Emergency radiology
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Emergency radiology · Mar 2009
Assessing potential spinal injury in the intubated multitrauma patient: does MRI add value?
The purpose of the study was to determine the role of magnetic resonance imaging (MRI) in intubated multitrauma patients with normal computed tomography (CT) in excluding unstable ligamentous injury to the cervical spine. A retrospective evaluation was done on those multitrauma patients admitted to the intensive care unit of a level 1 trauma centre who had normal single-slice helical CT cervical spine and underwent MRI for cervical spine clearance from 1/1/04 to 30/6/05. ⋯ Single-slice helical CT with sagittal reformats had a negative predictive value of 82% for discoligamentous injury and 100% for unstable injury. A normal single-slice helical CT with sagittal reformats of the cervical spine in intubated trauma patients excluded unstable injuries at follow-up cervical spine MR imaging.
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Emergency radiology · Jan 2009
Case ReportsHypopharyngeal perforation because of blunt neck trauma.
Hypopharyngeal rupture because of blunt neck trauma is an extremely rare clinical entity. Early diagnosis and appropriate management are of great importance, given that an overlooked injury can lead to catastrophic consequences. We herein describe the case of a 21-year-old man who presented with a knee injury after a low-speed motor cycle accident, but was otherwise asymptomatic. ⋯ Complete imaging examinations finally revealed characteristic findings of hypopharyngeal perforation. The patient was treated conservatively with success. A high degree of clinical suspicion is therefore the key to an early diagnosis and successful management of this rare injury.
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Emergency radiology · Jan 2009
Case ReportsCases from the Cleveland Clinic: cerebral venous sinus thrombosis presenting to the emergency department with worst headache of life.
A 31 year old woman presented with the worst headache of her life and was diagnosed with cerebral venous sinus thrombosis (CVST) by routine unenhanced computed tomography (CT) scan, subsequently confirmed with magnetic resonance imaging (MRI) and magnetic resonance venography (MRV). Awareness of this less common cause for acute neurological presentation in the Emergency setting is important; the imaging characteristics of CVST are reviewed.
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Emergency radiology · Sep 2008
Case ReportsSystemic air embolism after percutaneous transthorasic needle biopsy of the lung.
Computed tomography (CT)-guided percutaneous transthoracic biopsy of the lung is a well-established diagnostic technique, but it can pose complications to the patients. Air embolism is one of the rarest but potentially fatal complications of this procedure. ⋯ Careful reviewing of the obtained CT images during the procedure may avoid a missing systemic air embolism and can immediately provide an adequate therapy also in asymptomatic patients. This extremely rare complication is an inevitable event and may happen in spite of appropriate experience and meticulous care.
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Emergency radiology · Sep 2008
Comparative StudyDetection and evaluation of intracranial aneurysms with 16-row multislice CT angiography: comparison with conventional angiography.
The aim of our study was to compare multidetector row computed tomography (CT) angiography (MDCTA) with digital subtraction angiography (DSA) in the detection and characterization of intracranial aneurysms. Between September 2005 and May 2007, 55 consecutive patients with suspected intracranial aneurysms underwent conventional DSA and MDCTA. Thirty-two women and 23 men were enrolled in the study. ⋯ Regarding the aneurysms smaller than 3 mm, for readers 1 and 2, the sensitivities were 84.6% (95% CI = 57.8-95.7%; 11 of 13) and 92.3% (95% CI = 66.7-98.6; 12 of 13), respectively. MDCTA is accurate in the detection and characterization of intracranial aneurysms and can be used as a reliable alternative imaging technique to DSA. A strategy of using CT angiography as the primary method, with DSA reserved for any cases of uncertainty, appears safe and reliable.