Nivolumab-induced small bowel obstruction and perforation: a rare but life-threatening side effect of immunotherapy.

We present a case of a 58-year-old female with anti-PD-1 immunotherapy-related small bowel perforation. The patient was on long-term therapy with nivolumab for metastatic non-small cell lung cancer. She presented to the emergency department with acute abdominal pain, in which the CT revealed a short segment of dilated distal ileum proximal to a very short segment of bowel with mural thickening and a perforation near the transition point.

Temporal Trends in Imaging Utilization for Suspected Substance Use Disorder in an Academic Emergency Radiology Department.

Purpose: To assess temporal trends and utilization patterns of diagnostic imaging performed for substance use disorder (SUD)-related indications in an academic radiology emergency department (ED).

Methods: Retrospective analyses of ED imaging examinations acquired from 2005 to 2015 were performed. Imaging examinations performed for suspected SUD-related indications, based on the order history, were compared with those without a SUD-related indication.

Accuracy and timeliness of an abbreviated emergency department MRCP protocol for choledocholithiasis.

Purpose: To determine the diagnostic accuracy and time savings of an abbreviated magnetic resonance cholangiopancreatography (A-MRCP) protocol for detecting choledocholithiasis in patients visiting the emergency department (ED) for suspected biliary obstruction.

Methods And Materials: This retrospective study evaluated adult patients (ages 18+ years) visiting an academic Level 1 trauma center between January 1, 2016, and December 31, 2017, who were imaged with MRCP for suspected biliary obstruction. Patients were scanned with either a four-sequence A-MRCP protocol or a conventional eight-sequence MRCP (C-MRCP) protocol.

The added value of cross-sectional imaging in the detection of additional radiographically occult fractures in the setting of a Chopart fracture.

Purpose: Radiography has a low sensitivity for the detection of fractures related to the talonavicular and calcaneocuboid articulations, also known as Chopart fractures. The purpose of this study is to determine the sensitivity of radiographs for detecting additional foot and ankle fractures related to Chopart fracture using CT or MRI as the reference standard.

Method: We performed an IRB-approved, retrospective review of radiology reports between 2010 and 2014.

Necrotizing fasciitis of the lower extremity: imaging pearls and pitfalls.

Objective: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease.

Conclusion: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, ultrasound, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis.

Extrahepatic metastases of hepatocellular carcinoma: A spectrum of imaging findings.

Hepatocellular carcinoma (HCC) is the most common primary tumour of the liver, responsible for significant morbidity and mortality worldwide. In the Western world, it primarily affects patients with cirrhosis, secondary to hepatitis C virus and alcoholism. In the rest of the world, HCC is closely associated with hepatitis B virus infections.

Imaging of blunt vascular neck injuries: a clinical perspective.

Objective: We will review the common injuries and anatomic distributions of blunt cerebrovascular injuries (BCVIs) of the neck, explain the grading criteria, and discuss the corresponding management. Artifacts associated with BCVI on CT will also be examined.

Conclusion: Identifying common injury patterns and anatomic distributions associated with BCVI can help decide the grade and management earlier and reduce the risk for potential complications.

Imaging of blunt vascular neck injuries: a review of screening and imaging modalities.

Objective: We will review the epidemiology of blunt cerebrovascular injuries (BCVIs) and the rationale for screening. Current imaging modalities used to screen for BCVIs will be discussed with an emphasis on CT angiography.

Conclusion: Screening for BCVIs can decrease rates of postinjury complications, such as stroke.

Rapid imaging protocol in trauma: a whole-body dual-source CT scan.

The purpose of this study is to determine whether a single acquisition whole-body trauma multi-detector CT scan is able to reduce resuscitation time, scan time, and effective radiation dose without compromising diagnostic quality in the setting of polytrauma. Retrospective analysis of 33 trauma patients undergoing single acquisition whole-body CT with injury severity scores of ≥ 16 was compared to 34 patients imaged with a segmented whole-body CT protocol. Time spent in the emergency department, effective radiation dose, image quality, and mortality rates were compared.

Clinical utility of ultra high pitch dual source thoracic CT imaging of acute pulmonary embolism in the emergency department: are we one step closer towards a non-gated triple rule out?

Objectives/purpose: Aim of this study was to retrospectively compare the image quality and the radiation dose of an ultra high pitch CT scan for the evaluation of pulmonary embolism and visualization of cardiac structures in comparison to our institution's standard pulmonary embolism protocol.

Method And Materials: The study cohort consisted of 115 consecutive patients, 57 underwent CT pulmonary angiography on a dual source 128 slice scanner (Siemens Somatom Definition FLASH) via an ultra high pitch mode (Pitch 2.8) while 58 were scanned on a dual source 64 slice scanner (Siemens Somatom Definition Dual Source) with standard pitch (Pitch 0.

Reducing blood-borne exposure in interventional radiology: what the IR should know.

Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure.

Cardiovascular disease in Chinese Canadians: a case-mix study from an urban tertiary care cardiology clinic.

Background: Cardiovascular diseases (CVD) are the leading cause of death in Canada. Non-European ethnic groups such as the Chinese constitute an increasingly significant sector of the Canadian population.

Objective: To compare the frequency and risk factors of CVD in Chinese and white Canadians in a cardiology referral clinic that saw a high number of ethnic Chinese patients and provided equal access to advanced diagnostic facilities.