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The Journal of Pediatrics Oct 2020To determine the frequency of abdominal radiographs obtained in healthy children aged 6 months to 18 years to diagnose constipation in a pediatric emergency...
OBJECTIVE
To determine the frequency of abdominal radiographs obtained in healthy children aged 6 months to 18 years to diagnose constipation in a pediatric emergency department, and evaluate the impact of quality improvement (QI) interventions on their use.
STUDY DESIGN
QI study over 2.5 years at a large urban quaternary care children's hospital emergency department. Interventions consisted of educational presentations and individualized abdominal radiograph data reporting. The primary outcome measure was the percentage of abdominal radiographs performed on healthy patients discharged home with a diagnosis of constipation before and after QI interventions.
RESULTS
The baseline total percentage of abdominal radiographs performed in otherwise healthy children discharged home with a diagnosis of constipation was 36% (October 2016 to January 2018). According to questionnaire results, ruling out obstruction was the most common reason for ordering an abdominal radiograph. After the QI interventions, the total percentage of abdominal radiograph decreased to 18% (April 2018 to March 2019). This 18% decrease was significant (P < .001) and sustained over a 12-month follow-up period. Throughout the study period, the average length of stay was 1.07 hours longer for children who had an abdominal radiograph. Clinically important return visits to the emergency department were uncommon during the postintervention phase (125/1830 [6.8%]), and not associated with whether or not an abdominal radiograph was performed at the initial visit.
CONCLUSION
After these QI interventions, we noted a significant and sustained decrease in the percentage of abdominal radiographs obtained for otherwise healthy patients discharged home with a diagnosis of constipation.
Topics: Abdominal Pain; Adolescent; California; Child; Child, Preschool; Constipation; Electronic Health Records; Emergency Service, Hospital; Female; Hospitals, Pediatric; Humans; Infant; Length of Stay; Male; Patient Discharge; Quality Assurance, Health Care; Quality Improvement; Radiography, Abdominal
PubMed: 32553869
DOI: 10.1016/j.jpeds.2020.06.028 -
Clinical Imaging 2014Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is usually asymptomatic but may present with complications of acute... (Review)
Review
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is usually asymptomatic but may present with complications of acute diverticular inflammation, ulceration, hemorrhage, small bowel obstruction, perforation, retained foreign bodies, enterolith formation, and neoplasm development. Thus, the preoperative radiological diagnosis is crucial for proper management of the patients. This article reviews the anatomic and clinical features of Meckel's and describes the role of imaging in the detection of Meckel's and evaluation of its associated pathological processes.
Topics: Diagnostic Imaging; Humans; Meckel Diverticulum; Positron-Emission Tomography; Radiography, Abdominal; Reproducibility of Results; Tomography, X-Ray Computed
PubMed: 24998882
DOI: 10.1016/j.clinimag.2014.04.020 -
Abdominal Radiology (New York) May 2016
Review
Topics: Diagnosis, Differential; Humans; Pneumoperitoneum; Radiography, Abdominal
PubMed: 27193799
DOI: 10.1007/s00261-016-0643-9 -
Journal of the American College of... Aug 2018Dual-energy CT offers several new applications and opportunities for routine clinical practice. Increasing utilization in the context of both routine practice and... (Review)
Review
Dual-energy CT offers several new applications and opportunities for routine clinical practice. Increasing utilization in the context of both routine practice and clinical research raises questions about expected radiation dose when compared with conventional single-energy exams. Despite initial concerns, advanced iterative reconstruction techniques and creation of virtual unenhanced images in multiphase acquisitions offer methods for dose reduction. Although dose varies across patients and scanners, modern dual-energy exams allow for comparable and potentially decreased radiation dose when compared with single-energy CT. In this review, we examine dual-energy radiation dose considerations with discussion of accepted ACR diagnostic reference levels.
Topics: Humans; Radiation Dosage; Radiography, Abdominal; Radiography, Dual-Energy Scanned Projection; Tomography, X-Ray Computed
PubMed: 28958720
DOI: 10.1016/j.jacr.2017.08.012 -
Abdominal Radiology (New York) Mar 2018This article reviews basic concepts of report documentation for abdominal imaging examinations, focusing on practical elements for ensuring appropriate physician... (Review)
Review
This article reviews basic concepts of report documentation for abdominal imaging examinations, focusing on practical elements for ensuring appropriate physician reimbursement. Nuances of abdominal radiography, CT, MRI, and ultrasonography codes are highlighted. Special considerations for the coding of 3D-rendering and contrast administration are also described. Greater abdominal radiologist awareness of these codes and their reporting requirements can help ensure proper documentation within radiology reports, thereby optimizing legitimate reimbursement.
Topics: Accounts Payable and Receivable; Clinical Coding; Documentation; Humans; Insurance, Health, Reimbursement; Radiography, Abdominal; Radiologists
PubMed: 28664361
DOI: 10.1007/s00261-017-1235-z -
Abdominal Radiology (New York) Apr 2016
Topics: Humans; Radiography, Abdominal; Radiography, Interventional
PubMed: 26907712
DOI: 10.1007/s00261-016-0671-5 -
Hemodialysis International.... Jul 2016Introduction Lateral abdominal radiograph is suggested as an alternative to coronary artery computed tomography (CT) in evaluating vascular calcification. Simple scoring...
Both pelvic radiography and lateral abdominal radiography correlate well with coronary artery calcification measured by computed tomography in hemodialysis patients: A cross-sectional study.
Introduction Lateral abdominal radiograph is suggested as an alternative to coronary artery computed tomography (CT) in evaluating vascular calcification. Simple scoring systems including pelvic radiograph scoring and abdominal scoring system were utilized to study their correlation with coronary artery calcification. Methods In 106 MHD patients, coronary artery CT, lateral abdominal, and pelvic radiograph were taken. The Agatston scoring system was applied to evaluate the degree of coronary artery calcification which was categorized according to Agatston coronary artery calcification score (CACS) ≥ 30, ≥100, ≥400, and ≥1000. Abdominal aortic calcification was scored by 4-scored and 24-scored systems. Pelvic artery calcification was scored by a 4-scored system. Sensitivities and specificities of abdominal aortic calcification scores and pelvic artery calcification scores to predict different categories of coronary artery calcification were analyzed. We studied the diagnostic capability of abdominal aorta calcification and pelvic artery calcification to predict different CACS categories by calculating likelihood ratios. Receiver operator characteristic curves were used to determine the area under the curve for each of these testing procedures. Findings The prevalence was 48(45.3%), 15 (14.2%), 11 (10.4%), 11 (10.4%), and 11 (10.4%) for CACs > 0, ≥30, ≥100, ≥400, and ≥1000, respectively. The degree of CACs was positively correlated with patient age, prevalence of diabetes, abdominal aorta scores, and pelvic calcification scores. The areas under the curves for different CACS by all X-ray scoring systems were above 0.70 except pelvic 4-scored system for diagnosing CACS ≥30, without significant difference (P > 0.05). Discussion Both lateral abdominal and pelvic plain radiographs were demonstrated as acceptable alternatives to CT in evaluating vascular calcification.
Topics: Coronary Artery Disease; Cross-Sectional Studies; Humans; Middle Aged; Pelvis; Radiography, Abdominal; Renal Dialysis; Tomography, X-Ray Computed; Vascular Calcification
PubMed: 26932162
DOI: 10.1111/hdi.12399 -
The British Journal of Radiology Jul 2021This study aimed to conduct objective and subjective comparisons of image quality among abdominal computed tomography (CT) reconstructions with deep learning...
Superior objective and subjective image quality of deep learning reconstruction for low-dose abdominal CT imaging in comparison with model-based iterative reconstruction and filtered back projection.
OBJECTIVE
This study aimed to conduct objective and subjective comparisons of image quality among abdominal computed tomography (CT) reconstructions with deep learning reconstruction (DLR) algorithms, model-based iterative reconstruction (MBIR), and filtered back projection (FBP).
METHODS
Datasets from consecutive patients who underwent low-dose liver CT were retrospectively identified. Images were reconstructed using DLR, MBIR, and FBP. Mean image noise and contrast-to-noise ratio (CNR) were calculated, and noise, artifacts, sharpness, and overall image quality were subjectively assessed. Dunnett's test was used for statistical comparisons.
RESULTS
Ninety patients (67 ± 12.7 years; 63 males; mean body mass index [BMI], 25.5 kg/m) were included. The mean noise in the abdominal aorta and hepatic parenchyma of DLR was lower than that in FBP and MBIR ( < .001). For FBP and MBIR, image noise was significantly higher for obese patients than for those with normal BMI. The CNR for the abdominal aorta and hepatic parenchyma was higher for DLR than for FBP and MBIR ( < .001). MBIR images were subjectively rated as superior to FBP images in terms of noise, artifacts, sharpness, and overall quality ( < .001). DLR images were rated as superior to MBIR images in terms of noise ( < .001) and overall quality ( = .03).
CONCLUSIONS
Based on objective and subjective comparisons, the image quality of DLR was found to be superior to that of MBIR and FBP on low-dose abdominal CT. DLR was the only method for which image noise was not higher for obese patients than for those with a normal BMI.
ADVANCES IN KNOWLEDGE
This study provides previously unavailable information on the properties of DLR systems and their clinical utility.
Topics: Adult; Aged; Aged, 80 and over; Artifacts; Contrast Media; Deep Learning; Female; Humans; Liver; Male; Middle Aged; Radiographic Image Interpretation, Computer-Assisted; Radiography, Abdominal; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 34142867
DOI: 10.1259/bjr.20201357 -
Japanese Journal of Radiology Nov 2014Abdominal cystic lesions in children may originate from parenchymatous organs or from nonparencyhmatous structures. Although these lesions have well-described imaging... (Review)
Review
Abdominal cystic lesions in children may originate from parenchymatous organs or from nonparencyhmatous structures. Although these lesions have well-described imaging features, proper diagnosis usually depends on the accurate determination of the origin of the lesion. Because large lesions may resemble each other it is difficult to identify the site of origin, which results in a diagnostic dilemma. In this pictorial essay we describe abdominal nonparenchymatous cystic lesions and their mimics arising from parenchymatous organs in children.
Topics: Abdomen; Abdominal Neoplasms; Abscess; Child; Child, Preschool; Choledochal Cyst; Cysts; Diagnosis, Differential; Digestive System Diseases; Female; Humans; Infant; Infant, Newborn; Lymphatic Abnormalities; Magnetic Resonance Imaging; Male; Radiography, Abdominal; Teratoma; Tomography, X-Ray Computed; Ultrasonography
PubMed: 25199817
DOI: 10.1007/s11604-014-0355-4 -
Abdominal Radiology (New York) Oct 2016
Review
Topics: Abdomen; Radiography, Abdominal; Spine
PubMed: 27245846
DOI: 10.1007/s00261-016-0784-x