Current Trends in Emergency Department Imaging

As new imaging practices emerge, computed tomography (CT) remains a vital tool in the evaluation of patients in the emergency department (ED) with symptoms of chest pain and those involved with trauma, reports a new review.

Researchers from the U.S. Centers for Disease Control and Prevention (CDC, Atlanta, GA, USA) studied the demographics and current imaging practices of radiologists providing coverage for EDs, following recent data collected by the CDC that showed that out of the 11 million ED visits per year in the United States, 44% of patients undergo imaging studies. The data from 192 radiology groups that responded to the online survey were evaluated. Among these groups, CT scanners were the most common pieces of imaging equipment found in EDs (40%) followed by ultrasound units (27%).

The compiled results showed that 21% of the groups had designated emergency radiology divisions; 33% of the groups were using CT coronary angiography in the ED workup of chest-pain; 18% were using "triple-rule-out scans” (a single CT scan to rule out coronary artery disease, pulmonary embolism, and aortic dissection). Multiplanar reconstructions of chest, abdominal, and pelvic CT images were routinely performed by 49%, while 44% used reformatted CT images instead of conventional radiographs in the workup of cervical spine trauma, and 35% used reformations in thoracic and lumbar spine trauma. Sixty-seven respondents (35%) preferred CT for evaluating acute appendicitis in the setting of pregnancy. Of the groups surveyed, 15% obtained written consent before performing either non-contrast CT or magnetic resonance imaging (MRI) scans, as compared to 47% that obtained written consent before performing contrast-enhanced CT or MRI scans. All surveyed groups used multiple methods for communicating findings to ED physicians; however, the most prevalent method was via telephone (49%), followed by delivering the results in person (21%). Twenty-one percent of groups had dedicated emergency radiology divisions, the majority of them being in academic centers (73%). The review was published in the July 2008, issue of the Journal of the American College of Radiology (JACR).

"New imaging practices for the evaluation of entities such as chest pain, spine trauma, and abdominal pain and trauma are emerging in EDs,” said lead author John Thomas, M.D., and colleagues. "As one plans ED development, these trends should be considered.”


Related Links:
U.S. Centers for Disease Control and Prevention