Two new studies look at imaging-related lessons from the April 2013 terrorist bombing attack during the Boston Marathon—one of interest to post-traumatic stress disorder researchers, and the other of concern primarily to radiologists and the institutions where they practice.
The bombing presented an unanticipated opportunity for a group of researchers who had performed functional MRI brain scans on Boston-area teenagers for a study on childhood trauma. A month after the attack, the researchers surveyed those teenagers to assess PTSD symptoms. They determined that heightened reaction in the amygdala to negative emotional stimuli was a risk factor for PTSD.
“The amygdala responds to both negative and positive stimuli, but it’s particularly attuned to identifying potential threats in the environment,” said Kate McLaughlin, PhD, director of the Stress and Development Laboratory at the University of Washington. “In the current study of adolescents, the more their amygdala responded to negative images, the more likely they were to have symptoms of PTSD following the terrorist attacks.”
The other study, published online Tuesday in Radiology, involved an analysis by Boston’s Brigham and Women’s Hospital of its radiology emergency response to the bombing. As a Level 1 trauma center, the hospital received 40 patients injured in the bombing. Of those, 31 underwent imaging, including 57 X-rays performed on 30 patients and 16 CT scans of seven patients.
CT turnaround time averaged 37 minutes, compared with a median of 72 minutes during everyday operation of the emergency department. During the crisis, the ED supplemented its CT scanner by using two others elsewhere in the hospital. It also posted a radiologist at each machine. That, said John F. Brunner, MD, lead author of the Radiology article, made a big difference:
By having a radiologist stationed at each CT scanner, we could provide real-time protocols and preliminary interpretations of crucial results to help our trauma teams.
Dr Brummer, now at the University of Southern California, was an emergency radiology fellow at Brigham and Women’s on the day of the bombing. He was quoted in a Radiological Society of North America news release.
The median X-ray turnaround, on the other hand, was 52 minutes, much longer than the normal 31 minutes. The researchers attributed most of the delay to the fact that all of the portable X-ray machines relied on a single X-ray plate readout device. Those scanners have since been replaced by digital radiography equipment with wireless image transfer.
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