CT angiography revealed an acute pulmonary embolism in the lower left pulmonary artery with partial lung infarction of the lower lobe and noticed a contrast ground-glass opacity representing the acute alveolar hemorrhage.
Clinical case : Jena University Hospital
We established in our ER department certain algorithms for how we use the scanner.
We want the right patient in the CT scanner.
Professor Teichgräber says. In a department that sees an average of 33,000 patients each year, proper CT utilization is a key factor
At Jena University Hospital in Thuringia, Germany, Professor Ulf Teichgräber, MD, MBA, Institute Director at the Institute for Interventional and Diagnostic Radiology (IDIR), has worked with his colleagues to develop clinical algorithms for determining the appropriate use of CT across a multitude of patient conditions. The most common cases where CT is employed in Jena’s ER/trauma unit are trauma, chest pain, and stroke. Chest pain, caused by cardiac, aortic, and pulmonary disease, represents 12% and suspicion of stroke represents 3% of the yearly ER/trauma visits.
“We know that using CT in the ER has a clinical impact in decision making,” explains Dr. Lehmkuhl. “With an immediate diagnosis, we have a clear decision for patient care and also for discharge. With Revolution CT, there is the ability to image higher heart rates and still have sharp images of the aorta.” “The best way to prevent overutilization of CT in the ER is to clearly establish clinical CT protocols dedicated to the underlying disease and based on established guidelines for every major condition that presents to the ER. Then, the clinician can decide if CT is appropriate or not,” Professor Teichgräber says.
The new protocol is called the Big Five. “It’s a combination of the ECG gated heart CTA, combined angiography of the thoracic aorta and cerebral arteries, and CT brain perfusion,” says Lucas Lehmkuhl, MD, PhD, Modality Manager for CT at Jena University Hospital.