The Coronavirus Disease 2019 pandemic initially presented in the United States in the greater Seattle area, and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes and access must be optimized in preparation for the expected COVID-19 patient surges. This article discusses the processes that have been implemented at the University of Washington in managing the COVID-19 pandemic as well in preparing for patient surges, which may provide important guidance for other radiology departments who are in the early stages of preparation and management. Essentials Radiology policy goals are to reduce COVID-19-related morbidity and mortality through early diagnosis, appropriate treatment and prevention of disease dissemination.  Imaging currently is not routinely used to screen for COVID-19 unless access to RT-PCR results for COVID-19 is limited.  Postponing elective imaging and procedures will preserve resources and hospital beds, while also limiting patient population exposures.  Determination of time-sensitivity of procedures and imaging tests is by consensus with input from radiologists, patients, and/or ordering clinicians.  Radiology departments must prepare for patient surges through streamlined approaches to imaging that will limit exposures to healthcare workers and patients.

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Physicians' diagnoses and admission decisions changed frequently after CT, and diagnostic uncertainty was alleviated.

Hypothesis: Measurement of pelvic hemorrhage on computed tomographic (CT) scans can estimate the pelvic fracture component of total patient blood loss and predict the need for angiography.Design: Retrospective cohort study.Setting: Large level 1 trauma center.Patients: We examined data from 759 consecutive, nonreferral blunt trauma patients who sustained pelvic fracture.Main Outcome Measures: Pelvic-fracture-specific outcomes included estimation of extraperitoneal pelvic hemorrhage volume from emergency department CT scans and determination of arterial injury from angiograms. General patient outcomes determined from medical record review included transfusion requirement, estimated blood loss, and mortality. Subanalysis was performed on subjects with only pelvic fracture as a source of major hemorrhage (derived from discharge International Classification of Diseases, Ninth Revision, Clinical Modification codes).Results: Overall mortality was 96 (13%) of 759 patients. Blood transfusion was given to 418 (55%) patients, and 258 (34%) received 6 or more units in the first 72 hours. Pelvicfracture-related hemorrhage averaged 149 mL (range, 0-1423 mL). Angiography was performed on 163 patients, of whom 113 had arterial injury. Higher pelvic hemorrhage volumes on CT scans were seen in subjects with pelvic arterial injury demonstrated on angiograms (PϽ.001). In subjects without another source of major hemorrhage, pelvic CT hemorrhage volumes were strongly associated with transfusion requirement (PϽ.001). Subjects with large pelvic hemorrhage volumes (Ͼ500 mL) were more likely to have pelvic arterial injury (risk ratio, 4.8; 95% confidence interval, 3.0-7.8; PϽ.001) and require largevolume (Ն6 U) transfusions (risk ratio, 4.7; 95% confidence interval, 1.8-12.3; PϽ.001) than patients with smaller pelvic hemorrhage volumes. Conclusion:Pelvic hemorrhage volumes derived from pelvic CT scans were predictors of the need for pelvic arteriography and transfusions.

The coronavirus disease 2019 (COVID-19) pandemic initially manifested in the United States in the greater Seattle area and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes, and access must be optimized in preparation for the expected surges in the number of patients with COVID-19. In this article, the authors discuss the processes that have been implemented at the University of Washington in managing the COVID-19 pandemic as well in preparing for patient surges, which may provide important guidance for other radiology departments who are in the early stages of preparation and management.

At 11-gauge vacuum-assisted biopsy, highest diagnostic yield was achieved with 12 specimens per lesion, independent of mammographic appearance of the lesion. Even with standardized retrieval of 20 specimens per lesion, underestimation of disease still occurs.

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To assess the sensitivity of detecting the most commonly encountered foreign bodies in Emergency Radiology using all imaging modalities (conventional radiography, computed tomography, ultrasound, and magnetic resonance imaging). The following materials were inserted into a pig-leg phantom and imaged using conventional radiography, computed tomography, ultrasound, and magnetic resonance imaging: Plastics #1, 2, 3, 5, and compostable plastic; dry and wet wood, aluminum, gravel, glass (tinted and non-tinted), and Salmon and Halibut fish bones. The visibility of plastic is variable on both conventional radiography and computed tomography, depending on composition, but all types of plastic are well visualized on ultrasound. Wood is most easily identified and localized on both computed tomography and ultrasound, is only faintly visible on conventional radiography, and is not well visualized on magnetic resonance imaging. Gravel, glass, and aluminum are well visualized on all modalities, with the exception of magnetic resonance imaging, where there is significant artifact surrounding the foreign body. Fish bones (Halibut and Salmon) are well visualized on conventional radiography, computed tomography, and ultrasound. Conventional radiography and computed tomography are great modalities for detecting foreign bodies of various compositions. Computed tomography is particularly useful at localizing the foreign body and determining its relationship to surrounding structures and its depth of involvement. All foreign bodies are visualized on ultrasound if the location is known and the foreign body is in the plane of the transducer. Magnetic resonance imaging is not helpful in detecting foreign bodies.