FDG-PET/CT Skull Base to Mid-Thigh There are no data to support the use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT as an initial diagnostic imaging study in the diagnosis of sepsis. MRI Chest Without and With IV Contrast Although MRI can readily detect pulmonary and pleural infections, there are no data to support the use of MRI chest without and with IV contrast as an initial diagnostic imaging study in the diagnosis of sepsis. MRI Chest Without IV Contrast Although MRI can readily detect pulmonary and pleural infections, there are no data to support the use of MRI chest without IV contrast as an initial diagnostic imaging study in the diagnosis of sepsis. Radiography Chest Chest radiography is a commonly obtained study in the ED because of its portability and rapid acquisition. Additionally, it has the potential of providing valuable information as an initial screening tool for infection/pneumonia, particularly in patients with sepsis who may not be able to provide a history. Furthermore, chest radiography is commonly obtained in septic patients for evaluation of adequate placement of external devices, such as endotracheal tubes and central venous catheters, at which time radiologists can concurrently evaluate for an underlying source of infection. Capp et al [8] performed a retrospective study of ED patients admitted to the ICU with the diagnosis of severe sepsis or septic shock over a 12 month period and evaluated the accuracy of chest radiography in the diagnosis of pneumonia. Of 1,400 patients admitted to the ICU, 170 met criteria for severe sepsis or septic shock, and 85 were diagnosed with pneumonia. The sensitivity and specificity of initial chest radiography was 58% (95% CI, 46%- 68%) and 91% (95% CI, 81%-95%), respectively, for the diagnosis of pneumonia. Sepsis Variant 2: Suspected or confirmed sepsis. Cough or dyspnea or chest pain. Normal or equivocal or nonspecific chest radiograph. Next imaging study.
Sepsis. FDG-PET/CT Skull Base to Mid-Thigh There are no data to support the use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT as an initial diagnostic imaging study in the diagnosis of sepsis. MRI Chest Without and With IV Contrast Although MRI can readily detect pulmonary and pleural infections, there are no data to support the use of MRI chest without and with IV contrast as an initial diagnostic imaging study in the diagnosis of sepsis. MRI Chest Without IV Contrast Although MRI can readily detect pulmonary and pleural infections, there are no data to support the use of MRI chest without IV contrast as an initial diagnostic imaging study in the diagnosis of sepsis. Radiography Chest Chest radiography is a commonly obtained study in the ED because of its portability and rapid acquisition. Additionally, it has the potential of providing valuable information as an initial screening tool for infection/pneumonia, particularly in patients with sepsis who may not be able to provide a history. Furthermore, chest radiography is commonly obtained in septic patients for evaluation of adequate placement of external devices, such as endotracheal tubes and central venous catheters, at which time radiologists can concurrently evaluate for an underlying source of infection. Capp et al [8] performed a retrospective study of ED patients admitted to the ICU with the diagnosis of severe sepsis or septic shock over a 12 month period and evaluated the accuracy of chest radiography in the diagnosis of pneumonia. Of 1,400 patients admitted to the ICU, 170 met criteria for severe sepsis or septic shock, and 85 were diagnosed with pneumonia. The sensitivity and specificity of initial chest radiography was 58% (95% CI, 46%- 68%) and 91% (95% CI, 81%-95%), respectively, for the diagnosis of pneumonia. Sepsis Variant 2: Suspected or confirmed sepsis. Cough or dyspnea or chest pain. Normal or equivocal or nonspecific chest radiograph. Next imaging study.