Portable CT: assessing thoracic disease in the intensive care unit.

Abstract

The objective of this study was to assess the usefulness of a portable CT scanner to evaluate and treat thoracic disease in patients in the intensive care unit. MATERIALS AND METHODS. Fourteen patients who were being treated in the intensive care unit underwent 20 portable CT scans. Twice a CT scan was obtained to guide an interventional chest procedure. The remaining I 8 scans were assessed for findings not evident on portable chest radiography and for findings that altered treatment. Image quality was judged in comparison with fixed CT scans. RESULTS. Unsuspected abnormalities, most relating to the pleura or chest wall, were found in 13 of the 17 available portable CT scans. Treatment was affected in four (25%) of the I 6 cases in which medical records were available for review. Two interventional procedures were performed successfully using portable CT guidance. Scan quality was judged to be comparable with that of fixed CT for mediastinal windows and somewhat inferior for lung windows. CONCLUSION. Portable CT gives images of diagnostic quality and allows confident guidance during interventional procedures in critically ill patients who therefore need not leave the intensive care unit environment.

Review of Portable CT with Assessment of a Dedicated Head CT Scanner

“…6 Soft-tissue windows were roughly comparable in quality with those in conventional scanners, whereas the quality of lung windows was decreased, due to the slower acquisition time of the portable scanner. Despite this, the scanner still produced viable thoracic imaging in the ICU setting.…”

“…7 The Tomoscan M tube voltage can be set to 120 or 130 kV, and it has a maximum tube current of 50 mA. 6 The scanner has 384 solid-state detectors. 6 With scanning parameters of 120 kV, 80 mAs, and a section thickness of 5 mm, the CT dose index was calculated at 47.2 mGy.…”

“…6 The scanner has 384 solid-state detectors. 6 With scanning parameters of 120 kV, 80 mAs, and a section thickness of 5 mm, the CT dose index was calculated at 47.2 mGy. 6 The Tomoscan has been evaluated for its potential applications in emergency departments, departments of surgery, and ICU settings.…”

“…6 With scanning parameters of 120 kV, 80 mAs, and a section thickness of 5 mm, the CT dose index was calculated at 47.2 mGy. 6 The Tomoscan has been evaluated for its potential applications in emergency departments, departments of surgery, and ICU settings. [14][15][16][17][18] For cranial imaging, a clinical evaluation of this machine in comparison with conventional scanners demonstrated increased noise and artifacts, but the diagnostic value was no different from that of the comparison unit.…”

“…1 Considering the clinical benefit, physicians can obviate the risks associated with intrahospital transport in situations in which portable CT is available for a patient in critical care. [1][2][3][4][5][6] These risks are numerous and include the compromise of monitoring equipment, intravenous lines, and intubation tubes. 5 In patients being transported for the specific purpose of a head CT, potential adverse events include hypotension, hypoxia, and increased intracranial pressure.…”