In recent years, there has been an increase in emergency patients, especially among the elderly.
While CT scans are commonly utilized in the ER, there are some situations where accurate diagnoses may not be achieved due to various factors, such as the use of NCECT in cases when Contrast-enhanced CT should be administered or the presence of non-specific clinical presentations.
This poster introduces common patterns of oversights and various methods to avoid them while presenting CT or MRI images.
12 diseases and 10 tips covered in this poster are as follows:
Diseases: SAH, Cerebral infarction, Cerebral venous sinus thrombosis, Epidural hematoma, Pulmonary thromboembolism, Aortic dissection, SMA embolism, SMA dissection, Ovarian torsion, Gastrointestinal tract perforation, Strangulation obstruction, NOMI
Tips (Fig 1):
#1. "Windowing": Adjust window level and width a little stronger to optimize visualization of borders between structures, air, bone, and pathologies like acute thrombus and hematoma.
#2. MPR: Multi-Planar Reconstruction can reveal findings which are not evident on axial images.
#3. Thin slice: Thin slice images enable us to find even small abnormalities or subtle changes.
#4. Checklist: Make a list of diseases you do not want to miss and use it every time you read.
#5. Mechanical survey: Track down organs and structures to find abnormalities from top to bottom without thinking of certain diseases.
#6. Top and bottom slices: Stay alert even at the top and bottom of the CT slices.
#7. Indirect findings: Look for not only direct findings but also related ones to the diseases.
#8. Interval change: Try to exam again with a time interval or compare with previous exams. It can identify changes over time or subtle findings that may have been missed in a single study.
#9. Contrast enhancement: Administer contrast agent to assess blood flow in inflammation or organ ischemia and active bleeding in hemorrhagic pathologies.
#10. Another modality: MRI can be more sensitive, especially in central nervous diseases.