Traumatic cardiac injury (TCI) is a critical condition with high morbidity and mortality, often presenting with nonspecific clinical signs or being masked by coexisting thoracic trauma. Prompt diagnosis is essential but challenging. Using representative clinical cases as an organizing framework, this narrative review summarizes the imaging manifestations of TCI across blunt, penetrating, and iatrogenic mechanisms, with attention to modality-specific capabilities, limitations, and practical selection based on hemodynamic status and expected injury patterns. Representative pathologies include myocardial rupture, hemopericardium, cardiac herniation, pseudoaneurysm, device-related injuries, and coronary perforation, as well as underrecognized entities such as intramyocardial hematoma and bullet embolism. Electrocardiography and cardiac troponin, rather than imaging, remain the initial screening tests for blunt cardiac injury; imaging is directed at patients with hemodynamic compromise, abnormal screening results, or a mechanism suggesting a specific structural lesion. Within that pathway, contrast-enhanced computed tomography (CT), with selective electrocardiography (ECG) gating, is central to structural assessment in stable patients, echocardiography enables rapid bedside triage when instability precludes transfer, and magnetic resonance imaging (MRI) provides tissue characterization in the subacute setting.By outlining trauma mechanisms, modality strengths, and common clinical contexts, this review offers practical guidance to support radiologists in recognizing TCI, selecting the most informative next imaging test, and coordinating care with trauma surgeons, emergency physicians, and cardiologists. Because much of the available evidence derives from case reports and small series, management statements are presented as reported practice rather than as evidence-graded recommendations.
The Radiological Society of North America (RSNA) established its Gold Medal in 1919 and the American College of Radiology (ACR) followed in 1931, yet, these highest honors in radiology have overwhelmingly gone to men. Of the 211 ACR Gold Medalists, only 18 have been women; of the 221 RSNA Gold Medalists, only 23 have been women. Among the small fraction of women recipients, just nine women have earned both. These dual awardees, Marie Sklodowska-Curie, Edith Quimby, Alice Ettinger, Rosalyn Yalow, Kay Vydareny, Sarah Donaldson, Valerie Jackson, Anne Roberts, and Beverly Coleman, are true academic “unicorns.” Their careers span the physics of radioactivity and to sonography of an unborn child. We profiled them through virtual interviews with the five living awardees, published interviews, research contributions, and institutional records. Three themes surfaced, unprompted, across every conversation: leadership carried as an intentional responsibility, mentorship as a full cycle of being sponsored and then sponsoring others, and an enduring commitment to clinical excellence as the grounds of their academic and administrative authority. These nine women offer practical lessons and lasting inspiration for emerging leaders.
In 2022, Lung-RADS introduced a “Lung-RADS 0” category for CT findings suggestive of acute infectious or inflammatory processes. This study aimed to evaluate thoracic radiologist agreement with Lung-RADS 0 assignments and assess outcomes on follow up imaging.This retrospective review was conducted on lung cancer screening CT scans from November 2022 to July 2025. LungView (LungView, Fulton, MD, USA) software identified scans assigned Lung-RADS 0. Cases without follow-up were excluded. Thoracic radiologists reviewed the CT scans for agreement with Lung-RADS 0 and reclassified those with disagreements. Follow-up scans were assessed for resolution or progression of findings.Out of 4020 CT scans, 135 were categorized as Lung-RADS 0 (3.3%). After excluding 6 cases with no follow-up, 129 scans and their clinical reports were analyzed and reviewed independently by board certified radiologists within the thoracic division. The reviewers felt that 26.4% of the studies should have been originally reported as Lung RADS 2, 3 or 4, with the remainder (73.6%) deemed appropriately reported as Lung RADS 0. Resolution or improvement of findings occurred in 79/129 cases (61.2%), while 33.3% showed no change or worsening. Two malignancies were diagnosed at follow-up, neither of which was delayed due to the Lung-RADS 0 classification. This study highlights the need for consistent and correct application of Lung-RADS 0 category defined by ACR to avoid unnecessary shorter-term follow-ups. There was no delayed diagnosis of malignancy for those patients with nodules assigned as Lung RADS 0.
OBJECTIVES:To evaluate the computed tomography (CT) findings of liver injury after chest compressions in patients who achieved return of spontaneous circulation following cardiopulmonary resuscitation. METHODS:This retrospective single-center study included consecutive patients who underwent abdominal CT after successful resuscitation (1/2006-9/2024). CT images were retrospectively reviewed to identify liver injury attributable to chest compressions. Imaging findings, injury distribution, hemorrhagic features were analyzed. RESULTS:Among 716 resuscitated patients who underwent CT, liver injury after chest compressions was identified in 11 patients (mean age, 60.5 years ± 15.8 [standard deviation]; 4 men, 7 women). All liver injuries were detected on contrast-enhanced CT (5.3%, 11/206), whereas only one liver injury was detectable on noncontrast CT (0.1%, 1/716). Lacerations predominantly involved the left lobe (64%) and caudate lobe (55%), with segment 4 being the most frequent dominant site. Right lobe involvement was uncommon. Bleeding along the falciform ligament was observed in 36% of cases. Hemoperitoneum occurred in two patients, both of whom died from hemorrhagic shock related to liver injury. CONCLUSION:Liver injury after chest compressions is an uncommon but clinically relevant complication in resuscitated patients. Contrast-enhanced CT is crucial for detection. Awareness of characteristic imaging features-including preferential involvement of the left and caudate lobes, and bleeding along the falciform ligament-can improve diagnostic recognition on post-resuscitation CT.
Purpose The increasing cost of acute stroke evaluation has been well documented. Given the expanded use of intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) in published guidelines, we hypothesized that increasing imaging-associated expenditures would correspond to higher rates of reperfusion therapy. Methods A six-year retrospective analysis of all Code Stroke activations at our institution was conducted. For each Code Stroke, data on initial neuroimaging modality ordered and decision to treat with IVT or EVT was documented.Analysis evaluated trends in estimated total imaging cost, number of Code Stroke activations per year, cumulative radiation exposure, and the average imaging cost per treated Code Stroke patient, defined as a case resulting in IVT or EVT treatment. Results From 2020 to 2025, annual Code Stroke activations and associated imaging expenditures rose nearly three-fold from 133 to 298 cases, driven by an approximately 800% increase in CTA head and neck utilization. Annual imaging expenditure increased from $70,616 to $259,290.Despite the increasing number of Code Stroke activations, the number of patients receiving IVT or EVT has remained stable (19 cases in 2020 vs 16 in 2025), with treatment yield declining from 14.3% to 5.4%. Consequently, the proportion of Code Strokes resulting in reperfusion decreased over time, with the average cost per treated patient increasing over 4-fold from $3717 to $16,205. Conclusion Our findings describe a disproportionate rise in imaging utilization and cost relative to the number of treated Code Strokes. These findings characterize longitudinal trends in imaging utilization and resource use within contemporary stroke evaluation pathways.
