Emergency radiology
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Emergency radiology · Aug 2017
Clinical and imaging features indicative of clinically worrisome pneumatosis: key components to identifying proper medical intervention.
The purpose of this retrospective study was to determine clinical and imaging factors on computed tomography (CT) associated with clinically worrisome pneumatosis intestinalis (PI) that may aid in the decision to provide conservative management or urgent surgical intervention. ⋯ CT imaging characteristics and clinical features can help predict clinically worrisome PI and guide crucial management decisions.
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Emergency radiology · Aug 2017
Pediatric chest CT at chest radiograph doses: when is the ultralow-dose chest CT clinically appropriate?
Computed tomography (CT) use in emergency departments represents a significant contribution to pediatric patients' exposure to ionizing radiation. Here, we evaluate whether ultralow-dose chest CT can be diagnostically adequate for other diagnoses and whether model-based iterative reconstruction (MBIR) can improve diagnostic adequacy compared to adaptive statistical iterative reconstruction (ASIR) at ultralow doses. ⋯ Ultralow-dose chest CT may be adequate for airway assessment, but suboptimal for the evaluation parenchymal lung disease. Although MBIR improves objective and subjective image quality, it does not completely restore the diagnostic adequacy of ultralow-dose CT when compared to standard-dose CT.
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Emergency radiology · Jun 2017
CT characteristics of traumatic sacral fractures in association with pelvic ring injuries: correlation using the Young-Burgess classification system.
The purpose of the study is to determine the incidence of sacral fracture patterns on CT imaging of pelvic trauma patients with correlation with mechanism of injury and pelvic ring injury pattern using the Young-Burgess classification system. ⋯ Avulsion fractures and longitudinal fractures of the sacrum are almost always associated with anterior pelvic ring injury. Conversely, transverse fractures of the lower sacrum and combined longitudinal and transverse sacral fractures are prone to occur in isolation.
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Emergency radiology · Feb 2017
Automatic tube current modulation for whole-body polytrauma CT with immobilization devices: is there an increase in radiation dose and degradation of image quality?
The objective of this study was the assessment of the image quality and radiation dose in polytrauma CT using immobilization devices. An anthropomorphic whole body and a liver phantom were scanned on a 128-slice CT scanner with four different protocols using automatic tube current modulation (120 kVp, 150 ref. mAs; 120 kV, 200 ref. mAs; 140 kVp, 150 ref. mAs; and 140 kVp, 200 ref. mAs) and four different setups (no immobilization device (setup A), vacuum mattress 1 (setup B), vacuum mattress 2 (setup C), and spineboard (setup D)). Qualitative and quantitative image quality parameters and radiation dose were assessed. ⋯ Severe streak artifacts, provoked by the inflation valve of the mattresses were detected at the level of the head and shoulder. Applying immobilization devices for whole-body CT with automatic tube current modulation increases the radiation dose and decreases the quantitative image quality slightly. Severe artifacts, induced by the inflation valve of the mattress, can influence the diagnostic accuracy at the level of the head and shoulder.
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Emergency radiology · Feb 2017
Emergency radiology and mass casualty incidents-report of a mass casualty incident at a level 1 trauma center.
The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. ⋯ The mean number of radiographic studies performed per patient was 3 (range 1-8), and the total number of injuries detected was 88. The surge in imaging requirements during an MCI can be significant and exceed normal operating capacity. This report of our radiology experience during a recent MCI and subsequent after-action review serves to provide an example of how radiology capacity and workflow functioned during an MCI, in order to provide emergency radiologists and response planners with practical recommendations for implementation in the event of a future MCI.