Standardized whole-body computed tomography as a screening tool in blunt multitrauma patients

Abstract

The authors present the potential of using a preset CT protocol covering the whole body of the patient who has suffered blunt trauma to screen for injuries, based on a review of the literature and on 4 years' direct experience. Standardized whole-body CT is the fastest method of examining the whole body, capable of detecting a wide variety of traumatic lesions with a high sensitivity and specificity. Multidetector CT allows a full-body examination to be completed within 5 min, thus minimizing time to diagnosis and the institution of definitive clinical care. Current imaging algorithms that include abdominal ultrasonography and plain radiographic studies need to be reassessed in view of the technical advances in CT diagnosis, but should ultimately depend on the particular imaging capabilities and experience of a given trauma center.

Spine fractures in falling accidents: analysis of multidetector CT findings

“…In level-one trauma centers CT is routinely used for screening seriously injured patients [2,11,12], although conventional radiography has been reported sufficient in conscious, non-intoxicated patients without clinical symptoms of spinal injury [3]. Due to technical breakthroughs, multidetector CT (MDCT) is faster and has better temporal, spatial, and contrast resolution due to smaller isotropic voxels compared with conventional helical CT [13].…”

Delays in diagnosis in early trauma care: evaluation of diagnostic efficiency and circumstances of delay

“…Improvement in computed tomography (CT) technology has led to the introduction of multislice CT in early trauma diagnostics [9][10][11][12][13]. Despite the implementation of trauma centers and trauma management concepts in the 1980s and 1990s, delays in diagnosis in early trauma care with underestimations of injury severity and consecutive delays in surgery still occur [14][15][16][17][18][19][20][21][22].…”

Diagnostic value of pelvic radiography in the initial trauma series in blunt trauma

“…CT is a commonly used imaging modality following the initial radiographs in the trauma setting. In many level 1 trauma centers, CT is routinely used for screening seriously injured patients [2]. In pelvic injuries CT reveals possible retroperitoneal hematomas which are usually due to arterial bleeding and may require angiography and embolization.…”

“…In level 1 trauma centers, patients with serious blunt trauma undergo the initial trauma series, which usually includes FAST (Focused Assessment with Sonography in Trauma), lateral cervical spine radiography, anteroposterior chest and pelvic radiography followed by head, cervical spine, and whole-body computed tomography (CT) or multidetector CT (MDCT) [2]. Compared to conventional helical CT, MDCT is faster, and has fewer motion artifacts, reduced partial volume effects, decreased image noise, high-quality multiplanar reconstructions (MPR) and isotropic viewing, all of which increase the diagnostic power of this imaging modality, benefiting emergency trauma patients [3][4][5].…”