Evaluation of a Single-Pass Continuous Whole-Body 16-MDCT Protocol for Patients with Polytrauma

Abstract

examinations most often include the head, cervical spine, and thorax to pelvis. Although MDCT data acquisition time is no longer a cause of time delays, the need to reposition patients for conventional protocols can be time consuming [5,7]. Gralla et al. [5] reported the results of a prospective study in which 497 patients underwent whole-body CT. The mean repositioning time was 8 minutes, accounting for up to 26% of the total time in the CT room.The aim of our prospective study was to compare the acquisition times and image quality of two single-pass continuous wholebody MDCT protocols with those of our conventional segmental whole-body MDCT protocol. Two single-pass protocols with various injection flow rates and iodine concentrations were evaluated. S p e c i a l A r t ic l e • O r ig i n a l R e s e a rc h CMEThis article is available for CME credit. See www.arrs.org for more information. CT assessment of such patients should be systematic, complete, and accurate. Another key factor is the time required for radiologic examination, which, because the chance of survival increases the sooner trauma care is initiated, must be as short as possible [1,3]. The reliability and workflow of MDCT for emergency purposes have been supported by the results of several studies [3][4][5][6][7]. MDCT scanners are widely used because they rapidly produce high-resolution scans of large areas, offering short examination times for multiple body regions under emergency conditions. Such OBJECTIVE. The purpose of this study was to compare a conventional multiregional MDCT protocol with two continuous single-pass whole-body MDCT protocols in imaging of patients with polytrauma. SUBJECTS AND METHODS.Ninety patients with polytrauma underwent wholebody 16-MDCT with a conventional (n = 30) or one of two single-pass (n = 60) protocols. The conventional protocol included unenhanced scans of the head and cervical spine and contrastenhanced helical scans (140 mL, 4 mL/s, 300 mg I/mL) of the thorax and abdomen. The single-pass protocols consisted of unenhanced scans of the head followed by one-sweep acquisition from the circle of Willis through the pubic symphysis with a biphasic (150 mL, 6 and 4 mL/s, 300 mg I/mL) or monophasic (110 mL, 4 mL/s, 400 mg I/mL) injection. Acquisition times and interval delays between head, chest, and abdominal scans were recorded. Contrast enhancement was measured in the aortic arch, liver, spleen, and kidney. Diagnostic image quality in the same areas was assessed on a 4-point scale.RESULTS. Median acquisition times for the single-pass protocols were significantly shorter (-42.5%) than the acquisition time for the conventional protocol. No significant differences were found in mean enhancement values in the aorta, liver, spleen, and kidney for the three protocols. The image quality with both single-pass protocols was better than that with the conventional protocol in assessment of the mediastinum and cervical spine (p < 0.05). There was no significant difference between the single-pass protocols.CONCLUSION. Us...

Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey

“…In our institution, a single bolus examination protocol is performed for whole-body CT scan, which reduces the scanning time and allows more rapid evaluation of patients with polytrauma. 3 In our cohort of patients, the majority of the injuries were secondary blast injuries requiring a multimodality imaging approach. Radiological evaluation of penetrating shrapnel injuries should involve the identification of shrapnel fragments and resulting injuries.…”

“…CT images were obtained in compliance with the single-pass wholebody CT protocol. 3 All radiographs and CT scans were assessed retrospectively in terms of positive findings regarding penetrating and blunt trauma as well as more specific bomb blast injuries such as blast lung. Injuries were then categorized according to the injury mechanism, as described in Table 1.…”

Battlefield radiology

“…The most severely injured patients receive an MDCT traumagram. At Camp Bastion this is based on the Baltimore/Geneva protocol [4]. An unenhanced helical head is acquired with 5 mm collimation with an interval of 5 mm (pitch 0.531:1) to below the mandible.…”

Vascular Trauma: New Directions in Screening, Diagnosis and Management

“…Particularly in multi-trauma patients who require CT imaging of multiple body parts, the use of single pass whole body protocols result in significantly decreased radiation dose, contrast dose, and scan time, as well as total time in the CT suite (Fanucci, et al, 2007;Flamm. 2007;Loupatatzis, et al, 2008;Nguyen, et al, 2009;Ptak, et al, 2003). Given these benefits some investigators have advocated abandoning chest x-ray as a screening tool in favor of CT in all patients with blunt thoracic trauma.…”

“…Contrast induced nephropathy can occur in 1.2-2.6% of patients, however this can increase to 11-33% in high risk groups (Bellin, et al, 2002;Haveman, et al, 2006;Lencioni, et al, 2010;Morcos. 2005;Nguyen, et al, 2009;Pucelikova, et al, 2008;Rashid, et al, 2009;Wang, et al, 2007). …”