Multidetector CT of Blunt Thoracic Trauma

Kaewlai, Rathachai; Avery, Laura L.; Asrani, Ashwin; Novelline, Robert A.

doi:10.1148/rg.286085510

Cited by 232 publications

(137 citation statements)

References 40 publications

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“…With regards to the prevalence of thoracic trauma compared to other types of trauma, it is an important cause of morbidity and mortality, which has led to approximately 25% of trauma-related deaths in the United States (5). Thoracic trauma is the third most frequent injury after head and extremities in patients with multiple trauma (5).…”

Section: Introductionmentioning

confidence: 99%

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Blunt Thoracic Injury Mortality and Clinical Presentation

Yadollahi¹,

Arabi²,

Mahmoudi³

et al. 2018

Trauma Mon

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Background: Blunt thoracic trauma is the third most common injury in poly-trauma patients following head and extremities injuries; this study aimed at investigating the prevalence of blunt chest trauma and its injury pattern, mechanism of injury, length of hospital stay, treatment period, and risk factors. Methods: In this cross-sectional study, 7,410 patients, who referred to Shahid Rajaee hospital, during years 2010 to 2014 were selected through census sampling. The participants' demographic data, mechanism of injury, type of thoracic injury, location of fracture, length of stay, and injury severity scores (ISS) were recorded.Results: Most patients were male (5498, 74.2%), 63.3% were 15 to 40 years old, and their mean age was 37.53 ± 0.21 years. The most commonly reported mechanism of injury was car accident (2,999, 40.5%) followed by falls (1,529,20.6%, and motorbike accidents (964, 13.1%). Head, neck and thorax injuries were most common comorbidities in thorax trauma patients. The mortality rate was 1.5%. Indeed, the patients, who had rib fracture (P = 0.01) (OR3.66, CI [1.36 -9.82]), and multiple injuries of thorax (P < 0.001) (OR 8.10,.73]), had a higher mortality risk. Conclusions:The risk of blunt thoracic injuries was higher among specific types of injuries. Additionally, patients with blunt chest trauma, who had the risk factors of mortality required preventative measures and careful management in order to prevent traumarelated deaths.Keywords: Thoracic Injuries, Trauma, Blunt BackgroundTrauma is the leading cause of death in patients under 40 years of age (1) and the fourth leading cause of death globally (2, 3). World health organization (WHO) announced in 2004 that trauma was the fourth main cause of death in Iran, and would turn into the third cause of death by 2020 (4).With regards to the prevalence of thoracic trauma compared to other types of trauma, it is an important cause of morbidity and mortality, which has led to approximately 25% of trauma-related deaths in the United States (5). Thoracic trauma is the third most frequent injury after head and extremities in patients with multiple trauma (5). In addition, approximately 0.06% of disability cases per year are caused by chest trauma (6). Blunt thoracic injuries are the third most common injury in poly-trauma patients following head and extremities trauma (7). Blunt chest trauma is directly responsible for 25% of all trauma deaths (8).Generally, more than 50% of blunt chest trauma cases occur in fatal accidents and a large number of them are caused by motor vehicle crashes (63% to 78%), followed by falls, blows from blunt objects, or explosive devices (10% to 17%) (9).Blunt traumatic injuries (BTI) represent a high incidence of morbidity and mortality worldwide (10). The most common mechanisms of blunt trauma are road traffic accidents (RTAs), falls, and being struck by heavy objects (11,12).Patients with blunt chest trauma may be at a significant risk of developing respiratory failure (13). Some studies have also reported that up to ...

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Section: Introductionmentioning

confidence: 99%

“…Thoracic trauma is the third most frequent injury after head and extremities in patients with multiple trauma (5). In addition, approximately 0.06% of disability cases per year are caused by chest trauma (6).…”

Section: Introductionmentioning

confidence: 99%

Blunt Thoracic Injury Mortality and Clinical Presentation

Yadollahi¹,

Arabi²,

Mahmoudi³

et al. 2018

Trauma Mon

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“…Bu durum atelektazinin derinleşmesine ve bunun sonucunda ilerleyen dönemlerde pnömoniye neden olmaktadır (3) . Hastamızda da özellikle ağrı yakınması ön planda idi.…”

Section: Discussionunclassified

“…Toraks travmalarının %70'i motorlu araç kazaları sonrası, %10-17'si yüksekten düşme sonrası meydana gelmektedir (2) . Künt toraks travmalarında en sık (hastaların yaklaşık %50'sinde) yaralanan iskelet sistemi komponenti kostalar olmaktadır (3) . Özellikle üçten fazla kosta kırığı birlikteliği hayatı tehdit edebilmektedir (4) .…”

Section: Introductionunclassified

Lung Herniation Associated with Rib Fracture in an 11-year-old child

Atıcı¹,

Eryazğan²

2017

tcdd

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“…It is problematic for many radiologists when describing the fracture site in patients with rib fracture. Some clinicians use additional plain chest radiographs to overcome the limitations of CT in symptomatic patients; however, the patients are exposed to additional radiation during this process (6,7). Three-dimensional reformation ty were used for the gradient effect.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Reformatted CT Rib Series in Patients with Thoracic Trauma

Moon

Park

Bang³

et al. 2013

J Korean Soc Radiol

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INTRODUCTIONBlunt thoracic trauma is a common reason for emergency room visits. Although the use of initial routine chest computed tomography (CT) is controversial, it is increasingly used for patients with traumatic injury, and has a higher diagnostic performance than that of plain radiographs (1-5).Chest CT is useful for the evaluation of rib fractures. However, rib fractures can be missed by chest CT when there is no related change due to rib fracture and the fracture line is parallel to the CT section plane. The evaluation of ribs is particularly difficult due to their peripheral location. It is problematic for many radiologists when describing the fracture site in patients with rib fracture. Some clinicians use additional plain chest radiographs to overcome the limitations of CT in symptomatic patients; however, the patients are exposed to additional radiation during this process (6, 7). Three-dimensional reformation of the chest CT is helpful, but it takes more time for the radiologist to read the CT images (6, 8).Recently, reformatting techniques have been used in many fields of radiology. These reformatting techniques make interpreting CT images more convenient and improve diagnostic performance because they provide additional information about the lesion (6, 9, 10). The reformatted images reflect the data with iso- Purpose: To assess the value of adding a reformatted computed tomography (CT) rib series to transversely reconstructed CT imaging in the evaluation of rib fractures in patients with suspected traumatic thoracic injuries. Materials and Methods: One hundred consecutive patients with suspected traumatic thoracic injuries underwent 128-section multi-detector row CT. Transverse CT images with 5-mm-thick sections were reconstructed and rib series were reformatted using isotropic voxel data. Three independent radiologists, who were blinded to the data, interpreted the CT scans at 2 sessions with a 4-week interval between the sessions. Only transverse CT images were reviewed at the first session. At the second session, the CT images were reviewed along with the reformatted CT rib series. The following parameters were analyzed: receiver operating characteristic (ROC) curve, pairwise comparisons of ROC curves, sensitivity, specificity, positive predictive value, and negative predictive value. Results: There were 153 rib fractures in 29 patients. The level of the area under the ROC curve, Az improved for all observers. The diagnostic sensitivity and specificity of each observer tended to improve in the second session. The mean confidence scores for all observers of patients with rib fractures improved significantly in the second session. Conclusion: A reformatted CT rib series together with transverse CT scan is useful for the evaluation of rib fracture. Original ArticlepISSN 1738-2637 J Korean Soc Radiol 2013;68(1):27-

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Multidetector CT of Blunt Thoracic Trauma

Cited by 232 publications

References 40 publications

Blunt Thoracic Injury Mortality and Clinical Presentation

Blunt Thoracic Injury Mortality and Clinical Presentation

Lung Herniation Associated with Rib Fracture in an 11-year-old child

Usefulness of Reformatted CT Rib Series in Patients with Thoracic Trauma

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