Emergency Radiology最新文献

{"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}

{"title":"Patient factors associated with embolization or splenectomy within 30 days of initiating surveillance for splenic trauma.","authors":"Fatah Tidadini, Eugenie Martinet, Jean-Louis Quesada, Alison Foote, Chayma El Wafir, Edouard Girard, Catherine Arvieux","doi":"10.1007/s10140-024-02285-3","DOIUrl":"10.1007/s10140-024-02285-3","url":null,"abstract":"<p><strong>Background: </strong>Non-operative management of hemodynamically stable patients with splenic trauma has been recommended for more than 25 years, but in practice embolization and/or splenectomy (intervention) is often needed within the first 30 days. Identifying the risk factors associated with the need for intervention could support more individualized decision-making.</p><p><strong>Methods: </strong>We used data from the SPLASH randomized clinical trial, a comparison of outcomes of surveillance or embolization. 140 patients were randomized, 133 retained in the study (embolization n = 66; surveillance n = 67) and 103 screened and registered in the non-inclusion register. Multivariate Cox proportional hazards models with time-varying covariates were used to identify risk factors contributing to embolization and/or splenectomy within 30 days after initiating surveillance only for splenic trauma.</p><p><strong>Results: </strong>123 patients (median age, 30 [23; 48] years; 91 (74%) male) initially received non-operative management. At the day-30 visit, 34 (27.6%) patients had undergone an intervention (31 (25.2%) delayed embolization and 4 (3.3%) splenectomy). Multivariate analysis identified patients with OIS grade 4 or 5 splenic trauma (HR = 4.51 [2.06-9.88]) and (HR = 34.5 [6.84-174]); respectively) and splenic complications: arterial leak (HR = 1.80 [1.45-2.24]), pseudoaneurysm (HR = 1.22 [1.06-1.40]) and pseudocyst (HR = 1.41 [1.21-1.64]) to be independently associated with increased risk of need for an intervention within 30 days of initiating surveillance.</p><p><strong>Conclusions: </strong>Our study shows that more than 1 in 4 patients who received non-operative management needed embolization or splenectomy by day 30. Arterial leak, pseudoaneurysm, pseudocyst, and OIS grade 4 or 5 were independent risk factors linked to the need for an intervention.</p><p><strong>Trial registration: </strong>clinicaltrials.gov Identifier NCT02021396.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"823-833"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371336","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":"Emergency imaging protocols for pregnant patients: a multi-institutional and multi- specialty comparison of physician education.","authors":"Liesl Eibschutz, Max Yang Lu, Payam Jannatdoust, Angela C Judd, Claire A Justin, Brandon K K Fields, Natalie L Demirjian, Madan Rehani, Sravanthi Reddy, Ali Gholamrezanezhad","doi":"10.1007/s10140-024-02284-4","DOIUrl":"10.1007/s10140-024-02284-4","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies have demonstrated that radiologists and other providers perceive the teratogenic risks of radiologic imaging to be higher than they actually are. Thus, pregnant patients were less likely to receive ionizing radiation procedures. While it is imperative to minimize fetal radiation exposure, clinicians must remember that diagnostic studies should not be avoided due to fear of radiation, particularly if the imaging study can significantly impact patient care. Although guidelines do exist regarding how best to image pregnant patients, many providers are unaware of these guidelines and thus lack confidence when making imaging decisions for pregnant patients. This study aimed to gather information about current education, confidence in, and knowledge about emergency imaging of pregnant women among radiology, emergency medicine, and OB/GYN providers.</p><p><strong>Methods: </strong>We created and distributed an anonymous survey to radiology, emergency medicine, and OB/GYN providers to evaluate their knowledge and confidence in imaging pregnant patients in the emergent setting. This study included a questionnaire with the intent of knowing the correct answers among physicians primarily across the United States (along with some international participation). We conducted subgroup analyses, comparing variables by specialty, radiology subspecialty, and training levels. Based on the survey results, we subsequently developed educational training videos.</p><p><strong>Results: </strong>108 radiologists, of which 32 self-identified as emergency radiologists, ten emergency medicine providers and six OB/GYN clinicians completed the survey. The overall correct response rate was 68.5%, though performance across questions was highly variable. Within our 18-question survey, four questions had a correct response rate under 50%, while five questions had correct response rates over 90%. Most responding physicians identified themselves as either \"fairly\" (58/124, 47%) or \"very\" (51/124, 41%) confident. Amongst specialties, there were differences in performance concerning the knowledge assessment (p = 0.049), with the strongest performance from radiologists. There were no differences in knowledge by training level (p = 0.4), though confidence levels differed significantly between attending physicians and trainees (p < 0.001).</p><p><strong>Conclusion: </strong>This study highlights deficiencies in knowledge to support appropriate decision-making surrounding the imaging of pregnant patients. Our results indicate the need for improved physician education and dissemination of standardized clinical guidelines.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"851-866"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460770","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}

{"title":"System-based strategies for mitigating burnout in radiology.","authors":"Diya Mathur, Brian D Barnacle, Ruth W Magera, Zanira Fazal, Abdul M Zafar","doi":"10.1007/s10140-024-02275-5","DOIUrl":"10.1007/s10140-024-02275-5","url":null,"abstract":"<p><strong>Background: </strong>Burnout is a chronic problem prevalent in radiology, with a significant burden on individuals and healthcare systems.</p><p><strong>Discussion: </strong>A substantial portion of the literature on managing burnout has focused on individual-based remedies. We posit that burnout is a systemic problem and present an overview of some system-based strategies that could be employed to mitigate burnout in radiology. These include managing workload, optimizing work shifts, maximizing autonomy, limiting work-life conflicts, creating opportunities for professional fulfillment, utilizing user-friendly electronic medical records (EMR), deploying efficient picture archiving and communication systems (PACS), building system redundancy, leadership transparency, and fostering a healthy work environment.  CONCLUSION: System-based strategies can help mitigate burnout.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"845-849"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787594","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":"Flank pain, hypertension, and hematuria: CT and 3D cinematic rendering in the evaluation of renal artery emergencies-a pictorial essay.","authors":"Mohammad Yasrab, Elliot K Fishman, Linda C Chu","doi":"10.1007/s10140-024-02279-1","DOIUrl":"10.1007/s10140-024-02279-1","url":null,"abstract":"<p><p>Non-traumatic acute renal artery emergencies encompass a spectrum of etiologies, including renal artery stenosis, arteriovenous malformations, aneurysms and pseudoaneurysms, dissections, thrombosis, and vasculitis. Prompt and accurate diagnosis in the emergency setting is crucial due to the potential for significant morbidity and mortality. Computed tomography (CT) and CT angiography (CTA) are the mainstay imaging modalities, offering rapid acquisition and high diagnostic accuracy. The integration of 3D postprocessing techniques, such as 3D cinematic rendering (CR), improves the diagnostic workflow by providing photorealistic and anatomically accurate visualizations. This pictorial essay illustrates the diagnostic utility of CT and CTA, supplemented by 3D CR, through a series of 10 cases of non-traumatic renal artery emergencies. The added value of 3D CR in improving diagnostic confidence, surgical planning, and understanding of complex vascular anatomy is emphasized.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"925-936"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046517","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 management of active bleeding: what the emergency radiologist needs to know.","authors":"Ryan T Whitesell, Cory R Nordman, Sean K Johnston, Douglas H Sheafor","doi":"10.1007/s10140-024-02289-z","DOIUrl":"10.1007/s10140-024-02289-z","url":null,"abstract":"<p><p>Active bleeding is a clinical emergency that often requires swift action driven by efficient communication. Extravasation of intravenous (IV) contrast on computed tomography (CT) is a hallmark of active hemorrhage. This can be seen on exams performed for a variety of indications and can occur anywhere in the body. As both traumatic and non-traumatic etiologies of significant blood loss are clinical emergencies, exams demonstrating active bleeding are often performed in emergency departments and read by emergency radiologists. Prompt communication of these findings to the appropriate emergency medicine and surgical providers is crucial. Although many types of active hemorrhage can be managed by interventional radiology techniques, endoscopic and surgical management or clinical observation may be appropriate in certain cases. To facilitate optimal care, it is important for emergency radiologists to understand the scope of indications for embolization of bleeding by interventional radiologists (IR) and when an IR consultation is warranted. Similarly, timely comprehensive diagnostic radiology reporting including pertinent positive and negative findings tailored for IR colleagues can expedite the appropriate intervention.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"903-918"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460768","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":"Pleural and pericardial effusions as prognostic factors in patients with acute pulmonary embolism: a multicenter study.","authors":"Hans-Jonas Meyer, Constantin Ehrengut, Anar Aghayev, Mattes Hinnerichs, Dominik Schramm, Felix G Meinel, Jan Borggrefe, Alexey Surov","doi":"10.1007/s10140-024-02281-7","DOIUrl":"10.1007/s10140-024-02281-7","url":null,"abstract":"<p><strong>Purpose: </strong>The prognostic role of pleural and pericardial effusion in patients with acute pulmonary embolism (PE) is still unclear with a trend for worse clinical outcome. The aim of the present study was to demonstrate the prognostic role of pleural and pericardial effusion in patients with acute PE in a large multicentre setting.</p><p><strong>Methods: </strong>The investigated patient sampled was retrospectively comprised of 1082 patients (494 female, 45.7%) with a mean age of 63.8 years ± 15.8. In every case, contrast enhanced computed tomography (CT) pulmonalis angiography was analyzed to diagnose and quantify the pleural and pericardial effusion. The 30-day mortality was the primary endpoint of this study.</p><p><strong>Results: </strong>A total of 127 patients (11.7%) died within the 30-day observation period. Pleural effusion was identified in 438 patients (40.5%) and pericardial effusion was identified in 196 patients (18.1%). The presence of pleural effusion was associated with 30-day mortality, HR = 2.78 (95%CI1.89-4.0), p < 0.001 (univariable analysis), and HR = 2.52 (95%CI1.69-3.76), p < 0.001 (multivariable analysis). The pleural effusion width and density were not associated with 30-day mortality. The presence of pericardial effusion was not associated with 30-day mortality in multivariable analysis, HR = 1.28 (95%CI 0.80-2.03), p = 0.29.</p><p><strong>Conclusions: </strong>Pleural effusion is a common finding in patients with acute pulmonary embolism, occurring in 40.5% of cases, and is a prognostic imaging finding associated with 30-day mortality. The presence of pleural effusion alone, regardless of volume or density, has been shown to be prognostic and should be included in CT reports. The prognostic role of pericardial effusion is limited.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"815-821"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105499","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}