Emergency Radiology最新文献_第6页

Predictors of diagnostic errors in computed tomography interpretation by emergency physicians leading to changes in clinical management in the emergency department. 急诊医生计算机断层扫描诊断错误导致急诊科临床管理改变的预测因素

IF 1.3

Emergency Radiology Pub Date : 2025-08-01 Epub Date: 2025-06-23 DOI: 10.1007/s10140-025-02357-y

Naoaki Shibata, Takafumi Yonemitsu, Nozomu Shima, Yuichi Miyake, Tomoya Fukui, Junya Fuchigami, Akira Ikoma, Tetsuo Sonomura, Shigeaki Inoue

{"title":"Predictors of diagnostic errors in computed tomography interpretation by emergency physicians leading to changes in clinical management in the emergency department.","authors":"Naoaki Shibata, Takafumi Yonemitsu, Nozomu Shima, Yuichi Miyake, Tomoya Fukui, Junya Fuchigami, Akira Ikoma, Tetsuo Sonomura, Shigeaki Inoue","doi":"10.1007/s10140-025-02357-y","DOIUrl":"10.1007/s10140-025-02357-y","url":null,"abstract":"Purpose: The use of computed tomography (CT) in the emergency department (ED) has been increasing due to its diagnostic value for emergency physicians (EPs). This study aimed to determine the predictors of EP interpretation errors (IEs) on CT scans leading to change in clinical management (IECM) in both endogenous and exogenous ED visits.Methods: This single-center, retrospective cohort study included patients with consecutive ED visits initially managed by EPs at our institution over 6 months. Patients who did not undergo CT imaging and presented with cardiopulmonary arrest upon arrival were excluded. CT images were interpreted by emergency radiologists immediately after acquisition, and IEs were identified. The primary outcome was IECM, determined by reference to the clinical management decisions made by EPs. A multivariate analysis was performed to determine the independent predictors of IECM.Results: Among the 2,037 patients, 158 (8%) had IEs, whereas 52 (3%) had IECM. Multisite CT imaging was the strongest independent predictor for both IECM (OR: 2.25, 95% CI: 1.21-4.19, P = 0.011) and IEs (OR: 2.32, 95% CI: 1.61-3.36, P < 0.001). Other predictors of IECM were prolonged ED stay and night-time ED visits as clinical factors. Additional predictors of overall IEs were contrast-enhanced CT and abdominopelvic CT as radiological factors.Conclusion: Multisite CT imaging, which involve multiple organs and extensive diagnostic information, significantly increases the likelihood of misinterpretation, leading to change in clinical management by EPs.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"513-522"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474256","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}

引用次数: 0

Preoperative intestine-to-liver CT ratio: useful predictor of resection in strangulated obstruction. 术前肠-肝CT比值：预测绞窄性梗阻切除的有用指标。

IF 1.3

Emergency Radiology Pub Date : 2025-08-01 Epub Date: 2025-07-16 DOI: 10.1007/s10140-025-02369-8

Seiichiro Fujishima, Hironori Tsujimoto, Yoshihisa Yaguchi, Hiroyuki Horiguchi, Keita Kouzu, Yusuke Ishibashi, Yujiro Itazaki, Takafumi Suzuki, Naoyuki Uehata, Risa Kariya, Asuma Ide, Hiroshi Shinmoto, Hideki Ueno

{"title":"Preoperative intestine-to-liver CT ratio: useful predictor of resection in strangulated obstruction.","authors":"Seiichiro Fujishima, Hironori Tsujimoto, Yoshihisa Yaguchi, Hiroyuki Horiguchi, Keita Kouzu, Yusuke Ishibashi, Yujiro Itazaki, Takafumi Suzuki, Naoyuki Uehata, Risa Kariya, Asuma Ide, Hiroshi Shinmoto, Hideki Ueno","doi":"10.1007/s10140-025-02369-8","DOIUrl":"10.1007/s10140-025-02369-8","url":null,"abstract":"Background: Prompt diagnosis of strangulated bowel obstruction (SBO) is critical because delayed recognition can lead to life-threatening complications. This study assessed whether the intestinal-to-liver CT attenuation value ratio-a comparison of ischemic bowel-wall enhancement to liver enhancement-can predict the need for intestinal resection in SBO patients.Materials and methods: We retrospectively analyzed 52 patients who underwent emergency surgery for suspected SBO from 2014 to 2021. Of these, 35 required intestinal resection due to irreversible ischemia (resection group), while 17 did not (no-resection group). Preoperative clinical and imaging findings were compared between groups.Results: The resection group had a longer time from onset to surgery (p = 0.034) and higher leukocyte counts (p = 0.037). CT values of the poorly enhanced intestinal wall and the intestinal-to-liver attenuation ratio were significantly lower in the resection group (p < 0.0001). Multivariate analysis identified time to surgery (OR 5.08; 95% CI 1.106-23.350; p = 0.037) and CT attenuation ratio (OR 15.50; 95% CI 2.622-91.686; p = 0.0025) as independent predictors of resection. When stratified by the median ratio cutoff (< 0.40 vs. ≥ 0.40), resection rates were 92% and 44%, respectively (p = 0.0001). Additionally, CT attenuation ratio had the diagnostic performance (AUROC 0.886; Youden index 0.736; sensitivity 97.1% and specificity 76.5%.) CONCLUSION: An intestinal-to-liver CT attenuation ratio below 0.40 is a strong predictor of intestinal ischemia requiring resection in SBO patients.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"581-589"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642113","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}

引用次数: 0

Identifying key CT features and clinical variables for predicting operative management of left ventricular assist device (LVAD) driveline infections. 确定预测左心室辅助装置（LVAD）传动系统感染手术处理的关键CT特征和临床变量。

IF 1.3

Emergency Radiology Pub Date : 2025-08-01 Epub Date: 2025-07-08 DOI: 10.1007/s10140-025-02363-0

Mahati Mokkarala, Aravinda Ganapathy, Yuktesh Kalidindi, Chelsea R Schmitt, Mark J Hoegger, Ryan G Short, Demetrios A Raptis, David H Ballard

{"title":"Identifying key CT features and clinical variables for predicting operative management of left ventricular assist device (LVAD) driveline infections.","authors":"Mahati Mokkarala, Aravinda Ganapathy, Yuktesh Kalidindi, Chelsea R Schmitt, Mark J Hoegger, Ryan G Short, Demetrios A Raptis, David H Ballard","doi":"10.1007/s10140-025-02363-0","DOIUrl":"10.1007/s10140-025-02363-0","url":null,"abstract":"Purpose: Despite technical advancements in left ventricular assist devices (LVADs), driveline infections (DLIs) remain a common complication evaluated by CT. The purpose of this study was to assess CT imaging features and clinical variables associated with operative versus non-operative management of LVAD DLIs.Materials/methods: This study analyzed 129 patients with LVAD driveline infections evaluated using CT. Two radiologists assessed CT scans for superficial and deep soft tissue stranding and fluid collections. Logistic regression was used to identify predictors of operative management using imaging and clinical variables, guided by Akaike information criterion. Results were reported as odds ratios, and Interreader agreement was evaluated using Cohen's Kappa.Results: Operative management was performed in 46.8% of patients. Positive driveline cultures (94.8% vs. 43.5%, p < 0.001) and new antibiotic use (98.3% vs. 72.7%, p < 0.001) were strongly associated with operative intervention. Mild subcutaneous fat stranding was the most frequent CT finding (62.6% and 66.9% by Readers 1 and 2, respectively), whereas deep fluid collections were rare (4.8-5.6%). Clinical predictors of operative management included new antibiotic use (p = 0.036), positive cultures (p < 0.001), and LVAD type. The resulting model achieved an AUC of 0.851 and overall accuracy of 78.6%. The absence of superficial fat stranding on CT significantly predicted non-operative management (p < 0.001).Conclusion: Positive driveline cultures, recent antibiotic initiation, and absence of skin or subcutaneous fat stranding on CT were associated with non-operative management in LVAD-related driveline infections. Absence of superficial fat stranding on CT may help distinguish suspected driveline infections that are unlikely to require surgical intervention.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"533-543"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583413","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 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 : 2025-08-01 Epub Date: 2025-06-21 DOI: 10.1007/s10140-025-02359-w

Husam H Mansour, Noor Khairiah A Karim, Noor Diyana Osman, Rohayu Hami, Yasser S Alajerami

{"title":"Diagnostic accuracy of chest CT for COVID-19 pneumonia in a resource-limited Gaza cohort: a retrospective study of 252 patients.","authors":"Husam H Mansour, Noor Khairiah A Karim, Noor Diyana Osman, Rohayu Hami, Yasser S Alajerami","doi":"10.1007/s10140-025-02359-w","DOIUrl":"10.1007/s10140-025-02359-w","url":null,"abstract":"Purpose: The study aimed to evaluate the diagnostic accuracy of chest CT for COVID-19 pneumonia in resource-limited Gaza. It compared CT performance to RT-PCR and examined how CT severity scores and interobserver agreement influence diagnostic accuracy, reproducibility, and clinical utility for early detection and triage.Methods: A retrospective analysis was performed on 252 consecutive patients diagnosed with COVID-19 pneumonia between September 2020 and June 2021 at three major governmental hospitals across the Gaza Strip. Chest CT scans were compared to RT-PCR as the gold standard for diagnosis. CT severity scores were calculated using a 25-point system, and interobserver agreement was assessed using kappa statistics. Sensitivity, specificity, and predictive values were calculated for various threshold levels.Results: Among the 252 patients included in the study, the mean age was 56.81 ± 11.34 years, with 113 males and 139 females. The diagnostic sensitivity of chest CT was 91.4%, with a specificity of 76.4%. The highest accuracy was observed with a severity score threshold of ≥ 15, with a Youden index of 0.630. Interobserver agreement was excellent (kappa = 0.87) for ground-glass opacities and consolidation. The NPV was 71.2%, indicating the need for supplementary RT-PCR testing in low-prevalence cases.Conclusion: Chest CT is a reliable diagnostic adjunct for COVID-19 pneumonia, especially in Gaza's severely resource-limited setting, where CT was more accessible than RT-PCR. A CT severity score threshold of ≥ 15 offers an optimal balance of sensitivity and specificity. These findings highlight the practical role of CT imaging in pandemic response in resource-constrained environments.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"503-511"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336324","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

Wide-Detector CT-Based optimized triple Rule-Out CT angiography for emergency chest pain: reducing contrast and radiation without compromising diagnostic quality. 基于宽探测器CT的优化三重排除CT血管造影用于急诊胸痛：在不影响诊断质量的情况下降低对比度和辐射。

IF 1.3

Emergency Radiology Pub Date : 2025-08-01 Epub Date: 2025-05-28 DOI: 10.1007/s10140-025-02351-4

Qiuhua Zhang, Kun Wang, Hong Ren

{"title":"Wide-Detector CT-Based optimized triple Rule-Out CT angiography for emergency chest pain: reducing contrast and radiation without compromising diagnostic quality.","authors":"Qiuhua Zhang, Kun Wang, Hong Ren","doi":"10.1007/s10140-025-02351-4","DOIUrl":"10.1007/s10140-025-02351-4","url":null,"abstract":"Background: The triple rule-out computed tomography angiography (TRO-CTA) has recently emerged as a technique that noninvasively evaluates the coronary arteries (CAs), the pulmonary arteries (PAs) and the thoracic aorta (TA).Objective: To evaluate the feasibility of an optimized scanning protocol to reduce the volume of iodine contrast media (ICM), injection rate, and radiation dose in patients undergoing TRO-CTA.Methods: Patients undergoing TRO-CTA were assigned to either group A or group B using a 16 cm wide-detector CT. Patients in group A were imaged with a traditional triple scanning protocol with a sequence of the PA, CAs, and TA. Patients in group B were imaged using the modified protocol with scanning sequence of PA, TA, and CAs, ICM of 55 ml, and injection rate of 4.5 mL/s. The image quality and effective radiation dose (ED) were compared.Results: There were no significant differences in basic information between groups A and B. Other than the left PA, RA, and RV, there were no significant differences in the CT attenuation values of relevant vascular structures between groups A and B. There were no significant differences in CNR values between the two groups except the LAD-D and LCX. The image quality scores were comparable between groups A and B except the CAs. However, there were significant differences between the two groups in ICM (p < 0.05), scanning time (p < 0.001) and ED (p = 0. 023).Conclusions: The optimized TRO-CTA scanning protocol can achieve less ICM and lower ED while maintaining image quality.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"551-558"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157375","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}

引用次数: 0

Investigating clinical indicators for neuroimaging abnormalities in acute headache cases: insights from a retrospective study. 研究急性头痛病例神经影像学异常的临床指标：来自回顾性研究的见解。

IF 1.7

Emergency Radiology Pub Date : 2025-06-01 Epub Date: 2025-05-14 DOI: 10.1007/s10140-025-02347-0

Felipe Mejía-Herrera, Roger Figueroa-Paz, Jaime Quintero-Ramirez, Luis Alfonso Bustamante-Cristancho

{"title":"Investigating clinical indicators for neuroimaging abnormalities in acute headache cases: insights from a retrospective study.","authors":"Felipe Mejía-Herrera, Roger Figueroa-Paz, Jaime Quintero-Ramirez, Luis Alfonso Bustamante-Cristancho","doi":"10.1007/s10140-025-02347-0","DOIUrl":"10.1007/s10140-025-02347-0","url":null,"abstract":"Purpose: Headache is common at emergency services and neuroimaging can help in timely diagnosis of life-threatening pathologies. We evaluated clinical indicators associated with abnormal neuroimaging in patients with acute headache, aiming to develop a scoring system with reliable diagnostic performance.Methods: This analytical and retrospective study was conducted at a teaching tertiary care hospital in Cali, Colombia, from January 2011 to December 2019. Patients aged 18 years or older with non-traumatic headaches who attended the emergency department and underwent neuroimaging were included. Demographic and clinical data were recorded, including headache associated signs and symptoms, imaging diagnosis and disposition. Statistically significant variables and clinically relevant variables were selected. Data was analyzed using a combination of logistic regression and Receiver Operator Characteristic (ROC) curves, leading to the derivation of three models.Results: 626 patients were included, 15.5% with abnormal neuroimaging. The variables with the highest odds ratio (OR) were: age > 40 years (OR 3.2 CI 1.86-5.56), motor deficit (OR 5.4 CI 2.62-11.18), visual deficit (OR 3.2 CI 1.56-6.63) and gait disturbance (OR 2.27 CI 0.87-5.96). Three abnormal neuroimaging prediction logistic regression models have been derived. The better scale is performed with model 1, which is validated internally and a cut-off point of 0.179, the Area Under the Curve (AUC) of 0.757 is obtained with a diagnostic accuracy of 0.79 (0.73-0.85).Conclusion: Our straightforward scale incorporates clinical factors associated with abnormal neuroimaging, with the aim of improving diagnostic performance and predictive capacity to distinguish patients who require neuroimaging.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"351-360"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973302","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

Imaging of acute small bowel pathologies in oncology patients in the ER part I: the role of Computed Tomography (CT) for the evaluation of Tumor and infections. 肿瘤学患者急性小肠病变的影像学研究：第一部分：计算机断层扫描（CT）在肿瘤和感染评估中的作用。

IF 1.7

Emergency Radiology Pub Date : 2025-06-01 Epub Date: 2025-04-14 DOI: 10.1007/s10140-025-02341-6

Hajra Arshad, Satomi Kawamoto, Linda C Chu, Elliot K Fishman

{"title":"Imaging of acute small bowel pathologies in oncology patients in the ER part I: the role of Computed Tomography (CT) for the evaluation of Tumor and infections.","authors":"Hajra Arshad, Satomi Kawamoto, Linda C Chu, Elliot K Fishman","doi":"10.1007/s10140-025-02341-6","DOIUrl":"10.1007/s10140-025-02341-6","url":null,"abstract":"Acute abdominal complaints constitute up to 40% of all emergency department (ED) presentations in oncology patients due to a multitude of causes. Small bowel pathologies present a diagnostic challenge due to their diverse range and frequently overlapping clinical presentation. In oncology patients, structural changes resulting from tumor growth, surgery and treatment effects can further complicate the diagnostic process. Due to a weakened immune system, oncology patients are also highly susceptible to infections of the gastrointestinal tract (GIT). Traditional computed tomography (CT) scans are used as the gold standard diagnostic modality. However, three-dimensional (3D) postprocessing techniques including maximal intensity projection (MIP), volume rendering (VR) and cinematic rendering (CR) have been employed to aid image evaluation. For a balanced and organized approach to describe diagnostic challenges in this complex population, we have divided the pictorial essay into two parts. The first part focuses on tumor- and infection-associated causes, as summarized below in the visual abstract. The second part will address treatment-related complications, including chemotherapy, radiotherapy, immunotherapy, graft-versus-host disease and post-surgical complications.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"463-474"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971923","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

Predicting hemorrhagic transformation in acute ischemic stroke: a systematic review, meta-analysis, and methodological quality assessment of CT/MRI-based deep learning and radiomics models. 预测急性缺血性卒中的出血转化：基于CT/ mri的深度学习和放射组学模型的系统回顾、荟萃分析和方方法论质量评估。

IF 1.3

Emergency Radiology Pub Date : 2025-06-01 Epub Date: 2025-03-26 DOI: 10.1007/s10140-025-02336-3

Mohsen Salimi, Pouria Vadipour, Amir Reza Bahadori, Shakiba Houshi, Ali Mirshamsi, Hossein Fatemian

{"title":"Predicting hemorrhagic transformation in acute ischemic stroke: a systematic review, meta-analysis, and methodological quality assessment of CT/MRI-based deep learning and radiomics models.","authors":"Mohsen Salimi, Pouria Vadipour, Amir Reza Bahadori, Shakiba Houshi, Ali Mirshamsi, Hossein Fatemian","doi":"10.1007/s10140-025-02336-3","DOIUrl":"10.1007/s10140-025-02336-3","url":null,"abstract":"Acute ischemic stroke (AIS) is a major cause of mortality and morbidity, with hemorrhagic transformation (HT) as a severe complication. Accurate prediction of HT is essential for optimizing treatment strategies. This review assesses the accuracy and utility of deep learning (DL) and radiomics in predicting HT through imaging, regarding clinical decision-making for AIS patients. A literature search was conducted across five databases (Pubmed, Scopus, Web of Science, Embase, IEEE) up to January 23, 2025. Studies involving DL or radiomics-based ML models for predicting HT in AIS patients were included. Data from training, validation, and clinical-combined models were extracted and analyzed separately. Pooled sensitivity, specificity, and AUC were calculated with a random-effects bivariate model. For the quality assessment of studies, the Methodological Radiomics Score (METRICS) and QUADAS-2 tool were used. 16 studies consisting of 3,083 individual participants were included in the meta-analysis. The pooled AUC for training cohorts was 0.87, sensitivity 0.80, and specificity 0.85. For validation cohorts, AUC was 0.87, sensitivity 0.81, and specificity 0.86. Clinical-combined models showed an AUC of 0.93, sensitivity 0.84, and specificity 0.89. Moderate to severe heterogeneity was noted and addressed. Deep-learning models outperformed radiomics models, while clinical-combined models outperformed deep learning-only and radiomics-only models. The average METRICS score was 62.85%. No publication bias was detected. DL and radiomics models showed great potential in predicting HT in AIS patients. However, addressing methodological issues-such as inconsistent reference standards and limited external validation-is essential for the clinical implementation of these models.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"409-433"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709141","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 a new computed tomography severity score in hemorrhagic fever with renal syndrome. 一种新的计算机断层扫描严重程度评分对肾综合征出血热的预后价值。

IF 1.7

Emergency Radiology Pub Date : 2025-06-01 Epub Date: 2025-03-12 DOI: 10.1007/s10140-025-02322-9

Se Woo Kim, Cheong-Il Shin, Min Woo Kang, Min Cheol Kim, Donghwan Kim

{"title":"Prognostic value of a new computed tomography severity score in hemorrhagic fever with renal syndrome.","authors":"Se Woo Kim, Cheong-Il Shin, Min Woo Kang, Min Cheol Kim, Donghwan Kim","doi":"10.1007/s10140-025-02322-9","DOIUrl":"10.1007/s10140-025-02322-9","url":null,"abstract":"Purpose: To develop of a novel computed tomography (CT) severity score for hemorrhagic fever with renal syndrome (HFRS) and evaluate its correlation with disease severity and adverse outcomes.Methods: This retrospective study included 37 patients diagnosed with HFRS from January 2012 to December 2023 who had available clinical laboratory and abdominal CT data during the acute phase. The CT severity score (range 0-5) was based on perirenal fat stranding, pararenal fascia thickening, anterior pararenal space fat stranding, ascites, and pleural effusion. Correlations between the score and markers of inflammation, thrombocytopenia, proteinuria, and adverse outcomes-including nephrotic range proteinuria and renal replacement therapy (RRT)-were analyzed.Results: The CT severity score exhibited moderate to strong correlations with markers of inflammation (white blood cell count, ρ = 0.65, p < 0.001), thrombocytopenia (platelet count, ρ = -0.54, p < 0.001), and proteinuria (urine protein-to-creatinine ratio, ρ = 0.56, p < 0.001). Higher scores were associated with increased nephrotic range proteinuria in Chi-squared test for trend (p-for-trend = 0.001). A one-point increase in the score significantly increased odds of requiring RRT in logistic regression analysis (odds ratio: 9.89, p = 0.047). The score achieved an area under the receiver operating characteristics curve of 0.819 for predicting RRT.Conclusion: The CT severity score correlates well with disease severity and adverse outcomes in HFRS and can be assessed using noncontrast CT, making it a valuable prognostic tool in young male population. Further validation in diverse populations is warranted.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"377-385"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613967","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}

引用次数: 0

Imaging of acute small bowel pathologies in oncology patients in the ER part II: the role of computed tomography (CT) in detection of treatment-related small bowel complications. 急诊肿瘤患者急性小肠病变的影像学第二部分：计算机断层扫描（CT）在检测治疗相关小肠并发症中的作用。

IF 1.7

Emergency Radiology Pub Date : 2025-06-01 Epub Date: 2025-04-12 DOI: 10.1007/s10140-025-02342-5

Hajra Arshad, Satomi Kawamoto, Linda C Chu, Elliot K Fishman

{"title":"Imaging of acute small bowel pathologies in oncology patients in the ER part II: the role of computed tomography (CT) in detection of treatment-related small bowel complications.","authors":"Hajra Arshad, Satomi Kawamoto, Linda C Chu, Elliot K Fishman","doi":"10.1007/s10140-025-02342-5","DOIUrl":"10.1007/s10140-025-02342-5","url":null,"abstract":"There is a high burden of acute abdomen presentations in oncology patients, stemming from tumor development, surgical interventions, and the side effects of treatments on the gastrointestinal tract. Chemotherapy, radiotherapy and postsurgical complications have previously been shown to affect the small bowel; however, newer modalities of cancer treatment including immunotherapy and antiangiogenic therapy have also been seen to cause bowel injury. Traditional computed tomography (CT) scans are used as the gold standard diagnostic modality. However, three-dimensional (3D) postprocessing techniques including maximal intensity projection (MIP), volume rendering (VR) and cinematic rendering (CR) have been utilized for image interpretation. For a more organized approach to describe diagnostic challenges in this complex population, we have divided the pictorial essay into two parts. The first part focused on tumor- and infection-associated causes. This second part will address treatment-related complications, including chemotherapy, radiotherapy, immunotherapy, graft-versus-host disease and post-surgical complications as summarized below.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"475-482"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974627","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