Management of Acute Contrast Reactions-Understanding Radiologists' Preparedness and the Efficacy of Simulation-Based Training in Canada.

Purpose: Acute radiologic emergencies, primarily severe contrast reactions, are rare but life-threatening events. Given a generalized paucity of formalized or mandated training, studies have shown that radiologists and trainees perform poorly when acutely managing such events. Moreover, skill base, knowledge, and comfort levels precipitously decline over time given the infrequent occurrence of these events during one's daily practice.

The Role of Contrast-enhanced Ultrasound in Guiding Radiofrequency Ablation of Hepatocellular Carcinoma: A Retrospective Study.

Purpose: The objective of the study was to determine the efficacy of contrast-enhanced ultrasound (CEUS) using ultrasound (US)-specific microbubbles in guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC).

Methods: A retrospective analysis of 50 patients with HCC treated with CEUS guided RFA using perflutren at our institution was performed. CEUS images were first compared to B-mode US images performed at the same RFA session to determine the ability of CEUS to increase the conspicuity of lesions.

Percutaneous autologous pancreatic islet cell transplantation for traumatic pancreatic injury.

Context: Traumatic pancreatic injury with pancreatic duct disruption is surgically managed with at least a partial pancreatectomy, often leading to poor blood glucose control and the subsequent development of diabetes mellitus. Autologous β-islet cell transplantation may therefore help to preserve pancreatic endocrine function.

Case Description: We describe 3 patients with pancreatic duct disruption from traumatic pancreatic injury who were treated with a partial pancreatectomy followed by autologous β-islet cell transplantation via a percutaneous transhepatic approach.

The DePICTORS Study: discrepancies in preliminary interpretation of CT scans between on-call residents and staff.

At many academic hospitals, radiology residents provide preliminary interpretations of CT studies performed outside of regular working hours. We examined the rate of discrepancies between resident interpretations and final reports issued by staff. We prospectively obtained 1,756 preliminary reports and corresponding final reports for computed tomography (CT) scans performed on call between November 2006 and March 2007.

Treatment of a juxtaglomerular tumour with radiofrequency ablation.

Juxtaglomerular tumors, or reninomas, are a rare cause of hypertension, almost always benign and accurately localized by a combination of biochemical tests and imaging. Because the tumors are usually small at presentation, and there are good markers for recurrence, we consider treatment by radiofrequency ablation a useful alternative to nephron-sparing surgery and describe its use in one patient.

Dalteparin versus enoxaparin for venous thromboembolism prophylaxis in acute spinal cord injury and major orthopedic trauma patients: 'DETECT' trial.

Background: To compare the impact of switching from enoxaparin 30 mg subcutaneously (SC) twice daily to dalteparin 5,000 units SC once daily for venous thromboembolism (VTE) prophylaxis in critically-ill major orthopedic trauma and/or acute spinal cord injury (SCI) patients.

Methods: DETECT was a retrospective, cohort study at a tertiary care referral teaching center-phase 1 from December 1, 2002 to November 30, 2003 (enoxaparin); and phase 2 from January 1, 2004 to December 31, 2004 (dalteparin). Major orthopedic trauma patients with pelvic, femoral shaft, or complex lower extremity fractures, and/or acute SCI patients admitted to the intensive care unit and who received a low-molecular-weight heparin (LMWH) for VTE prophylaxis were included.

Spatulated end-to-end bile duct reconstruction in orthotopic liver transplantation.

Biliary complications continue to be a major source of morbidity following orthotopic liver transplantation. The aim of this study was to analyze the incidence and management of biliary complications related to the technique of bile duct reconstruction. The patients were stratified into two groups: group I (n = 39) had bile duct reconstruction performed by an end-to-end single interrupted suture choledochocholedochostomy (EE-CDCD) and group II (n = 38) had a spatulated end-to-end CDCD (spEE-CDCD) reconstruction; both groups had an intraductal stent.

Computed tomography and angiographic interventional features of ruptured hepatocellular carcinoma: pictorial essay.

Spontaneous rupture is an uncommon and potentially fatal complication of hepatocellular carcinoma (HCC), occurring in approximately 15% of patients with HCC in Asia and 3% in the United Kingdom.3 The prognosis for hemorrhage of HCC is poor, particularly in those patients with underlying cirrhosis and severe coagulopathy. Computed tomography (CT) rather than angiography is the first-line modality for the detection of rupture.

Management of central venous stent migration in a patient with a permanent inferior vena cava filter.

Stent embolization is a rare complication in the treatment of central venous stenoses in patients receiving long-term hemodialysis. The authors report a case of nitinol stent embolization into the right atrium in which the stent could not be repositioned across an indwelling permanent inferior vena cava (IVC) filter. The migrated stent was managed by advancing the stent to the superior margin of the IVC filter and then deploying a second suprarenal IVC filter to prevent repeat embolization.

Advanced colon cancer before the age of 20 years: a case for extension of the current colonoscopy surveillance guidelines in hereditary nonpolyposis colorectal cancer syndrome.

Background: Hereditary nonpolyposis colorectal cancer (HNPCC) currently accounts for between 2% to 6% of all colorectal adenocarcinomas. Controversies exist regarding the current guidelines for colonoscopic screening for colon cancer.

Case Report: A case of colon cancer in a young Japanese man with a family history of colon cancer that did not meet the criteria for HNPCC is reported.

Intra-abdominal free fluid without solid organ injury in blunt abdominal trauma: an indication for laparotomy.

Background: The optimal management of patients sustaining blunt abdominal trauma (BAT), in whom intra-abdominal free fluid but no solid organ injury is found on imaging, remains unclear. The purpose of this study was to determine the incidence and significance of this finding.

Methods: All patients presenting with suspected BAT to a provincial trauma center over a 30-month period were reviewed.