The accuracy of focused abdominal CT in patients presenting to the emergency department

Latifi, Ali; Torkzad, Omid; Labruto, Fausto; Ullberg, Ulla; Torkzad, Michael R.

doi:10.1007/s10140-008-0775-5

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…This can be explained by recent technical improvements in CT scanner hard- and software delivering high-quality images of various body parts within a short time [4]-[6]. While several studies so far have demonstrated the technical feasibility of whole-body CT introducing various protocols and contrast media application techniques [7],[8], the exact role and clinical value of a whole-body CT in terms of non-trauma-associated additional findings, as compared to potential estimated radiation risks, is still a matter of debate. A recent multi-center trial suggested that the integration of whole-body CT into early trauma care significantly increases the probability of survival in polytrauma patients when compared to those undergoing non-whole-body CT [1].…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of incidental non-trauma associated findings in severely injured patients identified by whole-body spiral CT scans

2014

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BackgroundWhole-body Computed Tomography (CT) scan today is considered a crucial imaging technique in the diagnostic work-up of polytrauma patients implicating a potential survival benefit. Apart from prompt identification of life threatening injuries this imaging technique provides an additional benefit by diagnosing incidental non-trauma associated medical diseases. These incidental findings might be also life threatening and warrant urgent therapy. The downside of whole-body CT is a relatively high radiation exposure that might result in an increased life time cancer risk. The aim of this study was to investigate the frequency and type of non trauma associated incidental medical findings in relation to patient age and potential clinical relevance.MethodsBetween January 1st 2011 and December 15th 2012, a total of 704 trauma patients were referred to our hospital’s emergency room that triggered trauma room alarm according to our trauma mechanism criteria. Of these 534 (75.8%) received a whole-body CT according to our dedicated multiple trauma protocol. Incidental Findings (IF) were assigned in three groups according to their clinical relevance. Category 1: IF with high medical relevance (urgent life threatening conditions, unless treated) needing early investigations and intervention prior to or shortly after hospital discharge. Category 2: IF with intermediate or low medical relevance, warranting further investigations. Category 3: IF without clinical relevance.ResultsOverall 231 IFs (43.3%) were identified, 36 (6.7%) patients had IFs with a high clinical relevance, 48 (9.0%) with a moderate or minor clinical relevance and 147 (27.5%) with no clinical relevance. The distribution of incidental findings with high or moderate relevance according to age showed an incidence of 2.6%, 6.6% and 8.8% for patients younger than 40 years, 40 to 60 years and older than 60 years, respectively.ConclusionWhole-body CT scans of trauma patients demonstrate a high rate of incidental findings. Potentially life-threatening, medical findings were found in approximately every 15th patient, predominantly aged over 40 years and presenting with minor to moderate injuries and an Injury Severity Score (ISS) of 10 or less.

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Section: Introductionmentioning

confidence: 99%

Retrospective analysis of incidental non-trauma associated findings in severely injured patients identified by whole-body spiral CT scans

2014

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“…This can be explained by recent technical improvements in CT scanner hard-and software delivering high-quality images of various body parts within a short time [6][7][8][9][10]. While several studies so far have demonstrated the technical feasibility of whole-body CT introducing various protocols and contrast media application techniques [2,11,12], the exact role and clinical value of a whole-body CT in terms of patient outcome as compared to a CT of dedicated body regions is still a matter of debate. A recent multi-center trial suggested that the integration of whole-body CT into early trauma care significantly increases the probability of survival in polytrauma patients when compared to those undergoing non-whole-body CT [3].…”

Section: Introductionmentioning

confidence: 99%

Whole-body CT in polytrauma patients: effect of arm positioning on thoracic and abdominal image quality

et al. 2011

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The purpose of this study is to assess the influence of different arm positioning techniques on thoracic and abdominal image quality and radiation dose of wholebody trauma CT (wbCT). One hundred and fifty polytrauma patients (104 male, mean age 47±19) underwent wbCT with arms elevated above the head (group A, n=50), alongside the abdomen (group B, n=50), and on a pillow ventrally to the chest with both arms flexed (group C, n=50). Two blinded, independent observers measured image noise and rated image quality (scores 1-3) of the liver, aorta, spleen, spine, and lower lungs. Radiation dose parameters were noted, and the abdomens' anterior-posterior diameter and scan lengths were measured. Interreader agreements for image noise (r= 0.86; p<0.001) and subjective image quality (k=0.71-0.84) were good. Noise was lower (p<0.05), image quality of the liver, aorta, spleen, and spine was higher, and radiation dose lower in group A than in groups B and C (p<0.001, each). Image quality of the spleen, liver, and aorta were higher in group C than in group B (p<0.05, each). No significant differences in scan length (p=0.61) were found among groups. Abdominal anterior-posterior diameter correlated significantly with noise (r=0.82; p<0.01) and dose (r=0.47; p<0.001). Estimated effective radiation doses were significantly (p<0.001) higher in groups B (21.2 mSv) and C (21.9 mSv) as compared to A (16.1 mSv). In wbCT for polytrauma patients, positioning of the arms above the head results in better image quality and lower radiation dose. Placing the flexed arms on a large pillow ventrally to the chest significantly improves image quality as compared to positioning alongside the abdomen.

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La tomografía computarizada multidetector en el abdomen agudo

2011

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The accuracy of focused abdominal CT in patients presenting to the emergency department

Cited by 3 publications

References 22 publications

Retrospective analysis of incidental non-trauma associated findings in severely injured patients identified by whole-body spiral CT scans

Retrospective analysis of incidental non-trauma associated findings in severely injured patients identified by whole-body spiral CT scans

Whole-body CT in polytrauma patients: effect of arm positioning on thoracic and abdominal image quality

La tomografía computarizada multidetector en el abdomen agudo

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