Pub Date : 2024-04-23DOI: 10.1007/s10140-024-02231-3
Gregory Dieudonne, Johnny Monu, David Hicks
{"title":"BPOP in early childhood following resection of osteochondroma: report of a case.","authors":"Gregory Dieudonne, Johnny Monu, David Hicks","doi":"10.1007/s10140-024-02231-3","DOIUrl":"https://doi.org/10.1007/s10140-024-02231-3","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1007/s10140-024-02230-4
Lewis Fanney, Vandan Patel, Shahwar M Tariq, Shijie Hong, Richard S. Davidson, Jie C. Nguyen
{"title":"Pediatric foot fractures on radiographs: distribution and predictors of surgery.","authors":"Lewis Fanney, Vandan Patel, Shahwar M Tariq, Shijie Hong, Richard S. Davidson, Jie C. Nguyen","doi":"10.1007/s10140-024-02230-4","DOIUrl":"https://doi.org/10.1007/s10140-024-02230-4","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140677476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-18DOI: 10.1007/s10140-024-02227-z
K. Yasaka, Masumi Mizuki Takahashi, M. Kurokawa, T. Kubo, Y. Watanabe, Hiroyuki Saigusa, O. Abe
{"title":"Transient interruption of contrast on CT pulmonary angiography: effect of mid-inspiratory vs. end-inspiratory respiration command.","authors":"K. Yasaka, Masumi Mizuki Takahashi, M. Kurokawa, T. Kubo, Y. Watanabe, Hiroyuki Saigusa, O. Abe","doi":"10.1007/s10140-024-02227-z","DOIUrl":"https://doi.org/10.1007/s10140-024-02227-z","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-06DOI: 10.1007/s10140-024-02224-2
Abdul M Zafar, Diya Mathur, Brian D Barnacle, Ruth W Magera
{"title":"Design of overnight radiology shifts - primum non nocere.","authors":"Abdul M Zafar, Diya Mathur, Brian D Barnacle, Ruth W Magera","doi":"10.1007/s10140-024-02224-2","DOIUrl":"https://doi.org/10.1007/s10140-024-02224-2","url":null,"abstract":"","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-02-05DOI: 10.1007/s10140-024-02208-2
Amir Hassankhani, Melika Amoukhteh, Payam Jannatdoust, Parya Valizadeh, Delaram J Ghadimi, Pauravi S Vasavada, Jennifer H Johnston, Ali Gholamrezanezhad
Pediatric distal forearm fractures, comprising 30% of musculoskeletal injuries in children, are conventionally diagnosed using radiography. Ultrasound has emerged as a safer diagnostic tool, eliminating ionizing radiation, enabling bedside examinations with real-time imaging, and proving effective in non-hospital settings. The objective of this study is to evaluate the diagnostic efficacy of ultrasound for detecting distal forearm fractures in the pediatric population. A systematic review and meta-analysis were conducted through a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases until October 1, 2023, following established guidelines. Eligible studies, reporting diagnostic accuracy measures of ultrasound in pediatric patients with distal forearm fractures, were included. Relevant data elements were extracted, and data analysis was performed. The analysis included 14 studies with 1377 patients, revealing pooled sensitivity and specificity of 94.5 (95% CI 92.7-95.9) and 93.5 (95% CI 89.6-96.0), respectively. Considering pre-test probabilities of 25%, 50%, and 75% for pediatric distal forearm fractures, positive post-test probabilities were 83%, 44%, and 98%, while negative post-test probabilities were 2%, 6%, and 15%, respectively. The bivariate model indicated significantly higher diagnostic accuracy in the subgroup with trained ultrasound performers vs. untrained performers (p = 0.03). Furthermore, diagnostic accuracy was significantly higher in the subgroup examining radius fractures vs. ulna fractures (p < 0.001), while no significant differences were observed between 4-view and 6-view ultrasound subgroups or between radiologist ultrasound interpreters and non-radiologist interpreters. This study highlighted ultrasound's reliability in detecting pediatric distal forearm fractures, emphasizing the crucial role of expertise in precisely confirming fractures through ultrasound examinations.
小儿前臂远端骨折占儿童肌肉骨骼损伤的 30%,传统的诊断方法是采用放射线照相术。超声波已成为一种更安全的诊断工具,它消除了电离辐射,可在床边进行检查并实时成像,而且在非医院环境中也被证明是有效的。本研究旨在评估超声波对检测儿童前臂远端骨折的诊断效果。根据既定指南,我们在PubMed、Scopus、Web of Science和Embase数据库中进行了全面的文献检索,系统性综述和荟萃分析的时间截止到2023年10月1日。研究纳入了报告前臂远端骨折儿科患者超声诊断准确性的符合条件的研究。提取相关数据元素并进行数据分析。分析纳入了 14 项研究,共 1377 名患者,汇总的敏感性和特异性分别为 94.5(95% CI 92.7-95.9)和 93.5(95% CI 89.6-96.0)。考虑到小儿前臂远端骨折的检测前概率为25%、50%和75%,检测后的阳性概率分别为83%、44%和98%,而检测后的阴性概率分别为2%、6%和15%。双变量模型显示,受过训练的超声波操作员与未受过训练的操作员相比,诊断准确率明显更高(P = 0.03)。此外,在检查桡骨骨折与尺骨骨折的亚组中,诊断准确率也明显更高(p = 0.03)。
{"title":"A meta-analysis on the diagnostic utility of ultrasound in pediatric distal forearm fractures.","authors":"Amir Hassankhani, Melika Amoukhteh, Payam Jannatdoust, Parya Valizadeh, Delaram J Ghadimi, Pauravi S Vasavada, Jennifer H Johnston, Ali Gholamrezanezhad","doi":"10.1007/s10140-024-02208-2","DOIUrl":"10.1007/s10140-024-02208-2","url":null,"abstract":"<p><p>Pediatric distal forearm fractures, comprising 30% of musculoskeletal injuries in children, are conventionally diagnosed using radiography. Ultrasound has emerged as a safer diagnostic tool, eliminating ionizing radiation, enabling bedside examinations with real-time imaging, and proving effective in non-hospital settings. The objective of this study is to evaluate the diagnostic efficacy of ultrasound for detecting distal forearm fractures in the pediatric population. A systematic review and meta-analysis were conducted through a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases until October 1, 2023, following established guidelines. Eligible studies, reporting diagnostic accuracy measures of ultrasound in pediatric patients with distal forearm fractures, were included. Relevant data elements were extracted, and data analysis was performed. The analysis included 14 studies with 1377 patients, revealing pooled sensitivity and specificity of 94.5 (95% CI 92.7-95.9) and 93.5 (95% CI 89.6-96.0), respectively. Considering pre-test probabilities of 25%, 50%, and 75% for pediatric distal forearm fractures, positive post-test probabilities were 83%, 44%, and 98%, while negative post-test probabilities were 2%, 6%, and 15%, respectively. The bivariate model indicated significantly higher diagnostic accuracy in the subgroup with trained ultrasound performers vs. untrained performers (p = 0.03). Furthermore, diagnostic accuracy was significantly higher in the subgroup examining radius fractures vs. ulna fractures (p < 0.001), while no significant differences were observed between 4-view and 6-view ultrasound subgroups or between radiologist ultrasound interpreters and non-radiologist interpreters. This study highlighted ultrasound's reliability in detecting pediatric distal forearm fractures, emphasizing the crucial role of expertise in precisely confirming fractures through ultrasound examinations.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-18DOI: 10.1007/s10140-024-02204-6
Mohammad Yasrab, Ryan C Rizk, Linda C Chu, Elliot K Fishman
Non-traumatic thoracic aorta emergencies are acute conditions associated with substantial morbidity and mortality. In the emergency setting, timely detection of aortic injury through radiological imaging is crucial for prompt treatment planning and favorable patient outcomes. 3D cinematic rendering (CR), a novel rendering algorithm for computed tomography (CT) image processing, allows for life-like visualization of spatial details and contours of highly complex anatomic structures such as the thoracic aorta and its vessels, generating a photorealistic view that not just adds to diagnostic confidence, but is especially useful for non-radiologists, including surgeons and emergency medicine physicians. In this pictorial review, we demonstrate the utility of CR in the setting of non-traumatic thoracic aorta emergencies through 10 cases that were processed at a standalone 3D CR station at the time of presentation, including its role in diagnosis and management.
非创伤性胸主动脉急症是一种急性病,发病率和死亡率都很高。在急诊情况下,通过放射成像及时发现主动脉损伤对于及时制定治疗计划和改善患者预后至关重要。三维电影渲染(CR)是一种用于计算机断层扫描(CT)图像处理的新型渲染算法,可将胸主动脉及其血管等高度复杂的解剖结构的空间细节和轮廓栩栩如生地呈现出来,生成逼真的视图,不仅增加了诊断信心,而且对包括外科医生和急诊内科医生在内的非放射科医生特别有用。在这篇图文综述中,我们通过 10 个病例展示了 CR 在非外伤性胸主动脉急症中的作用,这些病例是在就诊时由独立的 3D CR 站处理的,包括其在诊断和处理中的作用。
{"title":"Cinematic rendering of non-traumatic thoracic aorta emergencies: a new look at an old problem.","authors":"Mohammad Yasrab, Ryan C Rizk, Linda C Chu, Elliot K Fishman","doi":"10.1007/s10140-024-02204-6","DOIUrl":"10.1007/s10140-024-02204-6","url":null,"abstract":"<p><p>Non-traumatic thoracic aorta emergencies are acute conditions associated with substantial morbidity and mortality. In the emergency setting, timely detection of aortic injury through radiological imaging is crucial for prompt treatment planning and favorable patient outcomes. 3D cinematic rendering (CR), a novel rendering algorithm for computed tomography (CT) image processing, allows for life-like visualization of spatial details and contours of highly complex anatomic structures such as the thoracic aorta and its vessels, generating a photorealistic view that not just adds to diagnostic confidence, but is especially useful for non-radiologists, including surgeons and emergency medicine physicians. In this pictorial review, we demonstrate the utility of CR in the setting of non-traumatic thoracic aorta emergencies through 10 cases that were processed at a standalone 3D CR station at the time of presentation, including its role in diagnosis and management.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-02-23DOI: 10.1007/s10140-024-02213-5
Mobina Fathi, Arshia Mirjafari, Shirin Yaghoobpoor, Milad Ghanikolahloo, Zohre Sadeghi, Ashkan Bahrami, Lee Myers, Ali Gholamrezanezhad
Trauma is a significant cause of mortality and morbidity. It is crucial to diagnose trauma patients quickly to provide effective treatment interventions in such conditions. Whole-body computed tomography (WBCT)/pan-scan is an imaging technique that enables a faster and more efficient diagnosis for polytrauma patients. The purpose of this systematic review and meta-analysis is to evaluate the efficacy of WBCT in diagnosing injuries in polytrauma patients. We will also assess its impact on the mortality rate and length of hospital stay among trauma centers between patients who underwent WBCT and those who did not (non-WBCT). Twenty-seven studies meeting our inclusion criteria were selected among PubMed, Scopus, Web of Science, and Google Scholar. The criteria were centered on the significance of WBCT/pan-scan application in trauma patients. Stata version 15 was used to perform statistical analysis on the data. The authors have also used I2 statistics to evaluate heterogeneity. Egger and Begg's tests were performed to rule out any publication bias. Total of twenty-seven studies including 68,838 trauma patients with a mean age of 45.0 ± 24.7 years were selected. Motor vehicle collisions were the most common cause of blunt injuries (80.0%). Head, neck, and face injuries were diagnosed in 44% (95% CI, 0.28-0.60; I2 = 99.8%), 6% (95% CI, 0.02-0.09; I2 = 97.2%), and 9% (95% CI, 0.05-0.13; I2 = 97.1%), respectively. Chest injuries were diagnosed by WBCT in 39% (95% CI, 0.28-0.51; I2 = 99.8%), abdominal injuries in 23% (95% CI, 0.03-0.43; I2 = 99.9%) of cases, spinal injuries 19% (95% CI, 0.11-0.27; I2 = 99.4%), extremity injuries 33% (95% CI, 0.23-0.43; I2 = 99.2%), and pelvic injuries 11% (95% CI, 0.04-0.18; I2 = 97.4%). A mortality odd ratio of 0.94 (95% CI, 0.83-1.06; I2 = 40.1%) was calculated while comparing WBCT and non-WBCT groups. This systematic review and meta-analysis provide insight into the possible safety, efficacy, and efficiency of WBCT/pan-scan as a diagnostic tool for trauma patients with serious injuries, regardless of their hemodynamic status. In patients with serious injuries from trauma, whether or not there are indicators of hemodynamic instability, our recommended approach is to, wherever possible, perform a WBCT without stopping the hemostatic resuscitation. By using this technology, the optimal surgical strategy for these patients can be decided upon without causing any delays in their final care or greatly raising their radiation dose.
{"title":"Diagnostic utility of whole-body computed tomography/pan-scan in trauma: a systematic review and meta-analysis study.","authors":"Mobina Fathi, Arshia Mirjafari, Shirin Yaghoobpoor, Milad Ghanikolahloo, Zohre Sadeghi, Ashkan Bahrami, Lee Myers, Ali Gholamrezanezhad","doi":"10.1007/s10140-024-02213-5","DOIUrl":"10.1007/s10140-024-02213-5","url":null,"abstract":"<p><p>Trauma is a significant cause of mortality and morbidity. It is crucial to diagnose trauma patients quickly to provide effective treatment interventions in such conditions. Whole-body computed tomography (WBCT)/pan-scan is an imaging technique that enables a faster and more efficient diagnosis for polytrauma patients. The purpose of this systematic review and meta-analysis is to evaluate the efficacy of WBCT in diagnosing injuries in polytrauma patients. We will also assess its impact on the mortality rate and length of hospital stay among trauma centers between patients who underwent WBCT and those who did not (non-WBCT). Twenty-seven studies meeting our inclusion criteria were selected among PubMed, Scopus, Web of Science, and Google Scholar. The criteria were centered on the significance of WBCT/pan-scan application in trauma patients. Stata version 15 was used to perform statistical analysis on the data. The authors have also used I<sup>2</sup> statistics to evaluate heterogeneity. Egger and Begg's tests were performed to rule out any publication bias. Total of twenty-seven studies including 68,838 trauma patients with a mean age of 45.0 ± 24.7 years were selected. Motor vehicle collisions were the most common cause of blunt injuries (80.0%). Head, neck, and face injuries were diagnosed in 44% (95% CI, 0.28-0.60; I<sup>2</sup> = 99.8%), 6% (95% CI, 0.02-0.09; I<sup>2</sup> = 97.2%), and 9% (95% CI, 0.05-0.13; I<sup>2</sup> = 97.1%), respectively. Chest injuries were diagnosed by WBCT in 39% (95% CI, 0.28-0.51; I<sup>2</sup> = 99.8%), abdominal injuries in 23% (95% CI, 0.03-0.43; I<sup>2</sup> = 99.9%) of cases, spinal injuries 19% (95% CI, 0.11-0.27; I<sup>2</sup> = 99.4%), extremity injuries 33% (95% CI, 0.23-0.43; I<sup>2</sup> = 99.2%), and pelvic injuries 11% (95% CI, 0.04-0.18; I<sup>2</sup> = 97.4%). A mortality odd ratio of 0.94 (95% CI, 0.83-1.06; I<sup>2</sup> = 40.1%) was calculated while comparing WBCT and non-WBCT groups. This systematic review and meta-analysis provide insight into the possible safety, efficacy, and efficiency of WBCT/pan-scan as a diagnostic tool for trauma patients with serious injuries, regardless of their hemodynamic status. In patients with serious injuries from trauma, whether or not there are indicators of hemodynamic instability, our recommended approach is to, wherever possible, perform a WBCT without stopping the hemostatic resuscitation. By using this technology, the optimal surgical strategy for these patients can be decided upon without causing any delays in their final care or greatly raising their radiation dose.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139939834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-30DOI: 10.1007/s10140-024-02201-9
Mohamad Sufian Mohamed Burhan, Hamzaini Abd Hamid, Faizah Mohd Zaki, Chai Jia Ning, Isa Azzaki Zainal, Izzat Arslan Che Ros, Che Zubaidah Bt Che Daud, Mohd Yusran Bin Othman, Erica Yee Hing
Background: Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.
Objectives: To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.
Methods: A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.
Results: US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.
Conclusion: US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.
背景:对于患有中肠倒置和旋转不良的儿科患者来说,快速诊断对于预防严重并发症至关重要。虽然上消化道检查(UGIS)是传统方法,但超声波(US)的使用正日益受到重视:与上消化道检查相比,评估超声波对旋转不良和中肠空卷的诊断敏感性和特异性:方法:对吉隆坡(PPUKM 和 HTA)68 名儿童患者进行横断面研究,这些患者在手术前接受了 US 和/或 UGIS 检查,以怀疑中肠旋转不良,并将手术结果作为金标准:在诊断肠旋转不良方面,US 的特异性(100%)高于 UGIS(83%),但敏感性略低(97% 对 100%)。对于中肠旋转,US 的灵敏度超过了 UGIS(92.9% 对 66.7%),而特异性则相当。SMA/SMV标准的灵敏度(91.1%)高于US上的D3评估(78.9%),尽管两者的特异性都很高:结论:在识别肠旋转不良方面,US 与 UGIS 的效果相当,而在检测中肠旋转方面,US 的灵敏度更高,因此支持将 US 作为主要诊断工具。该研究主张,当 US 和 UGIS 二者之一无法得出结论时,应联合使用,以优化这些病症的诊断精确度。
{"title":"The performance of ultrasound and upper gastrointestinal study in diagnosing malrotation in children, with or without volvulus.","authors":"Mohamad Sufian Mohamed Burhan, Hamzaini Abd Hamid, Faizah Mohd Zaki, Chai Jia Ning, Isa Azzaki Zainal, Izzat Arslan Che Ros, Che Zubaidah Bt Che Daud, Mohd Yusran Bin Othman, Erica Yee Hing","doi":"10.1007/s10140-024-02201-9","DOIUrl":"10.1007/s10140-024-02201-9","url":null,"abstract":"<p><strong>Background: </strong>Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.</p><p><strong>Objectives: </strong>To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.</p><p><strong>Methods: </strong>A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.</p><p><strong>Results: </strong>US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.</p><p><strong>Conclusion: </strong>US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}