-02274-6","DOIUrl":"10.1007/s10140-024-02274-6","url":null,"abstract":"<p><strong>Purpose: </strong>Fifty percent of cranial CT scans performed achieve no benefit and entail risks. Our aim is to determine the yield of non-traumatic urgent cranial-CT and develop a pretest clinical probability scale approach.</p><p><strong>Methods: </strong>Adult patients seen in our emergency department between 2017-2021 and referred for urgent cranial-CT for non-traumatic reasons were retrospectively recruited and randomly selected. Presenting complaint (PC), demographic variables, Relevant radiological findings (RRF) on the urgent cranial-CT and Relevant clinical-radiological findings (RCRF: admission need or RRF detection on the urgent cranial-CT or cranial CT/MRI in the following three months) were recruited.</p><p><strong>Results: </strong>We recruited 702 patients, with median age 62 [47-76] years, 363 (51.7%) females. RCRF were observed in 404 (57.55%); of these, 352 (50.1%) required admission. RRF were detected in 190 (27.06%): 36 acute ischemic and 27 acute hemorrhagic lesions, 115 masses, 9 edema, and 27 hydrocephalus. Predictive PC for urgent cranial-CT were motor, speech, sensory deficits, sudden alteration of mental status, epileptic seizure, cognitive impairment, neurological symptoms in cancer patients, acute headache without a prior history and with meningeal signs; nausea, vomiting, or hypertensive crisis; visual deficits, and dizziness. This algorithm provided sensitivity, specificity, positive predictive value, and negative predictive value (NPV, 95%CI in brackets) of 92.1% (89-94.5%), 27.5% (22.5-33.0%), 63.3% (59.2-67.2%), and 71.9% (62.7-80.0%), to diagnose RCRF, and 97.4% (93.4-99.1%), 21.3% (17.8-25.1%), 31.5% (27.7-35.4%), and 95.6% (90.1-98.6%), to diagnose RRF. In patients not requiring admission (n = 350), the NPV for RRF was 98.8% (93.6-100%); the negative likelihood ratio 0.08 (0.01-0.57), and sensitivity remained at 97.8% (82.2-99.9%). Applying it would have avoided performing 85/350 urgent cranial-CT (24.29%). To find one RRF, we would have gone from performing 7.8 (350/45) to 5.9 (265/45) CTs, failing to diagnose 1/45 (2.2%) RRF.</p><p><strong>Conclusions: </strong>This proposed clinical scale could potentially decrease 24% of urgent cranial-CT.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"835-843"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765742","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":"Current analysis of age and cervical spine fractures.","authors":"Armin Tafazolimoghadam, Mahla Radmard, Shuchi Zinzuwadia, Akua Afrah Amoah, Arjun Chanmugam, David M Yousem","doi":"10.1007/s10140-024-02291-5","DOIUrl":"10.1007/s10140-024-02291-5","url":null,"abstract":"<p><strong>Purpose: </strong>The Canadian Cervical Spine Rule (CCR) was based on patient data from 25 years ago and recommended cervical spine computed tomography (CSCT) for trauma patients aged 65 and older. We sought to determine the differences in rate of symptomatic and asymptomatic fractures of trauma patients ≥ 65 and < 65 years old, given the changing demographics and heterogeneity in today's elderly population.</p><p><strong>Methods: </strong>This retrospective study of CSCT results from two hospitals in our health system included 5 years of trauma patient data. In addition to the primary variable of fracture rates, we separated the patients into symptomatic / asymptomatic groups and ≥ 65 and < 65 years of age.</p><p><strong>Results: </strong>In the ≥ 65 age group, 190 fractures among 9455 CSCTs (2.0%) were identified (112 females = 58.9%); 29 (0.3%) were in asymptomatic patients. In patients < 65, there were 199 (1.6%) fractures out of 12,531 CSCTs of which 19 (0.15%) were asymptomatic and 46 were female (23.1%). The rates of fractures in the older cohort (2.0%) were substantially different than those reported in the original CCR articles (5.2% and 6.6%). However, the fracture rates reported for those < 65 (1.4% and 1.7% historically) were similar to the current findings (1.6%).</p><p><strong>Conclusion: </strong>The cervical spine fracture rate at our institution for patients ≥ 65, at 2.0%, was higher than those patients < 65 (1.6%) and favored female (58.9-23.1%) patients. The findings were much lower than those CCR percentages that led to scanning trauma patients who are 65 and older. Asymptomatic fractures are rarer still (0.15-0.30%).</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"881-886"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544437","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":"Radiology resident proficiency in pediatric trauma cases: a comparative analysis based on trauma center status using the WIDI SIM exam.","authors":"Kevin Pierre, Abheek Raviprasad, Alexandria Iakovidis, Isabella Amador, Jay Talati, Christopher Sistrom, Roberta Slater, Linda Lanier, Evelyn Anthony, Dhanashree Rajderkar, Anthony Mancuso, Priya Sharma","doi":"10.1007/s10140-024-02296-0","DOIUrl":"10.1007/s10140-024-02296-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the correlation between pediatric and adult trauma center status and radiology resident performance on pediatric trauma cases using the WIDI SIM exam.</p><p><strong>Materials and methods: </strong>The WIDI SIM is a validated computer-aided simulation that assesses radiology residents' preparedness for independent call duty. It includes 65 cases across various imaging modalities derived from actual patient encounters. Faculty score free-text responses using a standardized 0-10 scale rubric. We analyzed 8,488 WIDI SIM exam scores from 35 pediatric trauma cases across 52 programs. A negative binomial regression model adjusting for resident level, imaging modality, and case specialty was employed to evaluate the impact of pediatric and adult trauma center status on resident performance.</p><p><strong>Results: </strong>Both pediatric trauma center status (p = 0.0005) and adult trauma center status (p = 0.0003) were significant predictors of higher resident scores. Resident level was also significant, with higher-level residents performing better than first-year residents (p < 0.001). Residents performed worse on MR and US modalities compared to CT, and performance varied by case specialty.</p><p><strong>Conclusion: </strong>Radiology residents' pediatric trauma imaging skills are significantly linked to pediatric and adult trauma center status. Given most pediatric traumas occur outside pediatric trauma centers, targeted training strategies should be considered to ensure residents develop essential diagnostic skills.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"867-871"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644198","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}