1,720,973 research outputs found
Screening US and CT for blunt abdominal trauma: A retrospective study.
No full textScreening US and CT for blunt abdominal trauma: A retrospective study
* Giuseppetti Gian MarcoCorresponding author contact information, E-mail the corresponding author,
* Salera Diego,
* Argalia Giulio,
* Salvolini Luca
* Institute of Radiology, Polytechnic University of Marche Medical School, Umberto I Hospital, Ancona, Italy
* Received 20 October 2004. Revised 31 January 2005. Accepted 1 February 2005. Available online 5 March 2005.
* http://dx.doi.org/10.1016/j.ejrad.2005.02.001, How to Cite or Link Using DOI
*
Cited by in Scopus (14)
*
Permissions & Reprints
Abstract
Objective:
To assess the accuracy of screening US and CT in patients with blunt abdominal trauma admitted to the trauma centre of our General Hospital.
Materials and method:
The abdominal US reports of 864 primary trauma patients (139 with major and 725 with minor injuries) and 162 CT reports of a subgroup of the same subjects (64 with major and 98 with minor injuries) were reviewed and compared to the best available reference standard. The accuracy of screening US was assessed by evaluating its overall ability to distinguish negative from positive cases by showing at least one of the lesions documented by the reference standard and its specific ability to depict all lesions; CT reports were evaluated only for the method's performance in depicting all lesions.
Results:
Screening US exhibited a satisfactory overall ability to distinguish negative from positive patients (91.5% sensitivity and 97.5% specificity in major trauma patients versus 73.3% sensitivity and 98.1% specificity in the minor trauma group) and a satisfactory specific ability to depict all injuries in major trauma patients. In minor trauma cases sensitivity was satisfactory for free fluid but unsatisfactory for organ injuries. Of the 21/864 false negative reports (5 in patients with major and 16 in cases with minor traumas), only one affected patient management, a major trauma case, by delaying an emergency laparotomy. The performance of CT in detecting each single lesion was predictably excellent in both patient groups.
Conclusion:
Its satisfactory accuracy for major trauma suggests that US could be employed not only to screen cases for emergency laparotomy but also as an alternative to CT. However, since major traumatic injuries generally carry an imperative indication for CT, especially as regards neurological, thoracic and skeletal evaluation, US should be employed to perform a prompt preliminary examination using a simplified technique in the emergency room simultaneously with resuscitation.
Keywords
* Emergency screening US;
* Blunt abdominal trauma;
* Emergency radiolog
Magnetic resonance cholangiopancreatography in primary sclerosing cholangitis in children
No full textSuspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting
No full textEur J Radiol. 2008 Mar;65(3):340-9. Epub 2007 Nov 7.
Suspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting.
Salvolini L, Scaglione M, Giuseppetti GM, Giovagnoni A.
Source
Radiology Department, Umberto I Hospital - Ospedali Riuniti - Politecnica delle Marche University, Via Conca, 60020 Ancona, Italy. [email protected]
Abstract
Both pulmonary arterial and peripheral venous sides of venous thromboembolism (VTE) can now be efficiently and safely investigated by multi-detector CT (MDCT) at the same time by a combined CT angiography/CT venography protocol. In the emergency setting, the use of such a single test for patients suspected of suffering from VTE on a clinical grounds may considerably shorten and simplify diagnostic algorithms. The selection of patients to be submitted to MDCT must follow well-established clinical prediction rules in order to avoid generalized referral to CT on a generic clinical suspicion basis and excessive population exposure to increased ionizing radiation dose, especially in young patients. Clinical and anatomical wide-panoramic capabilities of MDCT allow identification of underlying disease that may explain patients' symptoms in a large number of cases in which VTE is not manifest. The analysis of MDCT additional findings on cardiopulmonary status and total thrombus burden can lead to better prognostic stratification of patients and influence therapeutic options. Some controversial points such as optimal examination parameters, clinical significance of subsegmentary emboli, CT pitfalls and/or possible falsely positive diagnoses, and outcome of untreated patients in which VTE has been excluded by MDCT without additional testing, must of course be taken into careful consideration before the definite role of comprehensive MDCT VTE "one-stop-shop" diagnosis in everyday clinical practice can be ascertained.
PMID:
17988813
[PubMed - indexed for MEDLINE
Three-dimensional computerized modelling of anatomical structures by computerized tomography imaging
No full text
Stenting right main bronchus with montgomery T tube for upper lobe ventilation
No full textThe involvement of the right main bronchus (RMB) along with the upper lobe bronchus and bronchus intermedius by malignant tumor is frequently encountered. However, the use of a stent for palliation of airway stenosis of the RMB might obstruct upper lobe orifice and pose complications such as atelectasis or recurrent pneumonia. We report the use of modified Montgomery T tube in a 78-year-old man with neoplasm of the RMB by placing the tracheostomy arm of the T tube in the upper lobe bronchus to maintain its patency
Angiography with spiral computed tomography. The basic principles and clinical potentials
No full text- …
