Whole-Body CT in Multiple Trauma Patients: Clinically Adapted Usage of Differently Weighted CT Protocols. / Polytrauma-Ganzkörper-CT: Klinisch adaptierter Einsatz unterschiedlich gewichteter CT-Untersuchungsprotokolle.
Rofo
; 190(12): 1141-1151, 2018 Dec.
Article
in En, De
| MEDLINE
| ID: mdl-30419572
ABSTRACT
PURPOSE:
Whole-body CT (wbCT) has been established as an internationally accepted diagnostic modality in multiple trauma. Until 2011, a uniform CT scanning protocol was used for all multiple trauma patients (pat.) at our hospital (OLD protocolâ=âOP). In 2011, 2 new differently weighted protocols were introduced TIME protocol (TP) for hemodynamically unstable pat. and DOSE protocol (DP) for pat. with stable vital parameters. The aim of this study was to compare the original "One-fits-all-concept" with the new, clinically oriented approach to wbCT. MATERIALS ANDMETHODS:
This study retrospectively evaluated 3 distinct wbCT protocols, looking at automatic exposure control variation (AEC; OP/TP) and arm positioning close to the body/overhead (TP/DP). The analysis included waist circumference (WC, cm), injury severity score (ISS), examination time (ET, min), image noise (IN), and effective dose (E, mSv). Normality of distribution was assessed with the Kolmogorov-Smirnov test. Data are given as median and range. Test of significance with Kruskal-Wallis test or Mann-Whitney-U-test. Level ofsignificance:
0.05.RESULTS:
308 pat. were included in the study (77â% m; age 46âa, 18â-â90âa; WC 93âcm, 66â-â145âcm). ISS was 14 (OP; nâ=â104; 0â-â75), 18 (TP; nâ=â102; 0â-â75) and 9 (DP; nâ=â102; 0â-â50). ET was 3.9âmin (OP; 3.3â-â5.6âmin), 4.1âmin (TP; 2.8â-â7.2âmin) and 7.7âmin (DP; 6â-â10âmin). IN showed no significant differences when comparing OP/TP but was significantly reduced in DP. For a wbCT (vertex to ischium), E could be reduced from 49.7âmSv to 35.4âmSv by optimizing AEC (OP/TP). Through the overhead repositioning of the arms in DP, a further reduction to 28.2âmSv was achieved.CONCLUSION:
AEC and arm repositioning have a crucial influence on image quality and dose. The presented clinical approach is superior to the original concept. KEY POINTS · The use of 2 differently weighted wbCT protocols allows a more flexible approach to the patient's clinical presentation.. · The clinically adapted concept presented in this study allows trauma care centers to reduce the collective dose.. · Whole-body CT is leading to exposure to relevant radiation doses - further multicenter research is required.. CITATION FORMAT · Reske SU, Braunschweig R, Reske AW etâal. Whole-Body CT in Multiple Trauma Patients Clinically Adapted Usage of Differently Weighted CT Protocols. Fortschr Röntgenstr 2018; 190 1141â-â1151.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Multiple Trauma
/
Tomography, X-Ray Computed
/
Whole Body Imaging
Type of study:
Guideline
/
Observational_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
De
/
En
Journal:
Rofo
Year:
2018
Document type:
Article
Affiliation country: