Florian Lorenz Glaser-Gallion MD, Abstract Co-Author: Nothing to Disclose

Nicola Susanne Glaser-Gallion MD, Presenter: Nothing to Disclose

Hatem Alkadhi MD, Abstract Co-Author: Nothing to Disclose

Paul Stolzmann MD, Abstract Co-Author: Nothing to Disclose

Juergen Fornaro, Abstract Co-Author: Nothing to Disclose

Bjoern Stinn, Abstract Co-Author: Nothing to Disclose

Simon Wildermuth MD, Abstract Co-Author: Nothing to Disclose

Sebastian Leschka MD, Abstract Co-Author: Nothing to Disclose

To evaluate two different CT protocols in polytraumatized patients regarding image quality, CT room time, and radiation dose.

Two hundred consecutive polytraumatized patients were investigated with one of two different CT protocols. Protocol A consisted if a standard serial polytrauma CT with separate acquisition of head and neck (nonenhanced) and separate contrastenhanced acquisitions of chest and abdomen (150 ml contrast, fixed scan delay); arms were elevated after the head&neck scan. Protocol B was performed with head scanned nonenhanced and neck to pelvic floor scanned in one contrast-enhanced acquisition after splitbolus contrast injection (50 ml contrast, delay of 35 sec, 100 ml contrast, scan start with bolus tracking) with arms taken down for a combined angiographic and parenymateous contrast phase. Image quality was evaluated by two radiologists for head, neck, chest, abdomen, and pelvis using a 3-point score (1:excellent,3:non-diagnostic). The time in the CT suite was recorded and radiation dose was calculated from the dose length product.

The CT suite time was significantly higher for protocol A (9.7±2.8min) than in protocol B (7.2±2.0min;p<0.05). Image quality was similar for head (A:1.1±0.2;B:1.1±0.1), neck (A:1.3±0.3;B:1.2±0.3), chest (A:1.2±0.3;B:1.2±0.2), and pelvis (A:1.4±0.3;B:1.4±0.4). Image quality of abdomen was significantly better in protocol A (1.4±0.3) compared to protocol B (1.7±0.5;p<0.05), but was diagnostic for organ injuries in protocol B in all but one patient. Radiation dose was significantly lower in protocol B (11.2±0.8mSv) than in protocol A (14.6±2.9mSv;p<0.05). Additional injuries of regions not visualized in protocol A were found in 14 patients in protocol B (forearm/wrist fractures,n=12; carotid dissection,n=2).

The splitbolus CT protocol in polytraumatized patients reduces CT room time and radiation dose while maintaining diagnostic image quality and extends CT evaluation to forearm/wrist fractures and arterial neck trauma.

The implementation of a splitbolus CT protocol in polytraumatized patients facilitates the trauma management by avoiding relocation of the arms during the CT study and by providing supplementary angio

Glaser-Gallion, F, Glaser-Gallion, N, Alkadhi, H, Stolzmann, P, Fornaro, J, Stinn, B, Wildermuth, S, Leschka, S, Image Quality, CT Room Time, and Radiation Dose in Two Different CT Protocols for Polytraumatized Patients.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11015580.html