Migration of a Retained Epicardial Pacing Wire Into the External Carotid Artery.

Background: Temporary epicardial pacing wires (TEPWs) are commonly used for postoperative arrhythmia management in cardiac surgery. Although generally safe, they can cause rare complications, including migration years after placement.

Case Summary: A 59-year-old man with a history of cardiac arrest and acute myocardial infarction requiring urgent coronary artery bypass grafting 2 years prior presented with new-onset dysphagia and odynophagia.

Avoiding missed opportunities in AI for radiology.

Purpose: In the last decade, the development of Deep Learning and its variants, based on the application of artificial neural networks, has reinvigorated Artificial Intelligence (AI). As a result, many new applications of AI in medicine, especially Radiology, have been introduced. This resurgence in AI, and its diverse clinical and nonclinical applications throughout healthcare, requires a thorough understanding to reap the potential benefits and avoid the potential pitfalls.

Epicardial fat modifies the relationship between coronary calcium score and all-cause mortality: The St. Francis Heart Study.

Objective: Epicardial fat is associated with cardiovascular risk factors and adverse outcomes. However, it is not clear if epicardial fat remains to be a mortality risk when coronary calcium score (CAC) is taken into account.

Methods: We studied the 1005 participants from the St.

Calcific Plaque Modification by Acoustic Shockwaves: Intravascular Lithotripsy in Cardiovascular Interventions.

Purpose Of Review: To provide a review of recent literature on the treatment of moderate-to-severe calcification in coronary and peripheral vasculature with intravascular lithotripsy (Shockwave Medical, Santa Clara, CA).

Recent Findings: Moderate-to-severe calcific plaques constitute a significant proportion of lesions treated with transcatheter interventions in the coronary and peripheral vascular beds and portend lower procedural success rates, increased periprocedural major adverse events, and unfavorable long-term clinical outcomes compared to non-calcific plaques. Intravascular lithotripsy (IVL) is a new technique that uses acoustic shock waves in a balloon-based system to induce fracture in the calcium deposits to facilitate luminal gain and stent expansion.

Substantial interreader agreement for biopsy with reduction in biopsy rate: A multireader diagnostic performance study of ACR TI-RADS.

Purpose: To assess diagnostic performance of ACR TI-RADS in thyroid cancer detection and evaluate interobserver agreement among radiologists with lower interpreting experience.

Methods: Four radiologists retrospectively assessed 295 biopsied thyroid nodules from ultrasound studies performed between 2009 and 2019, blinded to histopathology. Diagnostic performance for cancer detection was determined individually, and interobserver agreement among four readers was evaluated with Fleiss kappa coefficient (ⱪ).

Can obstructive urolithiasis be safely excluded on contrast CT? A retrospective analysis of contrast-enhanced and noncontrast CT.

Purpose: The aim of this study was to determine if contrast-enhanced CT can safely exclude obstructive urolithiasis in patients with flank plain. We performed a retrospective cohort analysis to compare the negative predictive values of contrast-enhanced and non-contrast CTs for the detection of obstructing urolithiasis.

Methods: Through report analysis, we identified all non-contrast and contrast-enhanced CT examinations of the abdomen and pelvis performed on adult patients in the emergency department at a single, multi-site academic medical institution in 2017 with an indication of flank pain.

Utility of ultrasound after a negative CT abdomen and pelvis in the emergency department.

Purpose: The purpose of this study is to assess the utility of an abdominal and/or pelvic ultrasound (US) performed within 24 h after a negative CT of the abdomen and pelvis (CTAP) in the emergency department (ED). The secondary endpoint is to assess whether there is a significant increase in length of stay (LOS) in the ED due to immediate US reimaging.

Method: We reviewed the imaging reports of 335 patients over the course of 3 years in our ED who had an US within 24 h after a negative CTAP.

Rare imaging of a known entity: fat embolism seen on CT in lower extremity vein after trauma.

Fat embolism occurs in the vast majority of patients who have had trauma (approximately 90%). The most common occurrence is after long bone fracture. It has also been noted in cases after orthopedic surgery.

Ultrasound to Detect Pressure-related Deep Tissue Injuries in Adults Admitted via the Emergency Department: A Prospective, Descriptive, Pilot Study.

Stage 4 pressure ulcers (PUs) start with tissue death at the level of the bone, also known as deep tissue injury (DTI). Studies have shown the appearance of DTI on the skin is delayed for several days after the original pressure-related injury to the deep soft tissues. Studies also suggest DTI can be seen using ultrasound (US) technology.

Elastography-targeted Thyroid Nodule Aspiration: A Novel Approach.

Objectives: Since 2009, the rate of nondiagnostic (ND) thyroid nodule fine-needle aspiration (FNA) has ranged from 2% to 20%. A ND result can cause further patient morbidity secondary to repeated procedures and delay in diagnosis. The use of real-time strain elastography (RTE) in determining nodule malignant risk has gained considerable focus recently.