RSNA 2003 

Abstract Archives of the RSNA, 2003


G22-722

Are Plain Radiographs Still Necessary in the Era of Multislice CT in Polytrauma Patients with Suspected Thoracic and Lumbar Spine Injuries?

Scientific Papers

Presented on December 2, 2003
Presented as part of G22: Musculoskeletal (Spinal Trauma)

Participants

Sivakumar Manickam MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Many centres use plain films of the thoracic (TS) and lumbar spine (LS) to screen patients with suspected TS and LS injuries. The purpose of our study was to determine whether multislice CT (MSCT)done for chest and abdomen could replace plain films as the screening modality in polytrauma patients with suspected spinal injuries on admission. Methods and Materials: Eighty-nine patients who presented to hospital over a period of one year with polytrauma and suspected TS and LS injuries were studied. We retrospectively compared plain films with the post processed MSCT spinal images that were obtained from raw data initially acquired to study the chest and abdomen. Patients had AP and lateral spinal radiographs (TS n=13, LS n=48 and TS and LS n=28), and MSCT of the chest (n=11), abdomen (n=47) and chest and abdomen (n=31). MSCT was performed using fixed parameters (5/7.5/5) and additional reconstructions were done on 2.5mm and 1.25mm thickness. Two radiologists blinded to all clinical and imaging information independently evaluated the TS and LS plain films and the chest and abdominal MSCT studies. MSCT images were analysed on a workstation. The readers were asked to determine whether spinal fractures were present and the anatomical extent of these. Equivocal findings and /or differences were reconciled by consensus at a joint sitting. Both radiographs and MSCT were combined to constitute a standard of reference. Results: Of a total of 29 TS fractures, 22 were detected on plain films and all of them by MSCT. MSCT detected 41 of 43 LS fractures and 29 were seen on radiographs. MSCT detected 27 of the 29 LS fractures observed on radiographs and also found an additional fourteen. MSCT detected 19 more fractures than those seen on plain films and provided valuable information on the bony spinal canal. Furthermore, it demonstrated the complete anatomical extent of 6 fractures that were only partially visible on plain films. Conclusion: MSCT was more sensitive for detecting both TS and LS injury in polytrauma patients. MSCT was also superior in defining the anatomical extent of fractures in certain cases. MSCT is an effective screening modality in polytrauma patients with suspected spinal trauma and can replace radiographs.      

Cite This Abstract

Manickam MD, S, Are Plain Radiographs Still Necessary in the Era of Multislice CT in Polytrauma Patients with Suspected Thoracic and Lumbar Spine Injuries?.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3102506.html