Radiology

2010 ◽  
pp. 705-792
Keyword(s):  
Computed Tomography ◽  
Chest Radiograph ◽  
X Rays ◽  
Digital Radiology ◽  
X Ray ◽  
Barium Studies ◽  
Chest X Ray ◽  
Cardiac Enlargement

Radiology & the role of imaging 706 Plain X-rays 708 Digital radiology 709 Chest X-ray: useful landmarks 710 Chest radiograph 712 Patterns of lobar collapse 717 Cardiac enlargement 719 Computed tomography of the thorax 722 Abdominal X-ray: useful landmarks 724 Plain abdominal X-ray 726 Barium studies ...

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography

2018 ◽  
Vol 35 (10) ◽  
pp. 1032-1038 ◽  
Author(s):  
Aaron S. Weinberg ◽  
William Chang ◽  
Grace Ih ◽  
Alan Waxman ◽  
Victor F. Tapson
Keyword(s):  
Pulmonary Embolism ◽  
Chest Radiograph ◽  
High Probability ◽  
Hemodynamic Instability ◽  
X Rays ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Low Probability ◽  
Clinically Significant

Objective: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU. Design: Two physicians conducted chart reviews and original V/Q reports. A staff radiologist, with 40 years of experience, rated chest x-ray abnormalities using predetermined criteria. Setting: The study was conducted in the ICU. Patients: The first 100 consecutive patients with suspected PE who underwent a portable V/Q scan. Interventions: Those with a portable V/Q scan. Results: A normal baseline chest radiograph was found in only 6% of patients. Fifty-three percent had moderate, 24% had severe, and 10% had very-severe radiographic abnormalities. Despite the abnormal x-rays, 88% of the V/Q scans were low probability for a PE despite an average abnormal radiograph rating of moderate. A high-probability V/Q for PE was diagnosed in 3% of the population despite chest x-ray ratings of moderate to severe. Six patients had their empiric anticoagulation discontinued after obtaining the results of the V/Q scan, and no anticoagulation was started for PE after a low-probability V/Q scan. Conclusion: Despite the large percentage of moderate-to-severe x-ray abnormalities, PE can still be diagnosed (high-probability scan) in the ICU with a portable V/Q scan. Although low-probability scans do not rule out acute PE, it appeared less likely that any patient with a low-probability V/Q scan had severe hypoxemia or hemodynamic instability due to a significant PE, which was useful to clinicians and allowed them to either stop or not start anticoagulation.

scholarly journals Review of the Guidelines For Radiology Practice During COVID -19 Pandemic by Nepal Radiologists’ Association

2020 ◽  
Vol 10 (1) ◽  
pp. 38-45
Author(s):  
Anamika Jha ◽  
Sundar Suwal ◽  
Dan Bahadur Karki ◽  
Ram Kumar Ghimire
Keyword(s):  
Computed Tomography ◽  
Virus Disease ◽  
Clinical History ◽  
Radiology Department ◽  
Medical Council ◽  
X Ray ◽  
Safety Issues ◽  
Chest X Ray ◽  
Diagnostic Modalities

Nepal is also affected by Corona Virus Disease (COVID-19) pandemic which is likely to last for several months. The Reverse Transcriptase-Polymerase Chain Reaction is the current gold standard diagnostic test. Chest X-ray or Computed Tomography scan is considered inappropriate according to most society recommendations for screening though are emerging as frontline diagnostic modalities in conjunction with clinical history and laboratory parameters.Multiple guidelines have been released by prominent radiological societies worldwide to facilitate preparedness of radiology department in the war against COVID-19. Based on these, the Nepal Radiologists’ Association has proposed its guidelines, endorsed by the Nepal Medical Council, practical in our context, with the aim to limit exposure to the infection while ensuring best use of imaging, protection of health care personnel and other patients and maintenance of uninterrupted radiology department operations.This review article aims to summarize the highlights from various guidelines focusing on role of chest X-ray and Computed Tomography including the indications, specific findings, reporting format and important differentials and also addresses the safety issues.

scholarly journals Current Imaging Trends in COVID-19 Pneumonia

2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Anamika Jha ◽  
Benu Lohani ◽  
Ram Kumar Ghimire
Keyword(s):  
Computed Tomography ◽  
Health Care ◽  
Disease Transmission ◽  
Medical Council ◽  
X Ray ◽  
System Functioning ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Tomography Scan

COVID-19 has rapidly emerged as a pandemic threatening lives and healthcare systems worldwide.With the emergence of the disease in Nepal, all faculties of medicine need to be well prepared toface the challenge. Fortunately, now plenty of research is available to facilitate our preparednessin the war against COVID-19. The reverse transcriptase-polymerase chain reaction is the currentgold standard diagnostic test and chest Computed Tomography scan for screening the disease isconsidered inappropriate by most society recommendations. The Nepal Radiologists’ Associationhas proposed its guidelines which have been endorsed by the Nepal Medical Council. This articleaims to summarize the role of imaging focusing on chest X-ray and Computed Tomography scanincluding the indications, specific findings, and important differentials. Imaging needs to be donetaking necessary precautions, to minimize disease transmission, protect health care personnel, andpreserve health care system functioning.

scholarly journals The influence of chest X-ray results on antibiotic prescription for childhood pneumonia in the emergency department

2021 ◽  
Author(s):  
Josephine S. van de Maat ◽  
Daniella Garcia Perez ◽  
Gertjan J. A. Driessen ◽  
Anne-Marie van Wermeskerken ◽  
Frank J. Smit ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Treatment Decisions ◽  
X Rays ◽  
X Ray ◽  
Chest X Ray ◽  
Tract Infections

AbstractThe aim of this study is to evaluate the influence of chest X-ray (CXR) results on antibiotic prescription in children suspected of lower respiratory tract infections (RTI) in the emergency department (ED). We performed a secondary analysis of a stepped-wedge, cluster randomized trial of children aged 1 month to 5 years with fever and cough/dyspnoea in 8 EDs in the Netherlands (2016–2018), including a 1-week follow-up. We analysed the observational data of the pre-intervention period, using multivariable logistic regression to evaluate the influence of CXR result on antibiotic prescription. We included 597 children (median age 17 months [IQR 9–30, 61% male). CXR was performed in 109/597 (18%) of children (range across hospitals 9 to 50%); 52/109 (48%) showed focal infiltrates. Children who underwent CXR were more likely to receive antibiotics, also when adjusted for clinical signs and symptoms, hospital and CXR result (OR 7.25 [95% CI 2.48–21.2]). Abnormalities on CXR were not significantly associated with antibiotic prescription.Conclusion: Performance of CXR was independently associated with more antibiotic prescription, regardless of its results. The limited influence of CXR results on antibiotic prescription highlights the inferior role of CXR on treatment decisions for suspected lower RTI in the ED. What is Known:• Chest X-ray (CXR) has a high inter-observer variability and cannot distinguish between bacterial or viral pneumonia.• Current guidelines recommend against routine use of CXR in children with uncomplicated respiratory tract infections (RTIs) in the outpatient setting. What is New:• CXR is still frequently performed in non-complex children suspected of lower RTIs in the emergency department• CXR performance was independently associated with more antibiotic prescriptions, regardless of its results, highlighting the inferior role of chest X-rays in treatment decisions.

scholarly journals A Pictorial Review of the Role of Imaging in the Detection, Management, Histopathological Correlations, and Complications of COVID-19 Pneumonia

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 437
Author(s):  
Barbara Brogna ◽  
Elio Bignardi ◽  
Claudia Brogna ◽  
Mena Volpe ◽  
Giulio Lombardi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Patient Outcomes ◽  
Lung Ultrasound ◽  
Prognostic Role ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Diagnosis And Management ◽  
Pictorial Review ◽  
Chest X Ray

Imaging plays an important role in the detection of coronavirus (COVID-19) pneumonia in both managing the disease and evaluating the complications. Imaging with chest computed tomography (CT) can also have a potential predictive and prognostic role in COVID-19 patient outcomes. The aim of this pictorial review is to describe the role of imaging with chest X-ray (CXR), lung ultrasound (LUS), and CT in the diagnosis and management of COVID-19 pneumonia, the current indications, the scores proposed for each modality, the advantages/limitations of each modality and their role in detecting complications, and the histopathological correlations.

scholarly journals Role of peak expiratory flow rate and chest radiography in children above 5 years of age with acute asthma

2020 ◽  
Vol 7 (2) ◽  
pp. 372
Author(s):  
Sankeerthana Shankarnarayana ◽  
Jaidev M. Devdas ◽  
Sujonitha John ◽  
Habeeb Ullah Khan ◽  
Pavan Hegde
Keyword(s):  
Emergency Department ◽  
Oxygen Saturation ◽  
Standard Treatment ◽  
Acute Asthma ◽  
X Rays ◽  
Bronchodilator Therapy ◽  
X Ray ◽  
Before And After ◽  
Chest X Ray

Background: Asthma is a heterogeneous disease characterized by cough, wheeze and shortness of breath that vary in intensity and time with variable expiratory airflow limitation, associated with chronic airway inflammation. Aim of the study was to assess the usefulness of Peak Expiratory Flow Rate [PEFR] and oxygen saturation in determining severity of acute asthma, to measure objective change in PEFR and oxygen saturation following bronchodilator therapy and the role of chest X-rays in acute asthma.Methods: A prospective study of 50 children above 5 years with acute asthma who presented to the emergency department in a tertiary care hospital were included. PEFR and oxygen saturation before and after bronchodilator therapy was measured. Indication for chest X-rays, its clinical correlation and change in standard treatment of acute asthma based on X-ray reports was noted.Results: The mean PEFR and PEFR % of expected was lower in severe asthma when compared to moderate asthma and was statistically significant (p<0.001). The % of expected PEFR before salbutamol therapy was 48.78±14.36, which improved significantly to 67.13±14.22 after treatment (p<0.001). Oxygen saturation before and after salbutamol therapy was 94.96 ± 4.11 and 96.96±2.87 respectively with the change being significant (p value <0.001). Chest X-rays were performed in 12 (24%) children as per standard guidelines, of which 1(9%) was abnormal showing right basal consolidation. Chest X-ray correlated with clinical findings in 1 child and the findings on chest X-ray altered the ongoing treatment by addition of antibiotic.Conclusions: PEFR and oxygen saturation is useful in the emergency department to objectively assess the severity of acute asthma and the response to initial bronchodilator therapy. Chest X-rays are not routinely indicated in the standard treatment of acute asthma.

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