Huguley Memorial Medical Center

Burleson, TX, United States

Huguley Memorial Medical Center

Burleson, TX, United States
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Mazimba S.,Kettering Medical Center | Grant N.,Kettering Medical Center | Parikh A.,Kettering Medical Center | Patel T.,Kettering Medical Center | And 5 more authors.
Journal of the American College of Radiology | Year: 2012

Background: Coronary CT angiography (CCTA) is a relatively new technique whose role has yet to be fully defined. The initial appropriateness criteria (AC) guidelines published in 2006 have already been revised. There is paucity of data on the effect of the AC on the use of CCTA at academic centers and none for the private sector. Methods: All CCTA studies ordered at one institution (a large community hospital with internal medicine and cardiovascular training programs) from 2006 to 2008 were retrospectively evaluated, and the ordering indications were categorized per the published AC for both 2006 and 2010. Results: There were 384 studies, of which 243 were included in this study. The majority of the studies were ordered for chest pain (67.1% of patients). A significant proportion of studies (43.2%) were classified as inappropriate on the basis of the 2006 published criteria. Uncertain indications made up 39.1%, and appropriate indications were a minority. There was a significant regrading of appropriateness using the 2010 guidelines. Inappropriate testing remained similar at 48.1%, but uncertain cases decreased to only 2.8%, while appropriateness increased to 49.0% (P =.0001 for trend). Conclusions: The updated 2010 AC guidelines for CCTA resulted in a significant reclassification of the indications for ordering CCTA from the previous 2006 guidelines. This shift in the AC reflects increased familiarity and confidence with this new technology across the imaging community. A large proportion of CCTA studies were ordered for inappropriate indications using both sets of criteria. Further research and enhanced education are needed to disseminate the appropriate role of CCTA in cardiovascular imaging. © 2012 American College of Radiology.


Harrison M.L.,Huguley Memorial Medical Center | Lizotte P.E.,University of Michigan | Holmes T.M.,University of Arkansas for Medical Sciences | Kenney P.J.,University of Arkansas for Medical Sciences | And 2 more authors.
Western Journal of Emergency Medicine | Year: 2013

Introduction: High body mass index (BMI) values generally correlate with a large proportion of intraperitoneal adipose tissue. Because intra-peritoneal infectious and inflammatory conditions manifest with abnormalities of the adipose tissue adjacent to the inflamed organ, it is presumed that with a larger percentage of adipose surrounding a given organ, visualization of the inflammatory changes would be more readily apparent. Do higher BMI values sufficiently enhance the ability of a radiologist to read a computed tomography (CT) of the abdomen and pelvis, so that the need for oral contrast to be given is precluded? Methods: Forty six patients were included in the study: 27 females, and 19 males. They underwent abdominal/pelvic CTs without oral or intravenous contrast in the emergency department. Two board certified radiologists reviewed their CTs, and assessed them for radiographic evidence of intra-abdominal pathology. The patients were then placed into one of four groups based on their body mass index. Kappa analysis was performed on the CT reads for each group to determine whether there was significant inter-rater agreement regarding contrast use for the patient in question. Results: There was increasingly significant agreement between radiologists, regarding contrast use, as the study subject's BMI increased. In addition, there was an advancing tendency of the radiologists to state that there was no need for oral or intravenous contrast in patients with higher BMIs, as the larger quantity of intra-peritoneal adipose allowed greater visualization and inspection of intra-abdominal organs. Conclusion: Based on the results of this study, it appears that there is a decreasing need for oral contrast in emergency department patients undergoing abdominal/pelvic CT, as a patient's BMI increases. Specifically, there was statistically significant agreement, between radiologists, regarding contrast use in patients who had a BMI greater than 25.


PubMed | University of Michigan, Huguley Memorial Medical Center and University of Arkansas for Medical Sciences
Type: Journal Article | Journal: The western journal of emergency medicine | Year: 2014

High body mass index (BMI) values generally correlate with a large proportion of intra-peritoneal adipose tissue. Because intra-peritoneal infectious and inflammatory conditions manifest with abnormalities of the adipose tissue adjacent to the inflamed organ, it is presumed that with a larger percentage of adipose surrounding a given organ, visualization of the inflammatory changes would be more readily apparent. Do higher BMI values sufficiently enhance the ability of a radiologist to read a computed tomography (CT) of the abdomen and pelvis, so that the need for oral contrast to be given is precluded?FORTY SIX PATIENTS WERE INCLUDED IN THE STUDY: 27 females, and 19 males. They underwent abdominal/pelvic CTs without oral or intravenous contrast in the emergency department. Two board certified radiologists reviewed their CTs, and assessed them for radiographic evidence of intra-abdominal pathology. The patients were then placed into one of four groups based on their body mass index. Kappa analysis was performed on the CT reads for each group to determine whether there was significant inter-rater agreement regarding contrast use for the patient in question.There was increasingly significant agreement between radiologists, regarding contrast use, as the study subjects BMI increased. In addition, there was an advancing tendency of the radiologists to state that there was no need for oral or intravenous contrast in patients with higher BMIs, as the larger quantity of intra-peritoneal adipose allowed greater visualization and inspection of intra-abdominal organs.Based on the results of this study, it appears that there is a decreasing need for oral contrast in emergency department patients undergoing abdominal/pelvic CT, as a patients BMI increases. Specifically, there was statistically significant agreement, between radiologists, regarding contrast use in patients who had a BMI greater than 25.

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