Emergency Radiology最新文献

{"title":"Assessing the impact of trained Radiologist Assistants in a busy emergency teleradiology practice: a comprehensive evaluation.","authors":"Muktha Rawath R, Anjali Agrawal, Arjun Kalyanpur","doi":"10.1007/s10140-024-02264-8","DOIUrl":"10.1007/s10140-024-02264-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to study the feasibility and usefulness of trained Radiologist Assistants in a busy emergency teleradiology practice.</p><p><strong>Method: </strong>This is a retrospective study over a 21-month period (January 2021 to September 2022). The study analysed archived data from 247118 peer review studies performed by Radiologist Assistants (RAs) out of a total case volume of 828526 and evaluated the rate of discrepancies, the study types commonly noted to have discrepancies, and the severity of errors. These missed findings were brought to the attention of the radiologists for approval and further decision-making.</p><p><strong>Results: </strong>Peer review by RAs was performed on 30% (n = 247118) of the total volume 828526 studies reported, and yielded additional findings including but not limited to fractures (218; 23%), hemorrhage,(94; 10%) pulmonary thromboembolism, (n = 104; 11%), Calculus (n = 75; 8%) lesion (n = 66; 5%), appendicitis(n = 50; 4%) and others. These were brought to the attention of the radiologist, who agreed in 97% (1279 out of 1318) of cases, and communicated the same to the referring facility, with an addended report.</p><p><strong>Conclusion: </strong>Trained RAs can provide value to the peer review program of a busy teleradiology practice and decrease errors. This may be useful to meet the ongoing radiologist shortages.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"677-685"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579299","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":"Correction to: Ascending with ultrasound: telementored eFAST in flight-a feasibility study.","authors":"Peder Christian Engelsen, Fridtjof Heyerdahl, Dharani Dhar Maddali, Mehdi Sadat Akhavi, Ragnhild Marie Undseth, Ole Jakob Elle, Henrik Brun","doi":"10.1007/s10140-024-02265-7","DOIUrl":"10.1007/s10140-024-02265-7","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"629"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727069","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":"Association of enlarged extra-axial spaces and subdural hemorrhage in preterm infants at term-equivalent age.","authors":"Puneet Sharma, Beth M Kline-Fath, Shanmukha Mukthapuram, Robert A Shapiro, Nehal A Parikh","doi":"10.1007/s10140-024-02250-0","DOIUrl":"10.1007/s10140-024-02250-0","url":null,"abstract":"<p><p>To determine the incidence of enlarged extra-axial space (EES) and its association with subdural hemorrhage (SDH) in a regional cohort of preterm infants. As part of a prospective cohort study of 395 preterm infants, brain magnetic resonance imaging (MRI) was collected on each infant at term-equivalent age. Six preterm infants showed evidence of SDH. We reviewed the MRIs to identify the incidence of EES in these 6 infants and the cohort broadly. We then completed a retrospective chart review of the 6 infants to identify any concerns for non-accidental trauma (NAT) since the MRI was obtained. The incidence of SDH in the cohort was 1.6%. The incidence of EES was 48.1% including all 6 infants with SDH. The incidence of SDH in infants with EES was 3.2%. The retrospective chart review of the 6 infants did not yield any evidence of NAT. The incidence of EES and SDH in our cohort was significantly higher than similar cohorts of term infants, demonstrating an increased risk in preterm infants. The incidence of SDH in infants with EES was greater than in the total cohort, suggesting that it is a risk factor for asymptomatic SDH in preterm infants.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"619-623"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237148","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":"Multisystem factors contributing to redundant intracranial vascular imaging in the ED.","authors":"William A Mehan, Donghoon Shin, Karen Buch","doi":"10.1007/s10140-024-02240-2","DOIUrl":"10.1007/s10140-024-02240-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the multisystem factors contributing to redundant neurovascular orders in the ED.</p><p><strong>Methods: </strong>This was an IRB-approved, retrospective study, performed at a single institution examining a 5-year history of redundant CTA/MRA head and neck (HN) exams performed in the ED for patients with no documented clinical change in mental status/neurological exam necessitating additional imaging. Factors contributing to redundant ordering including provider experience, synchronous order placement, and radiologist recommendations were examined. Additionally, the impact of duplicative imaging in terms of medical cost and ED length of stay was evaluated.</p><p><strong>Results: </strong>250 patients met inclusion criteria with both CTA/MRA of the HN performed during a single ED encounter (total 500 exams). 190 (76%) redundant exams were not recommended by a radiologist and contributed to an added ED length of stay of 3.6 h on average. Provider experience was not a significant contributing factor. 60 (24%) of redundant exams were recommended by a radiologist and were most frequently CTAs needed to clarify an area of artifact/high-grade stenosis/occlusion on a primary MRA exam.</p><p><strong>Conclusion: </strong>Evaluation of contributing factors to redundant CTA/MRA HN exams ordering has highlighted multiple associated factors including provider experience, recommendations by radiologists for clarification of MRA findings, as well as systems processes related to synchronous CTA/MRA order placement.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"447-453"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070722","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":"Overutilization of head computed tomography in cases of mild traumatic brain injury: a systematic review and meta-analysis.","authors":"Mehdi Rezaee, Mohammad Mehdi Nasehi, Mohammad Effatpanah, Sama Jabbaripour, Maryam Ghamkhar, Hossein Karami, Reza Mehrizi, Pegah Torabi, Leila Ghamkhar","doi":"10.1007/s10140-024-02247-9","DOIUrl":"10.1007/s10140-024-02247-9","url":null,"abstract":"<p><p>Head computed tomography (CT) is the preferred imaging modality for mild traumatic brain injury (mTBI). The routine use of head CT in low-risk individuals with mild TBI offers no clinical benefit but also causes notable health and financial burden. Despite the availability of related guidelines, studies have reported considerable rate of non-indicated head CT requests. The objectives were to provide an overall estimate for the head CT overutilization rate and to identify the factors contributing to the overuse. A systematic review of PubMed, Scopus, Web of Science, and Embase databases was conducted up to November 2023, following PRISMA and MOOSE guidelines. Two reviewers independently selected eligible articles and extracted data. Quality assessment was performed using a bias risk tool, and a random-effects model was used for data synthesis. Fourteen studies, encompassing 28,612 patients, were included, with 27,809 undergoing head CT scans. Notably, 75% of the included studies exhibited a moderate to high risk of bias. The overutilization rate for pediatric and adult patients was 27% (95% CI: 5-50%) and 32% (95% CI: 21-44%), respectively. An alternative rate, focusing on low-risk pediatric patients, was 54% (95% CI: 20-89%). Overutilization rates showed no significant difference between teaching and non-teaching hospitals. Patients with mTBI from falls or assaults were less likely to receive non-indicated scans. There was no significant association between physician specialty or seniority and overuse, nor between patients' age or sex and the likelihood of receiving a non-indicated scan. Approximately one-third of head CT scans in mTBI cases are avoidable, underscoring the necessity for quality improvement programs to reduce unnecessary imaging and its associated burdens.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"551-565"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283352","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 endovascular and percutaneous urological interventions: A pictorial review.","authors":"Tara Prasad Tripathy, Kaneez Fatima, Ranjan Kumar Patel, Alamelu Alagappan, Jitender Singh, Sudipta Mohakud, Manoj Kumar Das, Prashant Nayak","doi":"10.1007/s10140-024-02241-1","DOIUrl":"10.1007/s10140-024-02241-1","url":null,"abstract":"<p><p>Emergency endovascular and percutaneous urological interventions encompass various diagnostic and therapeutic procedures to address various genitourinary conditions. These urological interventions are life-saving in addressing complications following biopsy, post-nephrectomy, post-transplant, and post-trauma. Compared to other surgical fields, there are relatively fewer urological emergencies. However, they require prompt radiological diagnosis and urgent interventions. This pictorial essay emphasizes various urological emergencies and urgent interventional management.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"605-612"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956762","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":"Volumetric computed tomography measurements as predictors for outcomes in a cohort of Fournier's gangrene patients.","authors":"Aravinda Ganapathy, David H Ballard, Favour Garuba, Adriene Lovato, Parisa Mazaheri, David Z Chen, McGinness Schneider, M Hunter Lanier, Obeid Ilahi, John P Kirby, Constantine A Raptis, Vincent M Mellnick","doi":"10.1007/s10140-024-02251-z","DOIUrl":"10.1007/s10140-024-02251-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the prognostic value of CT findings, including volumetric measurements, in predicting outcomes for patients with Fournier gangrene (FG), focusing on mortality, ICU admission, hospital stay length, and healthcare costs.</p><p><strong>Methods: </strong>A retrospective study was conducted on 38 FG patients who underwent CT scans before surgical debridement. We analyzed demographic data, CT volumetric measurements, and clinical outcomes using logistic and linear regression models.</p><p><strong>Results: </strong>No single CT measurement significantly predicted mortality or ICU admission. The best model for mortality prediction included age, air volume, NSTI score, and male sex, with an AUC of 0.911. Intubation likelihood was modeled with an AUC of 0.913 using age, NSTI score, and visceral to subcutaneous fat ratio. The ICU admission model achieved an AUC of 0.677. Hospital stay was predicted by air volume (β = 0.0002656, p = 0.0505) with an adjusted R-squared of 0.1287. Air volume significantly predicted hospital costs (β = 2.859, p = 0.00558), resulting in an adjusted R-squared of 0.2165.</p><p><strong>Conclusion: </strong>Volumetric CT findings provide valuable prognostic insights for FG patients, suggesting a basis for informed clinical decisions and resource allocation. Further validation in larger, multi-center studies is recommended to develop robust predictive models for FG outcomes.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"481-489"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261580","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":"Time trend analysis of Injury Severity score of adult trauma patients with emergent CT examination.","authors":"Stefanie Neef, Felix G Meinel, Roberto Lorbeer, Felix Ammermann, Marc-André Weber, Manuela Brunk, Philipp Herlyn, Ebba Beller","doi":"10.1007/s10140-024-02253-x","DOIUrl":"10.1007/s10140-024-02253-x","url":null,"abstract":"<p><strong>Purpose: </strong>Controversy exists about whole-body computed tomography (CT) as a primary screening modality for suspected multiple trauma patients. Therefore, the aim of this study was to analyze time trends of CT examinations for trauma patients in relation to the Injury Severity Score (ISS).</p><p><strong>Methods: </strong>We retrospectively analyzed 561 adult trauma patients (mean age = 54 years) who were admitted to the trauma room of our hospital, immediately followed by a CT examination, in 2009, 2013 und 2017. Review of electronic patient charts was performed to determine the cause of injury. ISS was either calculated upon hospital charts and CT imaging reports or documented in the TraumaRegister DGU® for trauma patients with ICU treatment or ISS ≥ 16.</p><p><strong>Results: </strong>An increasing number of CT examinations of acute trauma patients were performed at our hospital with 117 patients in 2009 compared to 192 in 2013 and 252 in 2017. Their mean age increased (50 years in 2009, 54 in 2013 and 55 in 2017;p = 0.046), whereas their mean ISS decreased over time (15.2 in 2009 compared to 12.1 in 2013 and 10.6 in 2017;p = 0.001), especially in women (15.1 in 2009, 11.8 in 2013 and 7.4 in 2017;p = 0.001 both), younger age groups (18 to 24 years:15.6 in 2009, 6.5 in 2013 and 8.9 in 2017; p = 0.033 and 25 to 49 years:15.0 in 2009, 11.2 in 2013 and 8.3 in 2017;p = 0.001) as well as motor vehicle collision (MVC) victims (16.2 in 2009, 11.8 in 2013 and 6.1 in 2017; p < 0.001). Trauma patients with a high ISS were especially more likely of older age (OR 1.02,p < 0.001) and with the type of incident being a fall (< 3 m: OR3.84,p < 0.001;>3 m: OR6.22,p < 0.001) compared to MVC.</p><p><strong>Conclusion: </strong>Previous studies suggesting a benefit of primary whole-body CT for trauma patients might not reflect the current patient population with decreasing ISS. Especially females, younger age groups and MVC patients might benefit from stricter selection criteria for receiving whole-body CT. Our results also emphasize the importance of prevention of fall or tumble for elderly people.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"507-514"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330617","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":"Imaging of pulmonary infections encountered in the emergency department in post-COVID 19 era- common, rare and exotic. Bacterial and viral.","authors":"Shruti Kumar, Sabarish Narayanasamy, Pankaj Nepal, Devendra Kumar, Baphiralyne Wankhar, Prem Batchala, Neeraj Kaur, Suryakala Buddha, Joe Jose, Vijayanadh Ojili","doi":"10.1007/s10140-024-02248-8","DOIUrl":"10.1007/s10140-024-02248-8","url":null,"abstract":"<p><p>Pulmonary infections contribute substantially to emergency department (ED) visits, posing a considerable health burden. Lower respiratory tract infections are prevalent, particularly among the elderly, constituting a significant percentage of infectious disease-related ED visits. Timely recognition and treatment are crucial to mitigate morbidity and mortality. Imaging studies, primarily chest radiographs and less frequently CT chests, play a pivotal role in diagnosis. This article aims to elucidate the imaging patterns of both common and rare pulmonary infections (bacterial and viral) in the post COVID-19 era, emphasizing the importance of recognizing distinct radiological manifestations. The integration of clinical and microbiological evidence aids in achieving accurate diagnoses, and guiding optimal therapeutic interventions. Despite potential overlapping manifestations, a nuanced understanding of radiological patterns, coupled with comprehensive clinical and microbiological information, enhances diagnostic precision in majority cases.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"543-550"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248154","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":"Comments on, \"Appropriateness and imaging outcomes of ultrasound, CT, and MR in the emergency department: a retrospective analysis from an urban academic center\".","authors":"Gillian Cooper, Patrick McGinnis, Yiting Lin, Ali Pourmand, Quincy K Tran","doi":"10.1007/s10140-024-02268-4","DOIUrl":"10.1007/s10140-024-02268-4","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"625-626"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589942","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}