Emergency Radiology最新文献

Primary small bowel malignancies are rare, often presenting with nonspecific symptoms or as acute emergencies, which can delay diagnosis. Contrast-enhanced CT is the primary imaging modality in the emergency setting, but detection and characterization of small bowel tumors remain challenging. Cinematic rendering (CR) is a recently developed three-dimensional post-processing technique that produces photorealistic images from CT data, enhancing visualization of small bowel pathology. This pictorial review outlines the CT imaging features of major small bowel malignancies, including adenocarcinoma, carcinoid tumor, gastrointestinal stromal tumor, lymphoma, and sarcoma, and describes features that highlight the utility of CR in augmenting traditional imaging. CR offers improved visualization of mucosal abnormalities, tumor extent, vascular involvement, and textural differences, potentially increasing diagnostic confidence, supporting presurgical planning, and facilitating communication among clinicians and patients. By emphasizing the added value of CR, we aim to provide radiologists with practical guidance for identifying small bowel neoplasms and suggest that integrating advanced 3D visualization into routine CT evaluation can support timely diagnosis and management in acute care settings.

Medical imaging plays a central role in the management of trauma patients. Analytic morphomics (AM) through enabling measurement of specific biological markers of body composition from medical images is emerging as a potential tool to predict patient outcomes across multiple medical and surgical disciplines. We sought to provide a comprehensive review of the utility of AM in predicting outcomes in trauma patients. A systematic review with a narrative synthesis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines and checklists. PubMed, Embase, Scopus, The Cochrane Library as well as Web of Science and Trip database were searched for studies that assessed the relationship between computed tomography-based AM parameters and clinical outcomes in patients from a trauma cohort. Multiple AM domains, including lumbar muscle quantity and quality, adiposity, craniofacial measurements, and opportunistic bone mineral density (BMD), were consistently associated with adverse outcomes including mortality, length of stay, complications, and functional recovery. CT-derived AM metrics provide valuable prognostic information in trauma populations, extending beyond conventional measures such as chronological age and injury severity scores.Registration: PROSPERO Registration ID: CRD420251112652.

Purpose: Intracranial dermoid cysts are rare, benign congenital lesions that can rupture spontaneously, leading to dissemination of fatty contents within the subarachnoid or ventricular spaces. Though often asymptomatic, rupture can produce a range of neurological symptoms and distinct imaging features. We aim to evaluate the clinical presentation, imaging characteristics, and outcomes of patients with ruptured intracranial dermoid cysts.

Methods: We conducted a retrospective review of patients diagnosed with ruptured intracranial dermoid cysts at a tertiary academic medical center from July 1997 to July 2024. Rupture was confirmed by the presence of fat droplets in the CSF spaces on CT and/or MRI. Imaging findings were independently reviewed by two radiologists.

Results: Twenty-two patients (14 female, 8 male; mean age 51.7 years) met inclusion criteria. The most common presenting symptoms were headaches (31.8%). Imaging revealed intraventricular fat in 72.7% of cases and subarachnoid fat in 81.8%, with visible primary cysts in 31.8%. MRI findings included T1 hyperintense fat droplets in all cases, hypointense rims on T2 in 35% of cases, and susceptibility signal loss on SWI in 71%. Follow-up imaging (available in 14 cases) did not show complete resolution of fat droplets, though a reduction in the number of droplets was observed over time.

Conclusion: Ruptured intracranial dermoid cysts are rare but recognizable by their characteristic imaging features, particularly on T1-weighted MRI. While symptoms often improve, residual fat globules persist for years.

Purpose: Subarachnoid hemorrhage (SAH) due to a ruptured intracranial aneurysm is a neurologic emergency with diagnostic and management challenges. While traditional imaging techniques such as CT angiography and digital subtraction angiography remain essential, they may be inconclusive at identifying the culprit aneurysm when multiple aneurysms are present.

Methods/results: We present a patient with SAH and four intracranial aneurysms identified on initial CT angiogram. MR vessel wall imaging (VW-MRI) played a pivotal role: it revealed focal wall enhancement in the basilar tip aneurysm, guiding successful targeted balloon assisted coiling.

Conclusion: This case illustrates the value of VW-MRI in identifying ruptured aneurysms by assessing wall abnormality rather than just lumen morphology. VW-MRI employs high-resolution, black-blood MR techniques to visualize vessel wall pathology. Our findings support integrating VWI into acute management algorithms when conventional imaging is inconclusive, potentially improving diagnostic accuracy and outcomes in patients with complex aneurysmal SAH presentations.

Autologous breast reconstruction using donor-site flaps such as the deep inferior epigastric perforator (DIEP) flap, transverse rectus abdominis myocutaneous (TRAM) flap, latissimus dorsi flap, profunda artery perforator (PAP) flap, and autologous fat grafting is a cornerstone of post-mastectomy reconstruction, offering durable results and significant psychosocial benefits. Despite these advantages, donor site complications are common and can pose diagnostic challenges for radiologists. This pictorial review illustrates the spectrum of these complications, including seroma, hematoma, infection, fat necrosis, abdominal wall bulges and hernias, wound dehiscence focusing on their characteristic appearances across variety of modalities, primarily focused on computed tomography (CT), though also including radiography, ultrasound, and magnetic resonance imaging (MRI). By integrating surgical context with multimodality imaging features, this review provides practical guidance to distinguish expected postoperative changes from clinically significant complications, thereby improving diagnosis and facilitating early intervention for patients undergoing autologous breast reconstruction.