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Emerg Radiol (2013) 20:401408 DOI 10.1007/s10140-013-1139-3
ORIGINAL ARTICLE
Rapid imaging protocol in trauma: a whole-body dual-source CT scan
Anto Sedlic & Christina M. Chingkoe & David K. Tso &
Sandro Galea-Soler & Savvas Nicolaou
Received: 13 December 2012 /Accepted: 4 June 2013 /Published online: 21 June 2013 # Am Soc Emergency Radiol 2013
Abstract The purpose of this study is to determine whether a single acquisition whole-body trauma multi-detector CT scan is able to reduce resuscitation time, scan time, and effective radiation dose without compromising diagnostic quality in the setting of polytrauma. Retrospective analysis of 33 trauma patients undergoing single acquisition whole-body CT with injury severity scores of 16 was compared to 34 patients imaged with a segmented whole-body CT protocol. Time spent in the emergency department, effective radiation dose, image quality, and mortality rates were compared. The single acquisition group spent 53.7 % less time in the emergency department prior to imaging (p=0.0044) and decreased scanning time by 25 %. The protocol yielded a 24.5 % reduction in mean effective radiation dose (24.66 mSv vs. 32.67 mSv, p<0.0001). The image noise was similar in both groups. Standardized mortality ratios were comparable. The single acquisition protocol significantly reduces time spent in the emergency department by allowing faster imaging at a lower radiation dose while maintaining image quality. Other contributors to reduction in radiation dose include use of dual-
source CT technology, removal of delayed CT intravenous pyelogram, and arm positioning.
Keywords Polytrauma . CT . Emergency radiology . Whole-body imaging
Introduction
Trauma remains the leading cause of death in people under 45 years of age [1]. Trauma care represents a huge financial burden to society with costs totaling a lifetime cost of $406 billion in the US including cost of medical treatment and lost productivity [2]. It accounts for 6,500 visits a year to the emergency department at our institution, a Level 1 trauma center, with approximately 15 % being polytrauma related.
The golden hour concept in trauma management is founded on the principle that early intervention leads to maximum survival and improved outcomes [3]. This concept underscores the importance of early and accurate diagnostic imaging. Furthermore, whole-body CT has a demonstrated role in the management of the polytrauma patient.
Polytrauma mortality has decreased...