Emergency radiology
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Emergency radiology · Oct 2018
Multicenter StudyBlunt bowel and mesenteric trauma: role of clinical signs along with CT findings in patients' management.
Bowel and/or mesentery injuries represent the third most common injury among patients with blunt abdominal trauma. Delayed diagnosis increases morbidity and mortality. The aim of our study was to evaluate the role of clinical signs along with CT findings as predictors of early surgical repair. ⋯ In patients without solid organ injury (SOI), the presence of free fluid along with abdominal guarding and three or more "minor CT findings" is a significant predictor of early surgical repair. The association of bowel wall discontinuity with extraluminal air warrants exploratory laparotomy.
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Emergency radiology · Oct 2018
Comparative StudyClinical outcomes after magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) for pulmonary embolism evaluation.
To compare patient outcomes following magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) ordered for suspected pulmonary embolism (PE). ⋯ Within the inherent limitations of a retrospective case-controlled analysis, we observed that the rate of MAPE was lower (more favorable) for patients following pulmonary MRA for the primary evaluation of suspected PE than following CTA.
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Emergency radiology · Oct 2018
An assessment of repeat computed tomography utilization in the emergency department in the setting of blunt trauma.
Computed tomography (CT) is a standard imaging modality utilized during the evaluation of trauma patients in the emergency department (ED). However, while it is common to utilize intravenous (IV) contrast as an adjunct, the use of multiple CT scans and how it impacts patient flow can lead to changes in patient management. Our objectives are to assess length of stay (LOS) and rates of acute kidney injury (AKI), when two CT scans of the abdomen/pelvis are performed compared to one CT scan. ⋯ Two CT scans performed during blunt trauma encounters demonstrated mixed benefit and were associated with an increased hospital LOS. Additionally, IV contrast was associated with lower rates of AKI.
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Emergency radiology · Aug 2018
ReviewA review of split-bolus single-pass CT in the assessment of trauma patients.
The purpose of this study was to review and compare the image quality and radiation dose of split-bolus single-pass computed tomography(CT) in the assessment of trauma patients in comparison to standard multi-phase CT techniques. ⋯ Parenchymal and vascular image qualities, as well as subjective image quality assessments, were equal or superior in comparison to non-split-bolus multi-phase trauma CT protocols. Split-bolus single-pass CT decreased radiation exposure in all studies. Further research is required to determine the superior split-bolus protocol and the specificity and sensitivity of detecting blunt cerebrovascular injury screening, splenic parenchymal vascular lesions, and characterization of pelvic vascular extravasation.
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Emergency radiology · Aug 2018
ReviewThe utility of scrotal ultrasonography in the emergent setting: beyond epididymitis versus torsion.
Scrotal pain is a common acute presentation for medical care. Testicular torsion and epididymo-orchitis are two diagnoses for which early detection is critical and their sonographic imaging features have been thoroughly described in the radiologic literature. Other important conditions for which radiologists must be aware have received less attention. This article will highlight key traumatic and non-traumatic causes of acute scrotal pain other than testicular torsion and epididymo-orchitis that may present in the emergency department setting.