scholarly journals Comparison of Dorsal-to-Ventral Ratios of the Cervical Paraspinal Musculature in French Bulldogs With and Without Cervical Intervertebral Disk Disease and Two Other Breeds Based on CT Scan Measurements

2021 ◽  
Vol 8 ◽  
Author(s):  
Julia Hart ◽  
Stefan Rupp ◽  
Katinka Hartmann ◽  
Carolin Fischer ◽  
Pia Düver ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ct Scan ◽  
Body Length ◽  
Vertebral Body ◽  
Influencing Factor ◽  
Intervertebral Disk ◽  
Ct Scans ◽  
Height Ratio ◽  
Significant Difference ◽  
Major Factors

Objective: To objectively assess the cervical paraspinal musculature of French bulldogs (FBs) using computed tomography (CT) scan-based measurements, outline differences in other breeds published in the literature, and investigate the potential influence of its cervical paraspinal musculature on predisposed sites for intervertebral disk disease.Animals: Thirty FBs that underwent CT scans of the cervical spine from the skull to C7/T1 were enrolled. Fifteen dogs were patients suffering from intervertebral disk herniation (IVDH group), and 15 dogs underwent CT scans due to brachycephalic obstructive airway syndrome (BOAS group).Methods: At the level of each cervical intervertebral disk from C2/C3 to C7/T1, measurements were performed and statistically analyzed. On the sagittal CT scan reconstruction, the height ratio of the dorsal to ventral paraspinal musculature and the angle of the disk axis to vertebral body length were assessed. On the transverse plane, the area ratio of the dorsal and ventral paraspinal musculature and the ratio of force moments were determined at each intervertebral disk level. Finally, ratios were compared to the values of Labrador retrievers and dachshunds published by Hartmann et al. (1).Results: Comparing the two FB groups, one significant difference was detected in the mean height ratio of the dorsal to ventral paraspinal musculature at the level of C5/C6 (P = 0.0092) and C6/C7 (P = 0.0076), with IVDH FBs having the more prominent dorsal paraspinal musculature. At the level of C3/C4, a significantly less prominent dorsal paraspinal musculature in FBs than in dachshunds (P = 0.0058) and a significantly steeper disk to vertebral body angulation were observed (P = 0.0005).Conclusion: Although some incidental differences were found, most parameters did not significantly differ between the BOAS and IVDH FBs. Significant conformational differences in the cervical paraspinal musculature and disk to vertebral body length angulation were found between FBs and two other breeds (chondrodystrophic and non-chondrodystrophic). This study's findings suggest that the paraspinal musculature is an additional biomechanical influencing factor on the preferential sites of IVDH in the cervical spine and that other major factors exist in IVDH development, especially in FBs.

scholarly journals Chest CT Imaging Characteristics of COVID-19 Pneumonia in Surviving and Non-Surviving Hospitalized Patients: A Retrospective Study in a Referral Center in Tehran, Iran

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Sara Besharat ◽  
Fatemehsadat Rahimi ◽  
Siamak Afaghi ◽  
Farzad Esmaeili Tarki ◽  
Fatemeh Pourmotahari ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Ct Scan ◽  
Chest Ct ◽  
Ct Scans ◽  
Early Management ◽  
Ct Findings ◽  
Imaging Characteristics ◽  
Significant Difference ◽  
Chest Ct Scan ◽  
Lung Lobes

Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, ICU-admitted, and non-surviving (expired) patients. Results: Of four CT categories, typical CT findings for COVID-19 were more frequent in the expired group (77.4%), compared to the ward-admitted (44.8%) and ICU-admitted (70.8%) groups (P = 0.017). However, no significant difference was observed in the prevalence of intermediate or atypical CT findings between the groups. Negative CT scans for the diagnosis of COVID-19 were significantly fewer in the expired group (0%) as compared to the ward-admitted (10.3%) and ICU-admitted (8.3%) groups (P = 0.0180). Also, the mean number of involved lung lobes and segments was significantly higher in the expired group compared to the other two groups (P = 0.032 and 0.010, respectively). The right upper lobe involvement, right middle lobe involvement, bilateral involvement, central lesion, air bronchogram, and pleural effusion were among CT scan findings with a significantly higher prevalence in non-surviving cases (P < 0.0001, 0.047, 0.01, 0.036, 0.038, and 0.047, respectively). Conclusion: The increased number of involved lung lobes and segments, bilateral and central distribution patterns, air bronchogram, and severe pleural effusion in the initial chest CT scan can be related to the increased severity and poor prognosis of COVID-19.

scholarly journals Anatomical and Radiological Study of Jugular Foramen

2019 ◽  
Vol 08 (03) ◽  
pp. 121-125
Author(s):  
Ajay Kumar ◽  
Alok Tripathi ◽  
Shobhit Raizaday ◽  
Shilpi Jain ◽  
Satyam Khare ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Skull Base ◽  
Jugular Foramen ◽  
Ct Scans ◽  
Transverse Diameter ◽  
Radiological Study ◽  
Significant Difference ◽  
Human Skulls ◽  
The Right

Abstract Background and Aim The purpose of present study was to obtain comprehensive data of morphometric and anatomical details of jugular foramen. Materials and Methods The study was performed on 30 dry adult human skulls along with computed tomography (CT) scans from 30 adult patients. The parameters observed were dimensions, shape, margins, confluence, septations, and distance from jugular foramen to mastoid base. Result In the dry skull observations, only anteroposterior diameter (APD) was significantly different between the right and left side, while for the CT scan observations both transverse diameter and APD exhibit significant difference. Conclusion We believe that data from the present study will help radiologists and neurosurgeons for diagnosis and treatment of skull base pathology around jugular foramen.

scholarly journals iPhone-Based Teleradiology for the Diagnosis of Acute Cervico-Dorsal Spine Trauma

2010 ◽  
Vol 37 (6) ◽  
pp. 849-854 ◽  
Author(s):  
Jayesh Modi ◽  
Pranshu Sharma ◽  
Alex Earl ◽  
Mark Simpson ◽  
J. Ross Mitchell ◽  
...  
Keyword(s):  
Ct Scan ◽  
Vertebral Body ◽  
Medical Images ◽  
Patient Data ◽  
Dorsal Spine ◽  
Spine Trauma ◽  
Rater Agreement ◽  
Body Fracture ◽  
Significant Difference ◽  
Posterior Elements

AbstractObjective:To assess the feasibility of iPhone-based teleradiology as a potential solution for the diagnosis of acute cervico-dorsal spine trauma.Materials and Methods:We have developed a solution that allows visualization of images on the iPhone. Our system allows rapid, remote, secure, visualization of medical images without storing patient data on the iPhone. This retrospective study is comprised of cervico-dorsal computed tomogram (CT) scan examination of 75 consecutive patients having clinically suspected cervico-dorsal spine fracture. Two radiologists reviewed CT scan images on the iPhone. Computed tomogram spine scans were analyzed for vertebral body fracture and posterior elements fractures, any associated subluxation-dislocation and cord lesion. The total time taken from the launch of viewing application on the iPhone until interpretation was recorded. The results were compared with that of a diagnostic workstation monitor. Inter-rater agreement was assessed.Results:The sensitivity and accuracy of detecting vertebral body fractures was 80% and 97% by both readers using the iPhone system with a perfect inter-rater agreement (kappa:1). The sensitivity and accuracy of detecting posterior elements fracture was 75% and 98% for Reader 1 and 50% and 97% for Reader 2 using the iPhone. There was good inter-rater agreement (kappa: 0.66) between both readers. No statistically significant difference was noted between time on the workstation and the iPhone system.Conclusion:iPhone-based teleradiology system is accurate in the diagnosis of acute cervico-dorsal spinal trauma. It allows rapid, remote, secure, visualization of medical images without storing patient data on the iPhone.

Finite Element Model of the Human Lower Cervical Spine: Parametric Analysis of the C4-C6 Unit

1997 ◽  
Vol 119 (1) ◽  
pp. 87-92 ◽  
Author(s):  
N. Yoganandan ◽  
S. Kumaresan ◽  
L. Voo ◽  
F. A. Pintar
Keyword(s):  
Finite Element ◽  
Cervical Spine ◽  
Finite Element Model ◽  
Compressive Stress ◽  
Vertebral Body ◽  
Element Model ◽  
Intervertebral Disk ◽  
Von Mises Stress ◽  
Lower Cervical Spine ◽  
Intervertebral Disks

In this study, a three-dimensional finite element model of the human lower cervical spine (C4-C6) was constructed. The mathematical model was based on close-up CT scans from a young human cadaver. Cortical shell, cancellous core, endplates, and posterior elements including the lateral masses, pedicle, lamina, and transverse and spinous processes, and the intervertebral disks, were simulated. Using the material properties from literature, the 10,371-element model was exercised under an axial compressive mode of loading. The finite element model response agreed with literature. As a logical step, a parametric study was conducted by evaluating the biomechanical response secondary to changes in the elastic moduli of the intervertebral disk and the endplates. In the stress analysis, the minimum principal compressive stress was used for the cancellous core of the vertebral body and von Mises stress was used for the endplate component. The model output indicated that an increase in the elastic modulii of the disk resulted in an increase in the endplate stresses at all the three spinal levels. In addition, the inferior endplate of the middle vertebral body responded with the highest mean compressive stress followed by its superior counterpart. Furthermore, the middle vertebral body produced the highest compressive stresses compared to its counterparts. These findings appear to correlate with experimental results as well as common clinical experience wherein cervical fractures are induced due to external compressive forces. As a first step, this model will lead to more advanced simulations as additional data become available.

Minimising medically unwarranted computed tomography scans

2012 ◽  
Vol 41 (3-4) ◽  
pp. 161-169 ◽  
Author(s):  
D.J. Brenner
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Decision Rules ◽  
Clinical Decision ◽  
Ct Scans ◽  
Slowing Down ◽  
Powerful Approach ◽  
Computed Tomography Scans ◽  
Risk Balance ◽  
Major Factors

As computed tomography (CT) is such a superb diagnostic tool and individual CT risks are small, whenever a CT scan is clinically warranted, the CT benefit/risk balance is by far in the patient's favour. However, if a CT scan is not clinically warranted, this balance shifts dramatically. It is likely that at least 25% of CT scans fall into this latter category, in that they could either be replaced with alternative imaging modalities or could be avoided entirely. Use of clinical decision rules for CT usage represents a powerful approach for slowing down the increase in CT usage, because they have the potential to overcome some of the major factors that result in some CT scans being undertaken when they may not be clinically helpful.

scholarly journals COMPARATIVE ANALYSIS IMAGE RESULTS OF PANCREAS IN PORTAL VEIN PHASE ON CT SCAN ABDOMEN CONTRAST WITHOUT AND WITH MINIMUM INTENSITY PROJECTION IN CT SCAN 64 SLICE

2019 ◽  
Vol 2 (3) ◽  
pp. 101
Author(s):  
Maria Ramandita ◽  
Lailatul Muqmiroh ◽  
Pramono Pramono
Keyword(s):  
Ct Scan ◽  
Ct Scans ◽  
Analytic Method ◽  
Portal Venous Phase ◽  
Minimum Intensity Projection ◽  
Significant Difference ◽  
Venous Phase ◽  
Spss Software ◽  
Contrast Ct ◽  
Minimum Intensity

Background: Minimum Intensity Projection is a post-proccesing technique on CT Scan that useful for showing structures with low Hounsfiled Unit (HU) values such as pancreas. To demonstrate the anatomy and pathology of the pancreatic organs, a contrast CT scan was performed on pancreatic phase but pancreatic phase was rarely used, so it was replaced by the portal venous phase, but this technique is still rarely used among the radiographers. Objective: This study aimed to prove the image of the portal venous pancreatic vein on contrast contrast CT scan by using minimum intensity projection (MinIP) on CT scan 64 slices will produce a more optimal image than without the minimum intensity projection (MinIP). Methods: This study is a retrospective study with an observational analytic method to assess differences of pancreatic image in contrasting contrast CT scans with and with MinIP reforms on CT 64 slice modalities Philips Briliance. 30 images as samples, with the criteria set by the researchers. The image will be post proccesing without and by using MinIP reformat. Image results will be evaluated by two radiologist, then the data obtained will be tabulated and processed using SPSS software version 17. Result: From this research obtained the result that MinIP reformat able to produce pancreas image more optimal than image without MinIP reformat on CT scan 64 slice and shows a significant difference. Overall assessment of the image has an improvement with the MinIP but for the homogeneity of pancreatic images decreased. Conclusions: There was a significant difference between pancreatic venous porta port results in contrasting CT scans of the abdomen without and with MinIP reformat.

317 Cost-Effectiveness of a Novel Cervical Spine Clearance Protocol: Obviating the Need for Routine Magnetic Resonance Imaging

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 268-268
Author(s):  
Jared Ament ◽  
Bart Thaci ◽  
Mena Said ◽  
Ripul Rajen Panchal ◽  
Kee Duk Kim ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cost Effectiveness ◽  
Weight Bearing ◽  
Ct Scans ◽  
Spine Injury ◽  
Trauma Patients ◽  
Mri Findings ◽  
Routine Magnetic Resonance Imaging ◽  
Significant Difference ◽  
Flexion Extension

Abstract INTRODUCTION Cervical spine injury (CSI) occurs in 2–4% of trauma patients in the USA causing significant decrements in quality of life and even death. Treatment of CSI is estimated to cost $9.7 billion annually. Computed tomography (CT) has an almost 100% negative predictive value (NPV) for cervical spine (c-spine) clearance, in both alert and obtunded patients. However, MRI can depict occult discoligamentous injury in some patients with negative CT scans. It remains unclear whether MRI findings should preclude c-spine clearance and prolong hospital stay. This review intends to critically assess CT-missed CSI patients and derive a safe, economically sustainable protocol for c-spine clearance. METHODS A retrospective review of prospectively collected CSI data from two, level-1 trauma centers, was conducted from 2015–2016. Primary outcome measures include: NPV and the incremental cost-effectiveness ratio (ICER) of a novel c-spine clearance protocol compared with standard of care. The protocol included thin-cut CT scans with either weight-bearing or flexion-extension films. The ICER was calculated using standard cost-utility analysis techniques in US dollars ($) per quality-adjusted-life-year (QALY), assuming a willingness-to-pay threshold of 50,000$/QALY. RESULTS >A total of 614 patients were reviewed. Mean age was 38.3 years (SD 18.6), 147 (23.9%) had altered mentation, and 12 (2%) had clinically meaningful CT-missed acute discoligamentous disruption. Our c-spine clearance protocol had a NPV of 99.8% (CI 96.5-100%). There was no statistically significant difference between awake and obtunded patients (P = 0.74). Mean time to c-spine clearance improved by 1.3 days (SD 0.9). Duration of c-spine immobilization was reduced by 930 person-days. Mean cost savings was $1230 (SD $242) per patient. Mean change in QALY was 0.02 (SD 0.01). The ICER was 61,500$/QALY. CONCLUSION Our novel CSI clearance protocol is both safe and highly cost-effective. It improves outcomes at less cost, making it a dominant strategy that centers should consider implementing.

scholarly journals Morphological study of cervical spinal body and vertebral body anatomy: CT scan based

2021 ◽  
Vol 8 (5) ◽  
pp. 1540
Author(s):  
A. K. Chaurasiya ◽  
Anil Dawar ◽  
Rajneesh Gour ◽  
Kunal Vaidya
Keyword(s):  
Cervical Spine ◽  
Ct Scan ◽  
Vertebral Body ◽  
Clinical Importance ◽  
Cervical Region ◽  
Spine Injury ◽  
Cervical Canal ◽  
Transverse Diameter ◽  
Vertebral Level ◽  
Canal Diameter

Background: The morphometery of the cervical spine vertebra is of clinical importance in traumatic, degenerative and inflammatory condition requiring surgery and instrumentation. The aim of this study was to determine the mid-sagittal, AP Transverse diameter, AP diameter of cervical vertebral body, surface area of canal and torg ratio at level C2 –C7.Methods: Study was performed in the department of general surgery, GMC and Hamidia Hospital Bhopal from January 2016 - June 2020 in 300 patients with clinically apparent cervical spondylosis and cervical spine injury belongs to central India of age group 20- 88 years including males and females by gathering their parameters (height and weight) and CT of cervical region from C1 to D1 spine.Results: In our study maximum sagittal canal diameter in males was found at C2 vertebral level (14.14 mm) and minimum at C4 vertebral level (14.00 mm) whereas the maximum sagittal canal diameter in females was found at C2 and C7 vertebral level (14.00 mm) and minimum at C4 vertebral level (13.82 mm) while mean sagittal canal diameter was greater in males than females. The maximum transverse canal diameter in both males and female was found at C7 level, it measures 21.09 mm in males and 21.38 mm in females.Conclusions: The CT scan can provide accurate cervical canal measurement that could serve as useful guide in preoperative surgical planning, instrumentation and size of prosthesis. 

Deletion 11q Abnormality in Patients with Chronic Lymphocytic Leukemia (CLL) May Not Have Poor Clinical Outcomes and Bulky Disease (clinical and radiological) At Presentation – Clinical Characteristics of (n=172) Previously Untreated Patients with CLL and del11q Cytogenetic Abnormality.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2890-2890
Author(s):  
Preetesh Jain ◽  
Long Xuan Trinh ◽  
Ohad Benjamini ◽  
Susan Lerner ◽  
Xuemei Wang ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Features ◽  
Research Funding ◽  
Clinical Characteristics ◽  
Ct Scans ◽  
Chromosome 11 ◽  
Bulky Disease ◽  
Β2 Microglobulin ◽  
Risk Of Death ◽  
Significant Difference

Abstract Abstract 2890 Introduction: Del11q aberration is universally considered as an adverse prognostic marker in patients with CLL. However, large studies describing the clinical characteristics of del11q in CLL patients (pts) have never been reported. We studied the clinical features, outcomes and treatment responses among (172) previously untreated pts with CLL and del11q. Methods: This is a retrospective analysis of CLL pts (n=172) with del11q, who presented at our institution between 2003–2012. All pts signed an informed consent as per the declaration of Helsinki and IRB approval. Del11q was determined from bone marrow (BM) aspirate or blood samples by FISH (Fluorescent in-situ hybridization) technique. Detection of the 11q22.3 (ATM gene) on chromosome 11 used a multi-color FISH technique. Pts were divided into five categories – One – 57; del11q alone, Two – 105; del11q and del13q, others – 10 (4; del11q with +12, 1; del11q with del17p and 5; del11q, del13q with +12). Baseline bulky lymphadenopathy by CT scan or physical exam (PE) was also analysed. The probabilities of OS, PFS and TTFT (time to first treatment) were estimated using KM plots (log rank). PFS was assessed in 121 treated pts, from date of starting therapy to date of progression or death on therapy. The Cox proportional hazards regression model was used to assess the association between pt characteristics and OS, PFS or TTFT. Results: At the baseline, majority of pts with del11q were young (median age <60 years), males (81.4%) without very high white cell count (median 33.8 K/UL), absolute lymphocyte count – (median 27.1 K/UL) and β2 microglobulin (3 mg/L). Only 16.7% (n=28) patients had advanced Rai stage (3, 4). Majority were IGHV unmutated (n=112; 89.6%), CD38 high (n=88; 51.8%), Zap-70 high (n=100; 75.8%). Status of bulky disease was assessed by PE and baseline CT scans. Bulky disease by PE was observed in n=11 (6.4%) only. Baseline CT scans were performed for 108 patients out of whom only 16 patients (14.8%) had bulky disease. Thus, majority of del11q pts did not have bulky disease by PE or by CT scanning. Analysis of time dependent variables was performed. Among the total 172 pts, 19 (11%) have died. and median time to death has not been reached (NR) - OS. 48/125 (38%) pts who were treated died or progressed and median PFS time was 49.2 months. Overall, 123 (71%) patients received therapy after initial presentation at MDACC. The median TTFT was 10.6 months. FCR based therapies were given in (91; 73 %) pts. Median PFS on FCR based therapy was 32 mo (Figure -1). CR was achieved in (70%; n=64) and overall response was 89%. Pts who received fludarabine based therapy had a significantly shorter TTFT as compared to non fludarabine based therapy (P<0.0001). Other pts (32) were treated with single agent rituximab and lenalidomide protocols. To address whether del11q has any influence over presence of deletion 13 q abnormality we compared (del11q alone; n=57) vs (del11 and del13q; n=105) patients. Patients with sole del11q had significant proportions of younger patients, lesser WBC count, and ALC and β2 microglobulin. Furthermore, there was no significant difference in OS, PFS and TTFT among the two categories. In the multivariate analysis for OS and PFS among the two categories, β2 microglobulin was significantly predictive of increased risk of death or progression among the two categories and FISH categories were not significantly predictive of OS or PFS or TTFT. Bulky disease by PE (and not by CT scan) was significantly associated with a shorter TTFT (HR=2.93; 95%CI -1.5–5.69 and P=0.002). Furthermore, a separate cohort of (n=500) patients with sole del13q was compared with del11q alone (n=57) and del11q with del13q (n=105). There was no significant difference in OS but the TTFT was significantly shorter in del11q alone (data not shown). Conclusions: We describe the clinical features of del11q in CLL patients. This study suggests that occurrence of del11q is frequent with del13q abnormality. The majority of patients with del11q did not have bulky disease as assessed by PE or by CT scan. Presence of bulky disease by PE predicted for a shorter TTFT. β2 microglobulin level significantly predicted for OS and PFS. FCR based therapy has good responses. Del11q is similar to del13q in terms of OS, PFS and TTFT. Del11q may not have very poor adverse outcomes in patients with CLL inspite of a shorter TTFT. Disclosures: Burger: Pharmacyclics: Consultancy, Research Funding. Wierda:Abbott: Research Funding; Genentech: Consultancy, Research Funding; GlaxoSmithKline: Consultancy, Research Funding; AmGen: Research Funding; Merck: Consultancy; Celgene: Consultancy; Pharmacyclics: Consultancy; Genzyme: Consultancy. Kantarjian:Genzyme: Research Funding.

scholarly journals P064: Effect of increased availability of pre-authorized radiological test ordering on CT scan utilization in the emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S100-S100
Author(s):  
K. Huszarik ◽  
K. Wood ◽  
M. Columbus ◽  
A. Dukelow
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Ct Scan ◽  
Patient Flow ◽  
Tertiary Care ◽  
Ct Scans ◽  
Significant Difference ◽  
Implementation Period ◽  
Flow Through ◽  
The Impact

Introduction: Computed tomography (CT) scan utilization has increased dramatically over the past 25 years. This has sparked concern for potential overuse leading to unnecessary radiation exposure for patients and increased health care costs, without any improvement in health outcomes. In order to improve workflow through the Emergency Department (ED) at our institution, an existing pre-authorization policy during weekday business hours allows emergency physicians to order CT scans directly without the need for approval from a radiologist. This policy was recently expanded on September 28, 2015 to allow pre-authorized CT scan orders during weekday evening hours. The objective of our study is to evaluate the impact of increased availability of pre-authorized CT scan ordering on CT scan utilization and patient flow through the ED at two tertiary care hospitals in London, Ontario. Methods: This is a retrospective review comparing monthly CT scan utilization rates in the pre-implementation period from September 28, 2014 to February 28, 2015, to rates in the post-implementation period from September 28, 2015 to February 28, 2016. Length of stay parameters including time from physician initial assessment to CT scan order, completion, report and patient discharge will also be compared between the groups. Results: Results will be presented at CAEP 2016. No significant difference is expected in the monthly number of CT scans ordered per registered ED visits between the pre- and post-implementation groups. We also anticipate a significantly shorter average length of stay for patients receiving a CT scan in the post-implementation group. Conclusion: We expect there will be no significant increase in CT scan utilization with increased availability of pre-authorized CT scan ordering in our EDs. We also anticipated decreased patient length of stay leading to improved patient flow through the ED. Findings may offer support for organizations to safely implement or increase availability of pre-authorized CT scan orders to help improve patient flow and decrease costs in the ED.

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