A-585 B. Peripheral skeleton
V.N. Cassar-Pullicino | Monday, March 11, 10:30 – 12:00 / Room A
In this interactive session focussing on peripheral musculoskeletal lesions presenting to the Accident and Emergency Department, we will review the strengths and weaknesses of the imaging modalities applied to chosen bone, joint and soft tissue lesions. The imaging-based approach will strengthen the understanding of the different pathological entities which vary from trauma to infection in both the paediatric and adult age groups.
B-0721 CT imaging in an emergency setting is not substantially delayed by iterative reconstruction
M.J. Willemink, A.M.R. Schilham, T. Leiner, W.P.T.M. Mali, P.A. de Jong, R.P.J. Budde | Sunday, March 10, 10:30 – 12:00 / Room N/O
Purpose: Iterative reconstruction (IR) is a promising noise reducing technique with the potential to reduce radiation-dose with preserved study interpretability or improve image-quality at similar radiation-dose. One of the major drawbacks of IR is a longer reconstruction time which may be problematic in the emergency setting. The purpose of the current study was to compare reconstruction time and speed of IR and filtered back-projection (FBP) in two commonly encountered emergency imaging scan-protocols: total body trauma CT and pulmonary CTA.
Methods and Materials: Fifteen patients underwent a total body CT after a traumatic event and twenty-five adults underwent a CTA for evaluation of pulmonary embolisms on a 256-slice CT-scanner. All data were reconstructed using FBP and two IR-levels (iDose4, Philips Healthcare). Quantification of reconstruction time and speed was done with a self-written plug-in for ImageJ (US National Institutes of Health).
Results: The mean delay in reconstruction time on total body trauma CTs was 44.4±8.1 and 44.9±7.0 seconds for iDose4-levels 1 and 6, respectively, and on pulmonary CTAs 10.1±9.6 and 12.0±11.8 seconds for iDose4-levels 2 and 4, respectively. The mean reconstruction time and speed for total body trauma CTs were 87.3±14.6, 131.7±16.7 and 132.2±17.9 seconds, and 20.1±1.6, 13.2±0.8 and 13.2±0.6 slices/s for FBP, iDose4-levels 1 and 6, respectively, and for pulmonary CTAs 25.5±7.0, 35.6±9.0 and 37.6±12.0 seconds, and 26.7±5.6, 18.7±2.3 and 18.0±2.8 slices/s for FBP, iDose4-levels 2 and 4, respectively.
Conclusion: CT image reconstruction in an emergency setting is not delayed substantially by IR. Furthermore, reconstruction time and speed did not differ substantially between different IR-levels.
A-495 Imaging of the most frequent emergencies of the genitourinary tract
L.E. Derchi | Sunday, March 10, 16:00 – 17:30 / Room E1
This presentation will deal with three of the most common and important acute problems of the GU system: testicular and ovarian torsion and the renal colic. US is the technique of choice in patients with acute scrotum and is able to identify torsion in up to 86 % – 94 % of cases. Tips and tricks to improve diagnostic accuracy and recognize possible false negatives will be presented. Difficulties can be encountered also in identifying ovarian torsion, and the role of US, CT and MRI in this field will be addressed, stressing the need for accurate correlation of clinical and radiological findings to reach the correct diagnosis. MDCT is the gold standard examination in patients with suspected renal colics, being able to recognize presence, location and size of the obstructing stone(s) in virtually all cases, or to identify other pathologic conditions which are responsible for the patient’s symptoms. However, stone disease is frequent, recurrent and often affects patients of relatively young age; then, radiation exposure concerns have to be taken into account. Protocols using US as the first approach can solve up to 75 % of cases, reserving MDCT only for those which are undetermined after US. The US examination techniques to be used in these situations will be addressed.