The cost of doing business in academic radiology departments.

This study identifies the major sources of overhead fees/costs and subsidies in academic radiology departments (ARDs) in the US and determines the differences between them based on geographic location or the size of their affiliated hospital. ARDs in the Northeast had the highest level of financial support from their affiliated hospitals when compared to those in the South/Southwest; however, a greater number of Midwest ARDs receive high levels of funding for teaching from their medical schools when compared to the northeast. Significantly fewer ARDs affiliated with hospitals of less than 200 beds receive subsidies for their activities when compared to those affiliated with larger hospitals.

Pediatric hand injuries: essentials you need to know.

The hand is a common site of injury in children and adolescents. The most common mechanism of injury in younger children is crush injury resulting from the hand caught in a closing door while most fractures in teenagers result from recreational sports. Accurate diagnosis of hand fractures is a requisite for timely management of these injuries in order to restore normal function and achieve a satisfactory outcome since poorly treated injuries can have significant functional consequences.

Utilization of dashboard technology in academic radiology departments: results of a national survey.

Purpose: The aim of this study was to identify the most widely used financial, productivity, and accessibility metrics used by academic radiology departments (ARDs) in a dashboard format via a national survey. The results provide a guide to the selection of preferred or commonly used indicators to facilitate dashboard implementation and use.

Methods: The study met the criteria for an exemption from institutional review board approval.

Imaging children with abdominal trauma.

Objective: Trauma is a leading cause of morbidity and mortality in children. The abdomen is the second most common site of injury. This article discusses abdominal trauma in children.

Computed tomography before transfer to a level I pediatric trauma center risks duplication with associated increased radiation exposure.

Introduction: Community hospitals commonly obtain computed tomographic (CT) imaging of pediatric trauma patients before triaging to a level I pediatric trauma center (PTC). This practice potentially increases radiation exposure when imaging must be duplicated after transfer.

Methods: A retrospective review of our level 1 PTC registry from January 1, 2004, to December 31, 2006, was conducted.

Contemporary imaging in abdominal emergencies.

Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks.

Pediatric thoracic trauma: imaging considerations.

Imaging plays an important role in the evaluation of the pediatric thorax following blunt and penetrating trauma. This essay reviews important differences between children and adults with respect to the pattern of thoracic injury. Additionally, the role of various imaging modalities in the assessment is discussed.

Controversies in emergency radiology: acute appendicitis in children--the case for CT.

Acute appendicitis is the most common condition requiring surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed nonoperatively.

Imaging the child with right lower quadrant pain and suspected appendicitis: current concepts.

Acute appendicitis is the most common condition presenting with right lower quadrant pain requiring acute surgical intervention in childhood. The clinical diagnosis of acute appendicitis is often not straightforward and can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed non-operatively.

Pneumatosis intestinalis and diarrhea in a child following renal transplantation.

Pneumatosis intestinalis is an uncommon finding beyond the neonatal period, but it has been reported in immunocompromized pediatric patients. The association of pneumatosis intestinalis in children following renal transplantation has to the best of our knowledge been only reported once in children. We describe a 4-year-old female who developed intermittent emesis, weight loss, and intermittently loose bloody stools after cadaveric renal transplantation at age 3.

Imaging of acute appendicitis in children.

Acute appendicitis is the most common acute abdominal condition that results in surgical intervention in childhood. The clinical diagnosis of acute appendicitis in children can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed nonoperatively.

Effect of cross-sectional imaging on negative appendectomy and perforation rates in children.

Purpose: To compare negative appendectomy and perforation rates in children who underwent ultrasonography (US), computed tomography (CT), or no imaging before urgent appendectomy.

Materials And Methods: All children who underwent urgent appendectomy during a 4(1/2)-year period were identified in a surgical billing database. Pathology reports were coded as negative or as showing acute inflammation or perforation.

Unenhanced helical CT in the evaluation of the urinary tract in children and young adults following urinary tract reconstruction: comparison with sonography.

Purpose: To compare the accuracy of unenhanced, helical CT with sonography for the detection of complications of urinary tract reconstruction.

Materials And Methods: Forty-six kidneys in 24 patients were examined with CT and sonography. All scans were assessed for ease of renal visualization, presence of renal, ureteral, and bladder calculi, renal scars, hydronephrosis, and abdominal wall hernia.

Using helical CT to diagnosis acute appendicitis in children: spectrum of findings.

Helical CT in children shows an overlapping and wide spectrum of appearances of the normal and acutely inflamed appendix. The normal appendix may measure up to 10 mm in maximal diameter but should not have other CT signs of acute inflammation.

When appendicitis is suspected in children.

Acute appendicitis is the most common condition requiring emergent abdominal surgery in childhood. The clinical diagnosis of acute appendicitis is often not straightforward because approximately one-third of children with the condition have atypical clinical findings. The delayed diagnosis of this condition has serious consequences, including appendiceal perforation, abscess formation, peritonitis, sepsis, bowel obstruction, and death.

Acute hemoperitoneum in children: prevalence of low-attenuation fluid.

Background: Recent evidence indicates that acute hemoperitoneum may have lower than expected attenuation values at CT.

Objective: To characterize the attenuation of acute hemoperitoneum at CT in children following blunt abdominal trauma and to assess the prevalence of low-attenuation fluid.

Materials And Methods: The CT scans of 19 consecutive children with isolated hepatic or splenic injury and associated peritoneal fluid were retrospectively analyzed.

Imaging evaluation of suspected appendicitis in a pediatric population: effectiveness of sonography versus CT.

Objective: The purpose of this study was to compare the diagnostic accuracy of graded compression sonography with that of helical CT for the diagnosis of appendicitis in a pediatric and young adult population.

Subjects And Methods: Between June 1996 and April 1999, 386 pediatric and young adult patients with suspected appendicitis were examined using sonography, CT, or both: 233 underwent sonography only, 71 underwent CT only, and 82 underwent sonography and CT. All sonograms and CT scans were prospectively interpreted as showing positive or negative findings for appendicitis by one of six pediatric radiologists.

Evaluation of suspected appendicitis in children and young adults: helical CT.

Purpose: To evaluate the accuracy of helical computed tomography (CT) for the diagnosis of appendicitis in children and to assess the utility of CT in establishing alternative diagnoses.

Materials And Methods: The medical records of 154 children (median age, 12 years; age range, 1-20 years) who were suspected to have appendicitis and who underwent CT were reviewed. The gastrointestinal tract was opacified in 151 of 154 patients: Only orally administered contrast material was used in 126 patients; only rectally administered contrast material, in 21 patients; and both oral and rectal contrast material, in four patients.

Detection of active intraabdominal hemorrhage after blunt trauma: value of delayed CT scanning.

Active hemorrhage is a rare finding at CT following blunt abdominal trauma. The time interval between IV contrast administration and scanning the abdomen may impact on the ability to visualize active hemorrhage at CT. We report a case of active hemorrhage associated with splenic injury that was identified only at delayed CT scanning.

Prevalence and distribution of extraperitoneal hemorrhage associated with splenic injury in infants and children.

Objective: The purpose of this study was to evaluate the prevalence and distribution of associated extraperitoneal hemorrhage in infants and children with splenic injury.

Conclusion: Splenic injury occasionally resulted in extraperitoneal hemorrhage that tracked into the anterior pararenal space. Extraperitoneal hemorrhage always occurred in association with intraperitoneal hemorrhage.

Selective management of pediatric pancreatic injuries.

Background: Despite trauma being the most common cause of pediatric pancreatitis, the diagnosis and management is often difficult.

Methods: The hospital course, diagnostic and surgical procedures, and complications for all children with traumatic pancreatitis evaluated at a Regional Level I Trauma Center were reviewed retrospectively.

Results: Twelve of 3,500 children (0.

Hepatic arterial pseudoaneurysm: a rare complication of blunt abdominal trauma in children.

We report a child who developed a hepatic artery pseudoaneurysm following blunt hepatic injury. This is a rare complication of hepatic trauma in children. The imaging evaluation and clinical management of hepatic artery pseudoaneurysms are presented.

Pediatric hepatic trauma: does clinical course support intensive care unit stay?

Purpose: The objective of this study is to determine if grade of liver injury predicts outcome after blunt hepatic trauma in children and to initiate analysis of current management practices to optimize resource utilization without compromising patient care.

Methods: A retrospective review of 36 children who had blunt hepatic trauma treated at a pediatric trauma center from 1989 to present was performed. Hepatic injuries graded (AAST Organ Injury Scaling) ranged from grade I to IV.

Blunt abdominal trauma in children: impact of CT on operative and nonoperative management.

Objective: The purpose of this study was to evaluate the impact of CT on operative management of children examined after blunt abdominal trauma.

Subjects And Methods: Fifteen-hundred consecutive children who sustained blunt abdominal trauma were prospectively examined with CT. CT findings and the decision for operative or nonoperative management were recorded prospectively.