Added value of routine chest MDCT after blunt trauma: Evaluation of additional findings and impact on patient management

American Journal of Roentgenology

Volumn 190, Issue 6, 2008, Pages 1591-1598

  Brink, Monique ^a   Deunk, Jaap ^a   Dekker, Helena M ^a   Kool, Digna R ^a   Edwards, Michael J R ^a   Van Vugt, Arie B ^a   Blickman, Johan G ^a  

^a RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

Blunt trauma; CT; Emergency radiology; Thorax; Wounds and injuries

Indexed keywords

IOBITRIDOL; IODINATED CONTRAST MEDIUM;

ADOLESCENT; ADULT; AGED; ALGORITHM; ARTICLE; BLUNT TRAUMA; CLINICAL EVALUATION; COHORT ANALYSIS; COMPARATIVE STUDY; CONFIDENCE INTERVAL; CONTROLLED STUDY; DIAGNOSTIC VALUE; FEMALE; HUMAN; INJURY SCALE; LUNG INJURY; MAJOR CLINICAL STUDY; MALE; MEDICAL EXAMINATION; MULTIDETECTOR COMPUTED TOMOGRAPHY; PATIENT CARE; PRIORITY JOURNAL; PROSPECTIVE STUDY; THORACIC SPINE; THORAX RADIOGRAPHY;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; FEMALE; HUMANS; IMAGING, THREE-DIMENSIONAL; MALE; MIDDLE AGED; PATTERN RECOGNITION, AUTOMATED; RADIOGRAPHY, THORACIC; REPRODUCIBILITY OF RESULTS; SENSITIVITY AND SPECIFICITY; THORACIC INJURIES; TOMOGRAPHY, X-RAY COMPUTED; WOUNDS, NONPENETRATING;

EID: 44849119776     PISSN: 0361803X     EISSN: None     Source Type: Journal    
DOI: 10.2214/AJR.07.3277     Document Type: Article

References (34)

1. Nagy K, Fabian T, Rodman G, Fulda G, Rodriguez A, Mirvis S. Guidelines for the diagnosis and management of blunt aortic injury: an EAST Practice Management Guidelines Work Group. J Trauma 2000; 48:1128-1143
2. Holtzman SR, Bettmann MA, Casciani T, et al. American College of Radiologists appropriateness criteria: blunt chest trauma - suspected aortic injury. American College of Radiology Website. www.acr.org. Published 1995. Updated 2005. Accessed March 8, 2007
3. Stiell IG, Clement CM, Rowe BH, et al. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA 2005; 294:1511-1518
4. Hanson JA, Blackmore CC, Mann FA, Wilson AJ. Cervical spine injury: a clinical decision rule to identify high-risk patients for helical CT screening. AJR 2000; 174:713-717
5. Avey G, Blackmore CC, Wessells H, Wright JL, Talner LB. Radiographic and clinical predictors of bladder rupture in blunt trauma patients with pelvic fracture. Acad Radiol 2006; 13:573-579
6. Blackmore CC. Clinical prediction rules in trauma imaging: who, how, and why? Radiology 2005; 235:371-374
7. Dyer DS, Moore EE, Ilke DN, et al. Thoracic aortic injury: how predictive is mechanism and is chest computed tomography a reliable screening tool? A prospective study of 1,561 patients. J Trauma 2000; 48:673-682
8. Blackmore CC, Zweibel A, Mann FA. Determining risk of traumatic aortic injury: how to optimize imaging strategy. AJR 2000; 174:343-347
9. Ungar TC, Wolf SJ, Haukoos JS, Dyer DS, Moore EE. Derivation of a clinical decision rule to exclude thoracic aortic imaging in patients with blunt chest trauma after motor vehicle collisions. J Trauma 2006; 61:1150-1155
10. Trupka A, Waydhas C, Hallfeldt KK, Nast-Kolb D, Pfeifer KJ, Schweiberer L. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study. J Trauma 1997; 43:405-411
11. Salim A, Sangthong B, Martin M, Brown C, Plurad D, Demetriades D. Whole body imaging in blunt multisystem trauma patients without obvious signs of injury: results of a prospective study. Arch Surg 2006; 141:468-473
12. American College of Surgeons. ATLS: advanced trauma life support course manual, 7th ed. Chicago, IL: American College of Surgeons, 2004
13. Linsenmaier U, Kanz KG, Rieger J, Rock C, Pfeifer KJ, Reiser M. Structured radiologic diagnosis in polytrauma [in German]. Radiologe 2002; 42:533-540
14. Mann FA, Cohen WA, Linnau KF, Hallam DK, Blackmore CC. Evidence-based approach to using CT in spinal trauma. Eur J Radiol 2003; 48:39-48
15. Ho RT, Blackmore CC, Bloch RD, et al. Can we rely on mediastinal widening on chest radiography to identify subjects with aortic injury? Emerg Radiol 2002; 9:183-187
16. Linsenmaier U, Krotz M, Hauser H, et al. Wholebody computed tomography in polytrauma: techniques and management. Eur Radiol 2002; 12:1728-1740
17. Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974; 14:187-196
18. Altman DG. Comparing groups-categorical data. In: Altman DG, ed. Practical statistics for medical research. London, United Kingdom: Chapman & Hall, 1997:236
19. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR 2001; 176:289-296
20. Self ML, Blake AM, Whitley M, Nadalo L, Dunn E. The benefit of routine thoracic, abdominal, and pelvic computed tomography to evaluate trauma patients with closed head injuries. Am J Surg 2003; 186:609-613
21. Exadaktylos AK, Sclabas G, Schmid SW, Schaller B, Zimmermann H. Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with "normal" chest radiograph? J Trauma 2001; 51:1173-1176
22. Hauser CJ, Visvikis G, Hinrichs C, et al. Prospective validation of computed tomographic screening of the thoracolumbar spine in trauma. J Trauma 2003; 55:228-234
23. Guerrero-Lopez F, Vazquez-Mata G, Cazar-Romero PP, Fernandez-Mondejar E, Guayo-Hoyos E, Linde-Valverde CM. Evaluation of the utility of computed tomography in the initial assessment of the critical care patient with chest trauma. Crit Care Med 2000; 28:1370-1375
24. Omert L, Yeaney WW, Protetch J. Efficacy of thoracic computerized tomography in blunt chest trauma. Am Surg 2001; 67:660-664
25. Demetriades D, Gomez H, Velmahos GC, et al. Routine helical computed tomographic evaluation of the mediastinum in high-risk blunt trauma patients. Arch Surg 1998; 133:1084-1088
26. Berry GE, Adams S, Harris MB, et al. Are plain radiographs of the spine necessary during evaluation after blunt trauma? Accuracy of screening torso computed tomography in thoracic/lumbar spine fracture diagnosis. J Trauma 2005; 59:1410-1413
27. Sroka NL, Combs J, Mood R, Henderson V. Scout anteroposterior and lateral CT scans as a screening test for thoracolumbar spine injury in blunt trauma. Am Surg 2007; 73:780-785
28. European Commission. Radiation protection 118: referral guidelines for imaging. Luxembourg: Office for Official Publications of the European Communities, 1997:19
29. Tien HC, Tremblay LN, Rizoli SB, et al. Radiation exposure from diagnostic imaging in severely injured trauma patients. J Trauma 2007; 62:151-156
30. Heyer CM, Mohr PS, Lemburg SP, Peters SA, Nicolas V. Image quality and radiation exposure at pulmonary CT angiography with 100- or 120-kVp protocol: prospective randomized study. Radiology 2007; 245:577-583
31. Papadakis AE, Perisinakis K, Damilakis J. Angular on-line tube current modulation in multidetector CT examinations of children and adults: the influence of different scanning parameters on dose reduction. Med Phys 2007; 34:2864-2874
32. Sybrandy KC, Cramer MJ, Burgersdijk C. Diagnosing cardiac contusion: old wisdom and new insights. Heart 2003; 89:485-489
33. Dutch Association of Traumatology. Policy in traumatology. www.acutezorg.nl/NVT%20beleidsplan%202004%20zoals%20gedrukt.pdf. Published and updated 2004. Accessed March 3, 2007
34. Hartman JAM, Lichtveld RA, de Vries GMJ, ten Wolde WLM. National protocol prehospital care [in Dutch], 6th ed. Zwolle, The Netherlands: Stichting LAMP, 2005