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1.
Emerg Radiol ; 27(6): 773-780, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33111154

RESUMEN

PURPOSE: This study examined the impact of the COVID-19 pandemic on emergency department CT use for acute nontraumatic abdominal pain, to better understand why imaging volume so drastically decreased during the COVID-19 pandemic. METHODS: This was a retrospective review of emergency imaging volumes from January 5 to May 30, 2020. Weekly volume data were collected for total imaging studies, abdominopelvic CT, and abdominopelvic CTs positive for common causes of acute nontraumatic abdominal pain. Two emergency radiology attendings scored all diverticulitis cases independently, and weekly volume data for uncomplicated and complicated diverticulitis cases was also collected. Volume data prior to and during the COVID-19 pandemic was compared, using 2019 volumes as a control. RESULTS: During the COVID-19 pandemic, overall emergency imaging volume decreased 30% compared to 2019 (p = 0.002). While the number of emergency abdominopelvic CTs positive for appendicitis and small bowel obstruction did not significantly change during the COVID-19 pandemic, the number of cases of diverticulitis decreased significantly compared to 2019 (p = 0.001). This reduction can be specifically attributed to decreased uncomplicated diverticulitis cases, as the number of uncomplicated diverticulitis cases dropped significantly (p = 0.002) while there was no significant difference in the number of complicated diverticulitis cases (p = 0.09). CONCLUSIONS: Reduced emergency abdominopelvic CT volume during the COVID-19 pandemic can partially be explained by decreased imaging of lower acuity patients. This data may help formulate future strategies for imaging resource utilization with an improved understanding of the relationship between perceived imaging risk and symptom acuity.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Diverticulitis/diagnóstico por imagen , Servicio de Urgencia en Hospital , Neumonía Viral/epidemiología , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Betacoronavirus , COVID-19 , Femenino , Humanos , Masculino , Massachusetts/epidemiología , Pandemias , Estudios Retrospectivos , SARS-CoV-2 , Revisión de Utilización de Recursos
2.
Emerg Radiol ; 24(2): 139-142, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27807654

RESUMEN

This study aimed to evaluate the radiologist's ability to identify excreted gadoxetate disodium within the gallbladder on CT scan. Thirty three healthy adults underwent imaging of the liver during work-up for potential liver donation. Three patients had undergone prior cholecystectomy and therefore were excluded. Imaging consisted of gadoxetate disodium-enhanced magnetic resonance cholangiography (MRC) and multiphase contrast-enhanced CT scan of the abdomen and pelvis. Two fellowship-trained abdominal imaging radiologists, who were blinded to the MRC images and the contrast agent used during MRC, independently reviewed the CT scans of the 30 patients that were included. The scans were evaluated for the presence or absence of abnormal hyperdensity within the gallbladder. Three patients did not receive intravenous gadoxetate disodium, 4 patients had their MRC after the CT scan, and 1 patient had the CT scans 5 days following the MRC. Twenty two patients had the CT scan within 24 h following the gadoxetate disodium-enhanced MRC. Of the 22 patients expected to have gadolinium in the gallbladder, both reviewers identified hyperdensity in the same 20 patients (90%). Both reviewers reported no abnormal hyperdensity within the gallbladder in the remaining 10 patients. CT scan can reveal excreted gadoxetate disodium within the gallbladder lumen and therefore gadoxetate disodium-enhanced CT scan can potentially play a role in the evaluation of cystic duct patency and work-up of acute cholecystitis.


Asunto(s)
Pancreatocolangiografía por Resonancia Magnética/métodos , Colecistitis/diagnóstico por imagen , Medios de Contraste/farmacocinética , Gadolinio DTPA/farmacocinética , Vesícula Biliar/diagnóstico por imagen , Meglumina/análogos & derivados , Compuestos Organometálicos/farmacocinética , Tomografía Computarizada por Rayos X/métodos , Adulto , Colecistitis/metabolismo , Femenino , Vesícula Biliar/metabolismo , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Meglumina/farmacocinética , Persona de Mediana Edad
3.
Curr Probl Diagn Radiol ; 48(6): 616-625, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30415790

RESUMEN

Disorders of the kidney and urinary collecting system are common encountered in the acute care setting. Computed tomography has progressively replaced intravenous pyelography for the evaluation of most urinary tract pathology including acute flank pain, suspected malignancy, congenital abnormalities, anatomical variants, and inflammatory/vascular conditions through evaluation of the "nephrogram" produced by intravenous contrast material filtering through the kidneys. In this review, we describe the most common types of abnormal nephrograms seen on renal computed tomography, and highlight the salient features and conditions associated with them, in addition to a pictorial review with specific and interesting related cases. The types of abnormal nephrograms reviewed are absent, unilateral delayed, striated, spotted, and persistent.


Asunto(s)
Enfermedades Renales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Enfermedad Aguda , Medios de Contraste , Diagnóstico Diferencial , Humanos
4.
Curr Probl Diagn Radiol ; 46(6): 423-431, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28162865

RESUMEN

In this article, we discuss the challenges in the diagnosis of acute abdominopelvic pain in pregnant patients, role of imaging, and advantages of MRI over other modalities. Methods consist of pictorial review. We review the differential diagnoses and illustrate the MRI findings in pregnant patients with acute abdominopelvic pain, including gastrointestinal, gynecologic, urologic, and vascular etiologies.


Asunto(s)
Abdomen Agudo/diagnóstico por imagen , Abdomen Agudo/fisiopatología , Imagen por Resonancia Magnética/métodos , Dolor Pélvico/diagnóstico por imagen , Dolor Pélvico/fisiopatología , Complicaciones del Embarazo/diagnóstico por imagen , Abdomen/diagnóstico por imagen , Enfermedad Aguda , Diagnóstico Diferencial , Femenino , Humanos , Pelvis/diagnóstico por imagen , Embarazo , Complicaciones del Embarazo/fisiopatología
5.
Curr Probl Diagn Radiol ; 46(3): 242-256, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27318411

RESUMEN

To review the classification of testicular tumors, describe the sonographic and pathologic features of each tumor type, and discuss the mimics, diagnostic pitfalls, and management of testicular tumors. Method consists of pictorial review. We review sonographic and pathologic findings of several testicular tumors and tumorlike entities. Although ultrasound is the first-line imaging modality to differentiate between intratesticular and extratesticular location of an intrascrotal mass, it is not specific for intratesticular lesion characterization. Therefore, correlation with histology sampling is often necessary.


Asunto(s)
Neoplasias Testiculares/diagnóstico por imagen , Neoplasias Testiculares/patología , Ultrasonografía/métodos , Diagnóstico Diferencial , Humanos , Masculino
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