Newsletter - November 2013     Dear MDCT.net users, Emergency patients need an immediate and unambiguous diagnosis for potentially life-threatening illnesses and traumatic injuries. Nowadays, MDCT offers the quickest and most precise approach to solving these diagnostic challenges regularly encountered by critical care physicians. In fact, as scanner technology has evolved over the years, MDCT has become so accurate and reliable that it has dramatically influenced and improved the management of emergency room patients. Therefore, this month we focus on MDCT in the practice of emergency radiology. We begin this issue of the newsletter with an editorial on how MDCT has revolutionized, and will continue to revolutionize, emergency patient care. We then highlight selected full-text research articles, book chapters, clinical cases and other content―all regarding the use of MDCT in the emergency setting. On a related topic, we note that a new e-lecture on brain perfusion CT, recorded at the annual meeting of the European Society of Neuroradiology, is now available for viewing on MDCT.net. Your MDCT.net team     MDCT: Imaging modality of choice in the emergency room A. Laghi The availability of MDCT has completely revolutionized the practice of emergency radiology. What was a dream for many physicians in past decades is now routine work for the youngest generation of radiologists and clinicians. view »       Abdomen and Pelvis Fever, vomiting and abdominal pain Woman, 54 years old view » Nausea, vomiting and abdominal pain Woman, 85 years old view »   Brain, and Head and Neck Injury to the head after a fall Woman, 83 years old view »   Cardiovascular Cardiac arrest with an aortic valve prosthesis Woman, 78 years old view » Chest pain with a history of bypass Man, 75 years old view » Heart failure with a history of stenting Male, 72 years old view »       Emergency Radiology - Imaging of Acute Pathologies A. Singh (Ed.) - Springer 2013 • Table of Contents • Imaging of Acute Aortic Conditions view » Further titles Emergency Radiology of the Abdomen - Imaging Features and Differential Diagnosis for a Timely Management Approach M. Scaglione, U. Linsenmaier, G. Schueller (Eds.) - Springer 2012 • Table of Contents • Acute Abdomen: Rational Use of US, MDCT, and MRI  view » Emergency Radiology – Imaging and Intervention B. Marincek, R.F. Dondelinger (Eds.) - Springer 2007 • Table of Contents • Role of 3D Imaging in the Emergency Room   view » Emergency Neuroradiology T. Scarabino, U. Salvolini, J.R. Jinkins - Springer 2006 • Table of Contents • CT in Intraparenchymal Haemorrhage  view »       Cardiovascular: Pulmonary embolism Pulmonary embolism can be accurately excluded from the results of CT angiography, but evidence is mounting to suggest that many of the requests for this examination are unneeded. A large retrospective study, published in Emergency Radiology, found that the diagnostic yield of pulmonary CT angiography for this clinical application is less than 10%. The authors concluded that the examination is overused and recommended that physicians give greater emphasis to the clinical work-up before CT referral. view » Brain, head and neck: Perfusion CT For perfusion CT to be a practical exam in the diagnosis of suspected acute stroke, perfusion parameters must be rapidly and accurately assessed. A study published in Emergency Radiology evaluated the diagnostic accuracy of a commercial program that generates cerebral lesion maps. Compared to manual assessment of perfusion parameters, the software had higher sensitivity but much lower specificity. However, when both manual and automatic assessments were done, the specificity was good. view » Abdomen and pelvis: Acute abdomen Acute, non-traumatic abdominal pain is a common reason for patients to seek emergency care, but the diagnostic yield of abdominal CT for this clinical presentation is not high. According to a study published in Digestive Diseases and Sciences, for patients who experience acute pain on multiple occasions, if the CT examination at the first presentation was negative, then it is likely that CT will be negative at successive presentations. According to the authors, the decision to use abdominal CT for repeat episodes should take into consideration each patient's clinical condition. view » Further titles • Tonolini M, Bianco R.  Nontraumatic splenic emergencies: cross-sectional imaging findings and triage. Emerg Radiol. 2013 Aug;20(4):323-332 • Martillotti J, Silva N, Chhabra J et al.  Dose of reduced z-axis length of computed tomography angiography (CTA) of the chest for pulmonary embolism using 64-detector rows and adaptive iterative reconstruction techniques. Emerg Radiol. 2013 Jan;20(1):39-44       From: ESNR Meeting, Frankfurt 2013 Neuroimaging in emergency and non-emergency settings The role of CT in brain perfusion imaging C. Ozdoba view »     FROM THE MDCT.net ARCHIVE A selection of further relevant contents     Technical Considerations The diagnostic accuracy of CT perfusion compared to MRI B. Ertl-Wagner CT perfusion (CTP) has become one of the mainstays of acute stroke imaging. Due to its short acquisition times and its wide availability, it can lead to an accurate diagnosis faster than magnetic resonance imaging (MRI). Even if both modalities were readily available on a 24/7 setting - which is unrealistic in most places – the longer scan time of MRI still results in a lengthier diagnostic decision-making process. view » Brain and Head and Neck Comprehensive imaging of acute ischemic stroke using multidetector CT: fast, safe and feasible V. Matarese The roles of emergency neuroimaging for clinically suspected acute stroke are to differentiate ischemic from hemorrhagic stroke and to estimate the extent of the stroke, so that referring clinicians can choose the best treatment modalities. view »     Abdomen and Pelvis view » Brain, and Head and Neck view » Cardiovascular view » Musculoskeletal view      Browse by... ... Body region, Pathology, Scanner type and Manufacturer to identify the appropriate protocol     If you wish to be removed from this email list, please click here If you would like to view our Privacy Policy, click here