Pediatric Sedation Service Boosts Diagnostic Imaging Results

2005 ◽  
Vol 39 (10) ◽  
pp. 52
Author(s):  
KERRI WACHTER
Keyword(s):  
Diagnostic Imaging ◽  
Imaging Results ◽  
Pediatric Sedation

scholarly journals Sinus Venosus Atrial Septal Defect as a Cause of Palpitations and Dyspnea in an Adult: A Diagnostic Imaging Challenge

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Michael S. Donovan ◽  
David Kassop ◽  
Robert A. Liotta ◽  
Edward A. Hulten
Keyword(s):  
Diagnostic Imaging ◽  
Imaging Modality ◽  
Sinus Venosus ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Detection Rates ◽  
Clinical Presentations ◽  
Imaging Results ◽  
Highly Sensitive ◽  
Anomalous Pulmonary Venous Return ◽  
Exercise Induced

Sinus venosus atrial septal defects (SV-ASD) have nonspecific clinical presentations and represent a diagnostic imaging challenge. Transthoracic echocardiography (TTE) remains the initial diagnostic imaging modality. However, detection rates have been as low as 12%. Transesophageal echocardiography (TEE) improves diagnostic accuracy though it may not detect commonly associated partial anomalous pulmonary venous return (PAPVR). Cardiac magnetic resonance (CMR) imaging provides a noninvasive, highly sensitive and specific imaging modality of SV-ASD. We describe a case of an adult male with exercise-induced, paroxysmal supraventricular tachycardia who presented with palpitations and dyspnea. Despite nondiagnostic imaging results on TTE, CMR proved to be instrumental in visualizing a hemodynamically significant SV-ASD with PAPVR that ultimately led to surgical correction.

scholarly journals Predictive value of D-dimer and analysis of risk factors in pregnant women with suspected pulmonary embolism after cesarean section

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Limin Zhang ◽  
Yunqiu Chen ◽  
Wenjuan Liu ◽  
Xinzhuo Wang ◽  
Shuang Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Cesarean Section ◽  
Diagnostic Imaging ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
High Sensitivity ◽  
Imaging Results ◽  
Acute Pe ◽  
D Dimer

Abstract Background Acute pulmonary embolism (PE) is one of the leading causes of maternal mortality, and cesarean section is an established independent risk factor for PE. The diagnostic utility of D-dimer for PE in non-pregnant women has been well-established, but its role in women with suspected PE after cesarean section is unclear. Furthermore, the optimal threshold level in this patient population is unknown. Traditional D-dimer levels have low diagnostic specificity, resulting in many pregnant women being exposed to potentially harmful radiation despite negative diagnostic imaging results. This research aimed to optimize the clinical threshold for D-dimer to improve specificity while ensuring high sensitivity and to identify risk factors for PE after cesarean section. Methods This retrospective study of 289 women who underwent diagnostic imaging (ventilation/perfusion [V/Q] or computed tomographic pulmonary angiography [CTPA]) for suspected acute PE after cesarean delivery from 2010 to 2021 was conducted. Clinical data and laboratory indicators within 24 h postpartum including D-dimer levels were collected for analyses. Results The final analysis included 125 patients, among whom 33 were diagnosed with acute PE (incidence of 11.42%, 95% confidence interval 7.7–15.1). The receiver operating characteristic curve analysis suggested that a D-dimer cut-off value of 800 ng/mL had specificity of 25.26% and sensitivity of 100% for detecting PE. The cut-off value was adjusted to 1000 ng/mL with a specificity of 34.74% and a sensitivity of 96.67%. Using a D-dimer cut-off value of 800 ng/mL (instead of the conventional value of 500 ng/mL) increased the number of patients excluded from suspected PE from 9.6 to 18.4% without additional false-negative results. Of note, a history of known thrombophilia was significantly more common in patients with PE than in those without (P < 0.05). No other independent risk factors were noted in our study. Conclusions The D-dimer cut-off value of 800 ng/mL ensures high sensitivity and increases specificity compared to the conventional threshold of 500 ng/mL. Utilizing this higher threshold can reduce the number of unnecessary CT and subsequently unnecessary radiation exposure, in women after cesarean delivery. Prospective studies should also be conducted to verify these results.

scholarly journals The Value of Cranial CT Imaging in Patients With Headache at the Emergency Department

2021 ◽  
Vol 12 ◽  
Author(s):  
Cynthia M. C. Lemmens ◽  
M. Christien van der Linden ◽  
Korné Jellema
Keyword(s):  
Emergency Department ◽  
Diagnostic Imaging ◽  
Ct Imaging ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Focal Neurological Deficit ◽  
Cranial Ct ◽  
Imaging Results ◽  
Headache Onset ◽  
Headache Patients

Background: Headache is among the most prevalent complaints in patients presenting to the emergency department (ED). Clinicians are faced with the difficult task to differentiate primary (benign) from secondary headache disorders, since no international guidelines currently exist of clinical indicators for neuroimaging in headache patients.Methods: We performed a retrospective review of 501 patients who presented at the ED with headache as a primary complaint between April 2018 and December 2018. Primary outcomes included the amount of diagnostic imaging, the different conclusions provided by diagnostic imaging, and the clinical factors associated with abnormal imaging results.Results: About half of the patients were diagnosed with a primary headache disorder. Cranial CT imaging at the ED was performed regularly (61% of the patients) and led to the diagnosis of underlying pathology in 1 in 7.6 patients. In a multivariate model, factors significantly associated with abnormal cranial CT results were age 50 years or older, presentation within 1 h after headache onset, clinical history of aphasia, and focal neurological deficit at examination.Conclusions: As separate clinical characteristics have limited value in detecting severe underlying headache disorders, cranial imaging is regularly performed in the ED. Clinical prediction model tools applied to headache patients may identify patients at risk of intracranial pathology prior to diagnostic imaging and reduce cranial imaging in the future.

scholarly journals SP9.1.3 Abdominal X-Rays in the Emergency Setting- A Review of Current Practice

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Lará Armstrong ◽  
Helen Monaghan ◽  
Sarah Jeffers
Keyword(s):  
Diagnostic Imaging ◽  
Radiation Exposure ◽  
Diagnostic Yield ◽  
Hospital Costs ◽  
Radiology Department ◽  
Emergency Setting ◽  
X Rays ◽  
X Ray ◽  
Imaging Results ◽  
Patient Radiation Exposure

Abstract Aim Abdominal radiographs (AXRs) are commonly used in the setting of acute abdominal pain. However, with low diagnostic yield, they can increase workload within the radiology department, increase patient radiation exposure and ultimately delay further diagnostic imaging. The average cost of an abdominal film, excluding staffing costs, is £45. This study aimed to investigate the appropriate use of AXRs in the emergency setting, as per the Royal College of Radiologists Guidelines (RCR). Methods A single centre retrospective review was conducted of all patients referred to the emergency surgical team over a 21 day period. Data was retrieved from electronic handover records. Demographics, radiology request forms and imaging results were obtained from up to date electronic care records. Results A total of 160 patients presented within the audit window, with a median age 49 (16-94) and 61.3% male. Overall, 36.9% of patients underwent an abdominal x-ray, 66.1% of which were not indicated in accordance with RCR guidelines. 71.2% of patients who underwent an abdominal x-ray required further diagnostic imaging by means of CT or USS. Only 10.2% of AXRs provided diagnostic information. Total cost expenditure for inappropriate AXRs = £1,755, excluding staffing costs. Conclusions Approximately two thirds of AXRs performed did not comply with the published RCR guidelines. Adherence to RCR guidelines can reduce needless radiation exposure, hospital costs and delay to diagnosis. We plan to conduct a teaching session on the RCR guidelines alongside the development of information posters, and re-audit our results.

Diagnostic Imaging of Ulnar Collateral Ligament Injury: A Systematic Review

2020 ◽  
Vol 48 (11) ◽  
pp. 2819-2827 ◽  
Author(s):  
Richard E. Campbell ◽  
Alexa N. McGhee ◽  
Kevin B. Freedman ◽  
Fotios P. Tjoumakaris
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Diagnostic Imaging ◽  
Sensitivity And Specificity ◽  
Ulnar Collateral Ligament ◽  
Imaging Modalities ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Overhead Athletes ◽  
Imaging Results

Background: Ulnar collateral ligament (UCL) injuries can be debilitating in overhead athletes. Accurate diagnosis is important; however, several imaging modalities are available for the assessment of UCL injuries. Purpose: To provide a comprehensive review of published literature regarding the diagnostic capabilities of different imaging modalities for UCL tears. Methods: PubMed, Medline, and Embase were queried for peer-reviewed literature published between January 1947 and June 4, 2019, pertaining to diagnostic imaging of UCL tears. Articles assessing static and stress radiography, ultrasound, magnetic resonance imaging (MRI), MRI with arthrography (MRA), and computed tomography arthrography of the UCL were included. Studies were excluded if imaging results were not compared with intraoperative diagnosis, as intraoperative findings are generally considered the gold standard for diagnostic comparison. The articles were assessed per the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines and reviewed with the Quality Assessment of Diagnostic Accuracy Studies, version 2 (QUADAS-2) assessment. Results: The literature search yielded 2478 articles, of which 15 were included in this review. Potential bias was noted in each QUADAS-2 subsection. Multiple studies demonstrate an association between UCL tears and osseous abnormalities identified on static radiographs; however, the use of static or nonstressed radiographs is not recommended for specific evaluation of UCL injuries. Conventional ultrasound was 81% sensitive and 91% specific, as compared with 96% and 81% for stress ultrasound, respectively. The sensitivity and specificity of MRI ranged from 57% to 100% and 89% to 100%. The sensitivity of computed tomography arthrography ranged from 63% to 86%. The sensitivity and specificity of MRA ranged from 81% to 100% and 91% to 100%. Conclusion: Of the currently available imaging modalities, MRA provides the best combination of sensitivity and specificity of the evaluation of the UCL. Further research comparing ultrasound with MRA is needed.

Radiologist Compliance With Institutional Guidelines for Use of Nonroutine Communication of Diagnostic Imaging Results

2015 ◽  
Vol 12 (4) ◽  
pp. 376-384 ◽  
Author(s):  
H. Benjamin Harvey ◽  
Tarik K. Alkasab ◽  
Pari V. Pandharipande ◽  
Jing Zhao ◽  
Elkan F. Halpern ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Imaging Results

scholarly journals Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil

2017 ◽  
Vol 50 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Rubens Chojniak ◽  
Dominique Piacenti Carneiro ◽  
Gustavo Simonetto Peres Moterani ◽  
Ivone da Silva Duarte ◽  
Almir Galvão Vieira Bitencourt ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Medical Schools ◽  
Cross Sectional Study ◽  
Teaching Methodology ◽  
Teaching Model ◽  
Education Policies ◽  
Cross Sectional ◽  
Formal Curriculum ◽  
Imaging Results ◽  
Elective Course

Abstract Objective: To map the different methods for diagnostic imaging instruction at medical schools in Brazil. Materials and Methods: In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Results: Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. Conclusion: The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

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