Emergency Radiology最新文献

{"title":"Clinical evaluation of an AI-based pneumonia detection system on chest CT: a qualitative and quantitative analysis.","authors":"Hamza Sekkat, Youssef Madkouri, Abdellah Khallouqi, Mohammed Talbi, Oussama El Mouden, Abdellah Halimi, Omar El Rhazouani, Youssef El Merabet, Farida Bentayeb","doi":"10.1007/s10140-026-02465-3","DOIUrl":"10.1007/s10140-026-02465-3","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"653-665"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638222","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":"Non-medical drivers of health and imaging patterns in intimate partner violence.","authors":"Patrick J Lenehan, Jaya Prakash, Sheryl Fuehrer, Rahul Gujrathi, Krishna Patel, Annie Lewis O'Connor, Efren Flores, Bernard Rosner, Bharti Khurana","doi":"10.1007/s10140-026-02485-z","DOIUrl":"10.1007/s10140-026-02485-z","url":null,"abstract":"<p><strong>Purpose: </strong>Non-medical drivers of health (NMDH) impact the risks and outcomes of intimate partner violence (IPV). Here, we investigate the relationship between NMDH and radiological manifestations of IPV.</p><p><strong>Methods: </strong>This study analyzed female cases (N = 151) reporting IPV between 2013 and 2018 and controls (N = 146) who did not report IPV, each with at least one radiologic study and social work note. NMDH variables were collected, including age, race, language, primary care provider, social support, social services, housing stability, and area deprivation index. Radiology reports were reviewed to determine injuries and severity. Each patient received a cumulative NMDH index ranging from 0 (no NMDH risk factors) to 5 (maximal risk factors). Poisson and logistic regression were used to calculate adjusted incidence rate ratios (aIRR) and odds ratios (aOR) for imaging utilization and injuries with respect to NMDH risk factors.</p><p><strong>Results: </strong>NMDH variables associated with IPV included lack of a primary care provider (p = 0.0034), lack of social support ( p < 0.0001), use of social services (p < 0.001), housing instability (p < 0.0001), and a higher NMDH index (p = 0.0002). Imaging utilization rates were not significantly different between patients with a higher versus lower NMDH index for cases (aIRR: 0.84, p = 0.24) or controls (aIRR: 0.72, p = 0.19). Among cases, a higher NMDH index was associated with increased odds of injury detection on radiologic studies (aOR: 1.78, p = 0.008).</p><p><strong>Conclusions: </strong>Multiple NMDH risk factors are associated with higher odds of IPV-related injuries visible on imaging. Integrating NMDH variables into clinical risk stratification tools may facilitate earlier identification and intervention for patients who experience IPV.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"845-853"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT pulmonary angiography findings and in-hospital outcomes of acute pulmonary embolism in a community hospital.","authors":"Sutthatip Intachai","doi":"10.1007/s10140-026-02478-y","DOIUrl":"10.1007/s10140-026-02478-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prognostic value of computed tomography pulmonary angiography (CTPA)-derived imaging parameters, particularly the right ventricular to left ventricular (RV/LV) diameter ratio, for predicting in-hospital mortality and severe clinical outcomes in patients with acute pulmonary embolism in a community hospital.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included adult patients with acute pulmonary embolism confirmed by CTPA between July 2021 and July 2025. The RV/LV diameter ratio was measured on axial images and analyzed as both a continuous variable and dichotomized at ≥ 1.0. Clinical outcomes included in-hospital mortality and a composite severe outcome comprising death, intensive care unit admission, or mechanical ventilation.</p><p><strong>Results: </strong>Twenty-four patients were included, most hemodynamically stable at presentation. The median RV/LV ratio was 0.77 (0.39-1.91), with eight patients (33.3%) having a ratio ≥ 1.0. In-hospital mortality occurred in two patients (8.3%), and seven (29.2%) experienced the composite severe outcome. RV/LV ratios were numerically higher in non-survivors than survivors, without statistically significant difference. No significant association was observed between RV/LV ratio and composite severe outcomes in continuous or dichotomized analyses (RR 0.97, 95% CI 0.24-3.88), with substantial overlap between groups.</p><p><strong>Conclusion: </strong>In this community hospital cohort, the CTPA-derived RV/LV ratio showed limited ability to discriminate adverse in-hospital outcomes and should be interpreted alongside clinical assessment rather than used as a standalone marker. Given the small sample size and limited number of events, these findings are exploratory and may reflect limited statistical power. Further validation in larger multicenter cohorts is needed.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"719-725"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722353","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":"Reduced variability of pulmonary artery enhancement using a single-acquisition combined first-pass and inferior-vena-cava-derived second-pass contrast technique in CT pulmonary angiography.","authors":"Yuya Kawakami, Ryosuke Irie, Yoshiki Yamagishi, Toshihiko Sugiura, Takashi Matsumoto, Takashi Iimori, Takashi Uno","doi":"10.1007/s10140-026-02520-z","DOIUrl":"https://doi.org/10.1007/s10140-026-02520-z","url":null,"abstract":"<p><strong>Purpose: </strong>First-pass imaging using the bolus tracking (BT) method is recommended for computed tomography (CT) pulmonary angiography (CTPA) in pulmonary thromboembolism. However, pulmonary artery (PA) CT numbers remain low despite continuous contrast injection, potentially due to Valsalva maneuver and volume effects. Our institution has introduced a single-acquisition protocol for CTPA that prolongs contrast injection time and captures overlapping first-pass and inferior-vena-cava (IVC)-derived second-pass recirculation. This study aimed to compare PA attenuation and enhancement variability between the conventional BT method and the new combined technique.</p><p><strong>Methods: </strong>Ninety-three patients who underwent CT for acute pulmonary thromboembolism were analyzed. Injection times were 30 s for the BT method and 50 s for the new method. In the BT method, scanning was initiated when attenuation in the ascending aorta reached 150 HU. In the new method, scanning was initiated 43 s after the start of contrast injection. CT number of the PA was measured, with values < 200 HU considered indicative of poor enhancement.</p><p><strong>Results: </strong>PA attenuation variability was lower with the new method than with the BT method (coefficient of variation, 16.4% vs. 29.5%). Although mean attenuation was higher with the BT method (332.8 ± 98.7 HU vs. 288.2 ± 47.3 HU), four cases of poor enhancement were observed with the BT method, whereas no such cases occurred with the new method.</p><p><strong>Conclusion: </strong>The single-acquisition combined first-pass and IVC-derived second-pass contrast enhancement technique reduced enhancement variability and provided more consistent PA enhancement than the conventional BT method, without additional radiation exposure or contrast dose.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600245","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":"Intravascular projectile embolism from firearm injuries: How did it get there?","authors":"Carlos Felipe Marín-Díaz, Santiago Quiceno-Ramírez, Karen Juliana Salinas-Castro, Erika Andrea Rincón-Escobar","doi":"10.1007/s10140-026-02522-x","DOIUrl":"https://doi.org/10.1007/s10140-026-02522-x","url":null,"abstract":"<p><p>Intravascular projectile embolization is a rare but potentially fatal complication of penetrating firearm injury, in which a low-energy projectile enters the cardiovascular system and migrates to a site remote from the wound of entry. Because the projectile comes to rest far from its expected trajectory, the diagnosis rests on imaging and may be overlooked. This pictorial essay reviews the classification and imaging of ballistic embolization from a mechanism-based, side-of-circulation perspective, illustrated by three cases spanning antegrade and retrograde migration within both the left and right circulation. CT angiography is the cornerstone of diagnosis, classification, and treatment planning; the projectile-trajectory mismatch is the key diagnostic clue, and classification by side of circulation determines management. Awareness of these atypical migration patterns helps radiologists maintain an appropriate search pattern, anticipate unexpected embolic sites, and communicate urgent findings that direct multidisciplinary management.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583824","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":"Incidental findings identified by universal screening for BCVI using CT angiography.","authors":"Madeline Manka, Kyle Kelleran, Michael Manka, Douglas Drumsta","doi":"10.1007/s10140-026-02517-8","DOIUrl":"https://doi.org/10.1007/s10140-026-02517-8","url":null,"abstract":"<p><strong>Purpose: </strong>Blunt cerebrovascular injuries (BCVIs) are injuries to the carotid or vertebral arteries resulting from blunt trauma. Screening for BCVI is done using neck computed tomographic angiography (CTA). Although several screening protocols have been developed, many institutions, including our regional Level 1 trauma center, have implemented universal screening protocols to ensure no injuries are missed. When screening for acute injuries, incidental findings (IFs) may be discovered as a result. The aim of this study is to determine the incidence of IFs discovered with universal screening for BCVI.</p><p><strong>Methods: </strong>Priority 1 and 2 adult (≥ 18) blunt trauma patients presenting between April 2023 and April 2024 were identified from our trauma registry. Medical records were retrospectively reviewed to identify the incidence of IFs in patients screened for BCVI.</p><p><strong>Results: </strong>A total of 1,832 eligible blunt trauma patients were evaluated, of whom 1,554 (84.83%) underwent screening with neck CTA. Of these, 58 patients (3.73%) had CTA evidence of BCVI, 20 (34.48%) of whom had no risk factors based on the expanded Denver criteria. A total of 265 IFs were discovered in 224 patients (14.55%). Included in these IFs were chronic arterial occlusions (n = 27), aneurysms (n = 9), moderate-severe stenoses (n = 139), and significant thyroid nodules (n = 26). Eighty-one patients (36.16%) were discharged yet had no evidence in their records that they were informed of these incidental findings.</p><p><strong>Conclusions: </strong>IFs are identified in a significant percentage of blunt trauma patients with universal screening for BCVI. Trauma centers using universal screening for BCVI must have protocols in place for informing patients of IFs to ensure proper follow-up care is obtained for these patients.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520213","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":"Bibliometric productivity of academic emergency radiology faculty in the United States: Current status.","authors":"Roni Kazazi, David M Yousem, Mehmet Emin Adin","doi":"10.1007/s10140-026-02503-0","DOIUrl":"https://doi.org/10.1007/s10140-026-02503-0","url":null,"abstract":"<p><strong>Background and purpose: </strong>Bibliometric benchmarks for academic emergency radiology faculty are not well established. We assessed the bibliometric profiles of U.S. academic emergency radiology faculty and determined the independent contributions of academic rank, faculty track, sex, and fellowship institution affiliation to scholarly productivity. A secondary aim was to compare bibliometric productivity of emergency radiology faculty against four other radiology subspecialties using rank-adjusted cross-subspecialty models.</p><p><strong>Materials and methods: </strong>This cross-sectional bibliometric analysis included 518 emergency radiology faculty from 67 U.S. institutions, with data collected from Scopus between September and December 2025. For cross-subspecialty comparisons, linear mixed-effects models adjusting for rank and institutional clustering were applied.</p><p><strong>Results: </strong>No significant sex differences were found at any rank after Bonferroni correction. Research/tenure-track faculty were significantly more productive than clinical-track faculty at the associate and full professor levels, but not at the assistant professor level. The productivity advantage of ASER-recognized fellowship institutions was entirely explained by their higher proportion of research/tenure-track faculty. After rank adjustment, emergency radiology faculty had significantly lower bibliometric output than neuroradiology and cardiothoracic imaging faculty (all p < 0.001). Interventional radiology was the most comparable subspecialty, with no significant differences in citations or h-index.</p><p><strong>Conclusions: </strong>Academic rank is the primary driver of bibliometric productivity in emergency radiology. Based on the findings of this study, faculty track independently influences output at mid- and senior career stages. No significant sex differences were identified. The fellowship institution productivity advantage reflects track composition rather than program presence. Emergency radiology faculty demonstrate lower rank-adjusted output than neuroradiology and cardiothoracic imaging, while remaining most comparable to interventional radiology.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of non-iatrogenic intramural esophageal dissection in the Emergency Department: Case report and literature review.","authors":"Ignacio Maldonado Schoijet, Oscar Campos Ramírez, Francisca Aliaga Plaza, Carmen Ginesta Frings, Sofía Maldonado Alcalde, Giancarlo Schiappacasse Faundes","doi":"10.1007/s10140-026-02513-y","DOIUrl":"https://doi.org/10.1007/s10140-026-02513-y","url":null,"abstract":"<p><p>Non-iatrogenic intramural esophageal dissection is a rare condition caused by the transverse and longitudinal separation of the mucosal and submucosal layers of the esophageal wall, with or without perforation, which leads to the separation of the submucosal and muscular layers and forms a false submucosal lumen. It can occur spontaneously or be related to iatrogenic causes or trauma, with the latter often associated with the ingestion of certain foods or medical pills. We present three cases of non-iatrogenic intramural esophageal dissection and review relevant literature. We discuss the causes, symptoms, prognosis, and, primarily, the radiologist's role in promptly diagnosing this condition, especially in the Emergency Department (ER).</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344412","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":"Modeling emergency radiology demand for FIFA 2026 and the Los Angeles 2028 Olympic Games using discrete-event simulation.","authors":"Jonathan Lee, Nathan Kim, Eric D Cyphers, Brandon K K Fields, Bryce D Beutler, Ali Gholamrezanezhad, John Brunner","doi":"10.1007/s10140-026-02510-1","DOIUrl":"https://doi.org/10.1007/s10140-026-02510-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate emergency CT interpretation demand during major sporting events, characterize surge-related backlog and turnaround time, and estimate how threshold-based teleradiology support could affect queue performance during short event-related imaging boluses.</p><p><strong>Methods: </strong>We developed a Monte Carlo discrete-event simulation in Python to model an 8-h emergency radiology shift with baseline CT demand and a 2-h event-related surge. CT arrivals followed a Poisson process. Local and teleradiology radiologists were modeled as parallel servers with stochastic interpretation times. Two scenarios were compared across 500 Monte Carlo iterations: local radiologists only and local radiologists supplemented by a rapid-response teleradiology team activated when the unread CT backlog reached 10 cases. Primary outcomes included mean turnaround time, 90th percentile turnaround time, unread queue wait time, maximum unread backlog, number of cases delayed for more than 60 min, and time above the activation threshold.</p><p><strong>Results: </strong>The model generated a mean of 132.7 CT examinations per shift in both scenarios. Local-only coverage resulted in a mean turnaround time of 48.7 min and a 90th percentile turnaround time of 89.6 min. With teleradiology support, the mean turnaround time decreased to 18.0 min, and the 90th percentile to 37.3 min. Mean maximum unread backlog decreased from 27.7 to 16.2 cases, and the mean number of cases delayed longer than 60 min decreased from 47.4 to 2.0. Sensitivity analysis showed that saturation risk increased sharply when surge arrivals rose and local staffing remained limited.</p><p><strong>Conclusion: </strong>Discrete-event simulation can help emergency radiology departments estimate when CT interpretation workflows may become saturated during major sporting events. In this model, threshold-based teleradiology reduced backlog and turnaround time but functioned as a surge buffer rather than a substitute for adequate local staffing and predefined escalation pathways.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337497","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":"Emphysematous cystitis: imaging patterns and diagnostic approach on CT.","authors":"Hajra Arshad, Satomi Kawamoto, Elliot K Fishman","doi":"10.1007/s10140-026-02506-x","DOIUrl":"https://doi.org/10.1007/s10140-026-02506-x","url":null,"abstract":"<p><p>Emphysematous cystitis, also known as 'cystitis emphysematosa,' is a rare complicated urinary tract infection characterized by gas within the bladder wall. Most cases are mild and detected incidentally; however, delayed management can lead to significant morbidity and mortality, particularly when infection extends to the upper urinary tract. With increasing use of cross-sectional imaging, radiologists are encountering this condition more frequently. This pictorial review presents 20 cases of emphysematous cystitis from our institution, illustrating the range of CT imaging patterns and clinical features from representative cases. We identified three distinct patterns of gas distribution: loculated or curvilinear focal collections (40% of cases), single layer of cobblestone/beaded necklace pattern (30% of cases), and circumferential dissection of the bladder wall with multilayered gas (30% of cases). Diabetes is the most common predisposing factor. Other risk factors included neurogenic bladder, long-term urinary catheters, immunosuppression, chemotherapy, recurrent urinary stones, and frequent urologic procedures. The clinical presentation ranges from incidental detection on imaging to symptomatic patients presenting with acute abdomen and dysuria in the emergency department (ED). Treatment primarily consists of antibiotic therapy, with surgical intervention required only in select severe cases. Understanding these CT patterns along with the associated clinical features and risk factors allows radiologists to accurately diagnose emphysematous cystitis and guide timely clinical management.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276400","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}