Multi-detector computed tomography imaging of blunt chest trauma

Abstract

Background and purpose: Chest trauma is a significant cause of mortality and morbidity, especially in the younger population. The purpose of this study was to evaluate the role of multidetector computed tomography (MDCT) in the assessment of patients with blunt chest trauma. Patients and methods: A prospective study was conducted on thirty (30) patients with blunt chest trauma (21 males and 9 females, aged from 6 to 62 years) and 29 control patients presented with any trauma other than blunt chest trauma (23 males and 6 females, aged from 10 to 68 years) at the Emergency Department, Tanta University Hospital, from January 2013 to February 2014. Cases were subjected to clinical evaluation and radiological assessment of the chest using conventional chest X-ray (CXR) and multi-detector computed tomography. Results: The most common mode of injury was motor vehicle accidents (56.7%). On MDCT scan, the frequency of chest injuries were; chest wall injuries (86.7%), pleural injuries (80%), parenchymal injuries (56.7%), mediastinal injuries (30%) and finally the dorsal spine injuries (16.7%). MDCT is more sensitive, specific, and accurate than CXR in the assessment of blunt chest trauma and management of patients. Conclusion: MDCT is the modality of choice for rapid assessment of emergency chest trauma patients, when chest X-ray was inconclusive.

Radiography Versus Computed Tomography in Paediatric Patients after Blunt Thoracic Trauma

“…20,21 Nonetheless, the role of CT in the diagnosis of thoracic blunt trauma in paediatric patients is less well defined. [6][7][8][9] In a study of 42 paediatric patients with blunt trauma evaluated by thoracic and abdominal CT, only 11 patients were found to have 12 abnormalities, of whom only four had thoracic injuries: mild pulmonary contusion (n = 2), minimal pneumothorax (n = 1), rib fracture (n = 1), and the remaining were abdominal injuries. 6 Thus, routine use of CT in asymptomatic paediatric patients with blunt trauma is not justified.…”

“…6 In a study of 30 paediatric patients with blunt thoracic trauma, 26 injuries were detected on CT, of which 17 were also detected on radiography. 7 CT is more sensitive for detection of chest wall, pleural, parenchymal, and mediastinal injuries. 7 In a study of 57 CT scans and 55 radiographs in paediatric patients with thoracic blunt trauma, radiography identified fewer injuries (51% vs. 83%, p<0.001).…”

“…7 CT is more sensitive for detection of chest wall, pleural, parenchymal, and mediastinal injuries. 7 In a study of 57 CT scans and 55 radiographs in paediatric patients with thoracic blunt trauma, radiography identified fewer injuries (51% vs. 83%, p<0.001). 8 All seven emergency chest interventions were based on radiography.…”

“…5 Nonetheless, the role of CT in the diagnosis of thoracic blunt trauma in paediatric patients is less well defined. [6][7][8][9] In paediatric patients with thoracic trauma, the incidence of cardiac and thoracic vascular injuries is much lower, and the risk of radiation exposure is higher, compared with adults. 10 This study aimed to compare radiography with CT in the detection of blunt thoracic injuries in paediatric patients.…”

Spectrum of multi-detector computed tomography imaging findings of thoracic vascular injuries secondary to blunt chest trauma: Correlation with vascular intervention and patient outcomes

“…8,9 Although chest radiographs are usually the first-line screening modality in most trauma centres, they offer limited potential in determining the presence of a vascular injury. 4,9,10 The current use of focused assessment with sonography for trauma (FAST) may confirm few additional thoracic trauma findings. 1 However, contrast-enhanced multi-detector computed tomography (MDCT) triumphs as the imaging modality of choice owing to quick acquisition as well as the ability to diagnose life-threatening and occult injuries that are undetectable on radiographs and ultrasound.…”