Current Problems in Diagnostic Radiology RSS feed: Current Issue. Current Problems in Diagnostic Radiology covers important and controversial topics in radiology. Each issue presents important viewpoints from leading radiologists. High-quality reproductions of radiographs, CT scans, MR images, and sonograms clearly depict what is being described in each article. Also included are valuable updates relevant to other areas of practice, such as medical-legal issues or archiving systems. With new multi-topic format and image-intensive style, Current Problems in Diagnostic Radiology offers an outstanding, time-saving investigation into current topics most relevant to radiologists. http://www.cpdrjournal.com/?rss=yesElsevier Inc.en © 2012 Mosby, Inc. All rights reserved. Current Problems in Diagnostic Radiology0363-0188413May 2012 © 2012 Mosby, Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.cpdrjournal.com/article/PIIS036301881100096X/abstract?rss=yesIt is my great pleasure to present this issue of Current Problems in Diagnostic Radiology dedicated to “Pelvic hemorrhage in female patients.” Arterial hemorrhage is one of the most serious problems associated with pelvic fractures or with nontraumatic pelvic emergencies in women, remaining the leading cause of death. Although ultrasound is often the primary modality used to image obstetrical and gynecologic pathology, multidetector row computed tomography (MDCT) is a crucial procedure for evaluating pelvic hemorrhage in female patients after blunt abdominal trauma and it is often the first test performed in the acute setting, particularly when a gynecologic source of bleeding is suspected. MDCT is particularly valuable for defining the exact site of any active pelvic bleeding as this can otherwise be difficult to localize and treat. The early identification of patients who might benefit from angiographic embolization could reduce blood loss and improve outcome.Letter from the Guest EditorAntonio Pinto10.1067/j.cpradiol.2011.08.001Current Problems in Diagnostic Radiology 41, 3 (2012)2012-05-01Current Problems in Diagnostic Radiology2012-05-01413S0363-0188(11)X0008-7Original Articles8182http://www.cpdrjournal.com/article/PIIS0363018811000739/abstract?rss=yes Pelvic bone fractures in female patients are a result of high-energy trauma and are a significant cause of morbidity and mortality. Their classification is based on the mechanism of the traumatic impact force and the evaluation of stability or instability of pelvic ring fracture. Vascular hemorrhage is frequently associated with pelvic bone disruption and is the main cause of death in polytrauma female patients. At many trauma centers, multidetector computed tomography (MDCT) has been considered the best modality in the trauma setting as it is also useful in characterizing multiple-body traumatic lesions. Specifically, MDCT angiography can lead to fast recognition of pelvic vascular injuries to triage patients with blunt pelvic trauma and to send those with ongoing arterial hemorrhage to appropriate emergent treatment. At contrast medium enhanced MDCT, extravasation of contrast material is an accurate finding of active bleeding and enables the interventional radiologist to selectively investigate the arteries most likely to be involved with prompt angiographic embolization. The potential sites of hemorrhage include the pelvic bone, the pelvic venous plexus, the major iliac veins, the major iliac arteries, and their peripheral branches. MDCT multiphase protocol can accurately differentiate arterial from venous hemorrhage. This article discusses the use of multiphase contrast medium enhanced MDCT in detecting and characterizing vascular pelvic injuries associated with pelvic fractures in trauma female patients. Bleeding Due to Pelvic Fractures in Female Patients: Pictorial Review of Multidetector Computed Tomography ImagingLuigia Romano, Antonio Pinto, Raffaella Niola, Ciro Stavolo, Teresa Cinque, Stefania Daniele, Maria Giuseppina Scuderi, Nicola Gagliardi10.1067/j.cpradiol.2011.07.006Current Problems in Diagnostic Radiology 41, 3 (2012)2012-05-01Current Problems in Diagnostic Radiology2012-05-01413S0363-0188(11)X0008-7Original Articles8392http://www.cpdrjournal.com/article/PIIS0363018811000752/abstract?rss=yes Vascular injuries are a major source of morbidity and mortality in patients with blunt pelvic trauma. Up to 40% of patients with pelvic fractures related to blunt traumatic injury experience intra-abdominal or intrapelvic bleeding, which is the major determining factor of mortality. Sources of hemorrhage within the pelvis include injuries to major pelvic arterial and venous structures and vascular damage related to osseous fractures. Among patients with pelvic fractures, up to 20% require emergent transcatheter embolization, depending on the type of injury. Angiography is the gold standard for the treatment of pelvic arterial hemorrhage associated with pelvic fractures. Transcatheter techniques provide direct identification of sources of bleeding. Selective catheterization and flow-directed particulate emboli can control bleeding from small arteries at sites of injury. Arterial Bleeding in Pelvic Trauma: Priorities in Angiographic EmbolizationRaffaella Niola, Antonio Pinto, Amelia Sparano, Rosa Ignarra, Luigia Romano, Franco Maglione10.1067/j.cpradiol.2011.07.008Current Problems in Diagnostic Radiology 41, 3 (2012)2012-05-01Current Problems in Diagnostic Radiology2012-05-01413S0363-0188(11)X0008-7Original Articles93101http://www.cpdrjournal.com/article/PIIS0363018811000740/abstract?rss=yes Postpartum hemorrhage is among the most common causes of maternal morbidity and mortality. Postpartum hemorrhage is defined as a blood loss of greater than 500 mL or any amount that, if not replaced, could cause shock or death in the mother. The most common cause of postpartum hemorrhage is uterine atony. This occurs when the normal myometrium fails to contract after delivery of the placenta. The initial treatment involves the administration of intravenous oxytocin and uterine massage. If the initial maneuvers fail to stop the postpartum hemorrhage, other techniques, such as uterine packing, suture techniques, uterine or hypogastric artery ligation, can be considered. In the last 30 years, a new angiographic approach for treatment of postpartum hemorrhage has emerged. Pelvic arterial embolization, after emerging as a treatment option to control and prevent pregnancy-related hemorrhage, has been established to be safe and effective. The goal of treatment for all causes of postpartum hemorrhage is cessation of bleeding in a timely fashion, before the onset of consumptive coagulopathy and end organ damage. Postpartum Hemorrhage: What Every Radiologist Needs to KnowAntonio Pinto, Raffaella Niola, Luca Brunese, Fabio Pinto, Matteo Losco, Luigia Romano10.1067/j.cpradiol.2011.07.007Current Problems in Diagnostic Radiology 41, 3 (2012)2012-05-01Current Problems in Diagnostic Radiology2012-05-01413S0363-0188(11)X0008-7Original Articles102110http://www.cpdrjournal.com/article/PIIS0363018812000096/abstract?rss=yesUpcoming Articles10.1067/S0363-0188(12)00009-6Current Problems in Diagnostic Radiology 41, 3 (2012)2012-05-01Current Problems in Diagnostic Radiology2012-05-01413S0363-0188(11)X0008-7IBCIBChttp://www.cpdrjournal.com/article/PIIS0363018812000102/abstract?rss=yesIn Recent Issues10.1067/S0363-0188(12)00010-2Current Problems in Diagnostic Radiology 41, 3 (2012)2012-05-01Current Problems in Diagnostic Radiology2012-05-01413S0363-0188(11)X0008-7OBCOBC