European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Position Statement on Dermatologic Ultrasound.

Dermatologic ultrasound is a recent application of ultrasound for the evaluation of healthy skin and appendages and their diseases. Although the scientific literature regarding this application is still not sufficient for evidence-based guidelines, general recommendations issued by scientific societies are necessary. The EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) steering committee for dermatologic ultrasound has developed a series of consensus position statements regarding the main fields of dermatologic ultrasound (technical requirement, normal skin and appendages, inflammatory skin diseases, tumoral skin diseases, aesthetic dermatology and practice-training requirements). This document is the foundation for future evidence-based recommendations and guidelines for dermatologic ultrasound practice.

Coping with war mass casualties in a hospital under fire: the radiology experience.

OBJECTIVE: We report the role of the imaging department at a level 1 trauma center during the Second Lebanon War (summer 2006). Our institution received 849 military and civilian casualties, an average of 25 war-injured patients per day, 338 with acute traumatic stress disorders and 511 physically injured, coming in waves after a rocket attack or a battle confrontation. About 12 potentially critical physically injured patients per day were referred to the imaging department for sometimes complex imaging procedures. The unpredictable waves of casualties and nature of the injuries forced us to reorganize our routine workflow to provide adequate care to casualties and to nonemergent patients. Our nurses' station was transformed into a small emergency department. The radiology staff was distributed into 12 diagnostic stations, providing 24-hour service. Communication was improved by means of walkie-talkies. Three ultrasound units were placed at the emergency department for immediate focused assessment with sonography for trauma performance enabling initial triage of patients. The site and extent of injuries were accurately diagnosed on CT and CT angiography. Digital angiography allowed definitive vascular diagnosis and interventional procedures. CONCLUSION: Adequate communication, strict workflow, and correct use of imaging protocols ensured optimal triage, diagnosis, and therapy of casualties while maintaining care for nonwar patients.

Pitfalls of the lactating breast on computed tomography.

Breasts are usually only incidentally included in computed tomography (CT) scans of the abdomen and chest in spite of the fact that pathologic findings are not rare. Because postpartum women are normally healthy, they rarely require examination; therefore, the presentation of lactating breasts on a CT scan is poorly known. The most common postpartum breast feature is engorgement, which is characterized by painful swelling associated with a sudden increase in milk volume, lymphatic and vascular congestion, and interstitial edema. Its appearance on a CT scan does not seem to have been described in the literature to date. The CT picture of a lactating breast shows the enlarged gland with bilateral cord- and mass-like hyperattenuated tissue. After abrupt cessation of breast-feeding, the edema component supervenes and breast tissue may become hypoattenuated. In such cases, further ultrasound evaluation is needed. We present 3 cases of postpartum breast engorgement as seen on CT.