MDCT of thoraco-abdominal trauma: an evaluation of the success and limitations of primary interpretation using multiplanar reformatted images vs axial images.

To assess whether independent evaluation of coronal and sagittal reformatted images can replace axial images for primary interpretation of multidetector row computed tomography (MDCT) images in patients with thoraco-abdominal trauma. 111 (M/F 69:42) patients with acute chest or abdominal trauma underwent 16-channel MDCT. Coronal and sagittal multiplanar reformatted (MPR) images were generated from thin-section axial images. Two radiologists independently interpreted the MPR images first followed by axial images for both imaging findings as well as adequacy of image quality. Differences between independent reader review of axial and MPR images were assessed using the Wilcoxon signed rank test. There was no significant difference in soft tissue findings identified on MPR vs axial images for either reader, p = 0.91 and 0.34, respectively. However, both readers identified more skeletal findings on the MPR as compared to the axial images, p = 0.026 and 0.040, respectively. There was no significant difference between the readers in their interpretation of axial (soft tissue, p = 0.56; skeletal, p = 0.65) or MPR (soft tissue, p = 0.32; skeletal, p = 0.65) findings. More skeletal findings were identified during the isolated review of MPR as compared to axial images alone. However, the use of MPR images alone still resulted in an unacceptably high number of missed soft tissue and even skeletal findings. A combined approach where both data sets are simultaneously available is therefore preferred.