Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma

Nguyen, Duy; Platon, Alexandra; Shanmuganathan, Kathirkamanathan; Mirvis, Stuart E.; Becker, Christoph; Poletti, Pierre-Alexandre Alois

doi:10.2214/AJR.07.3702

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Title		Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma
Authors		Nguyen, Duy Platon, Alexandra Shanmuganathan, Kathirkamanathan Mirvis, Stuart E. Becker, Christoph Poletti, Pierre-Alexandre Alois
Published in		American Journal of Roentgenology. 2009, vol. 192, no. 1, p. 3-10
Abstract		OBJECTIVE: The purpose of this study was to compare a conventional multiregional MDCT protocol with two continuous single-pass whole-body MDCT protocols in imaging of patients with polytrauma. SUBJECTS AND METHODS: Ninety patients with polytrauma underwent whole-body 16-MDCT with a conventional (n=30) or one of two single-pass (n=60) protocols. The conventional protocol included unenhanced scans of the head and cervical spine and contrast-enhanced helical scans (140 mL, 4 mL/s, 300 mg I/mL) of the thorax and abdomen. The single-pass protocols consisted of unenhanced scans of the head followed by one-sweep acquisition from the circle of Willis through the pubic symphysis with a biphasic (150 mL, 6 and 4 mL/s, 300 mg I/mL) or monophasic (110 mL, 4 mL/s, 400 mg I/mL) injection. Acquisition times and interval delays between head, chest, and abdominal scans were recorded. Contrast enhancement was measured in the aortic arch, liver, spleen, and kidney. Diagnostic image quality in the same areas was assessed on a 4-point scale. RESULTS: Median acquisition times for the single-pass protocols were significantly shorter (-42.5%) than the acquisition time for the conventional protocol. No significant differences were found in mean enhancement values in the aorta, liver, spleen, and kidney for the three protocols. The image quality with both single-pass protocols was better than that with the conventional protocol in assessment of the mediastinum and cervical spine (p<0.05). There was no significant difference between the single-pass protocols. CONCLUSION: Use of single-pass continuous whole-body MDCT protocols can significantly decrease examination time for patients with polytrauma and improve image quality compared with a conventional serial scan protocol. Monophasic injection with highly concentrated contrast medium can reduce injection flow rate and should therefore be preferred to a biphasic injection technique.
Keywords		Adolescent — Adult — Aged — Aged, 80 and over — Female — Humans — Male — Middle Aged — Multiple Trauma/radiography — Radiographic Image Enhancement/instrumentation/methods — Reproducibility of Results — Sensitivity and Specificity — Tomography, X-Ray Computed/instrumentation/methods — Whole Body Imaging/instrumentation/*methods — Young Adult
Identifiers		DOI: 10.2214/AJR.07.3702 PMID: 19098172
Full text		Article - Limited access to UNIGE Other version: http://www.ajronline.org/content/192/1/3.full.pdf
Structures		Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale
Research groups		Imagerie et radiologie interventionnelle du foie, des voies biliaires et du pancréas (316) Radiologie des urgences (800)
Citation (ISO format)		NGUYEN, Duy et al. Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma. In: American Journal of Roentgenology, 2009, vol. 192, n° 1, p. 3-10. doi: 10.2214/AJR.07.3702 https://archive-ouverte.unige.ch/unige:20005