Evaluation of the Aggregated Time Savings in Adopting Fast Brain MRI Techniques for Outpatient Brain MRI.

INTRODUCTION: Clinical validation studies have demonstrated the ability of accelerated MRI sequences to decrease acquisition time and motion artifact while preserving image quality. The operational benefits, however, have been less explored. Here, we report our initial clinical experience in implementing fast MRI techniques for outpatient brain imaging during the COVID-19 pandemic. METHODS: Aggregate acquisition times were extracted from the medical record on consecutive imaging examinations performed during matched pre-implementation (7/1/2019-12/31/2019) and post-implementation periods (7/1/2020-12/31/2020). Expected acquisition time reduction for each MRI protocol was calculated through manual collection of acquisition times for the conventional and accelerated sequences performed during the pre- and post-implementation periods. Aggregate and expected acquisition times were compared for the five most frequently performed brain MRI protocols: brain without contrast (BR-), brain with and without contrast (BR+), multiple sclerosis (MS), memory loss (MML), and epilepsy (EPL). RESULTS: The expected time reductions for BR-, BR+, MS, MML, and EPL protocols were 6.6 min, 11.9 min, 14 min, 10.8 min, and 14.1 min, respectively. The overall median aggregate acquisition time was 31 [25, 36] min for the pre-implementation period and 18 [15, 22] min for the post-implementation period, with a difference of 13 min (42%). The median acquisition time was reduced by 4 min (25%) for BR-, 14.0 min (44%) for BR+, 14 min (38%) for MS, 11 min (52%) for MML, and 16 min (35%) for EPL. CONCLUSION: The implementation of fast brain MRI sequences significantly reduced the acquisition times for the most commonly performed outpatient brain MRI protocols.

Pielite enfisematosa unilateral: relato de caso / Unilateral emphysematous pyelitis: case report

The present report describes the case of a 22-year-old female patient admitted to the emergency room with acute low back pain, dysuria, vomiting and fever (38.5ºC). Urinalysis and computed tomography findings revealed urinary tract infection associated with presence of gas in the collecting system, characterizing unilateral emphysematous pyelitis caused by Gram-negative bacteria. The present case report emphasizes the occurrence of this disease as a urinary tract infection complication.

Relata-se um caso de paciente de 22 anos de idade, gênero feminino, que foi admitida no pronto-socorro com lombalgia aguda, disúria, vômitos e febre (38,5ºC). Os achados de exames de urina e tomografia computadorizada demonstraram infecção no trato urinário associada a gás no sistema coletor, configurando pielite enfisematosa unilateral por Gram-negativo. O presente relato enfatiza a ocorrência deste agravo como complicação de infecção no trato urinário.