OBJECTIVE: Our objective was to show that a chest X-ray (CXR) and an abdominal computed tomography (CT) scan are sufficient to identify most clinically significant thoracic injuries in trauma patients, rendering the thoracic CT scan useful in only a subset of patients. METHODS: A retrospective study identified thoracic injuries in 374 trauma patients evaluated with a CXR, a thoracic CT scan, and an abdominal CT scan. Injuries seen on the initial CXR versus those seen on a CT scan only (occult) were identified and assessed for clinical relevance. RESULTS: An abdominal CT scan identified 65% (15/23) of occult pneumothoraces, 100% (25/25) of occult hemothoraces, 64% (18/28) of occult pulmonary contusions, and 58% (18/31) of occult rib fractures. No occult pneumothoraces seen on the thoracic CT scan alone required tube thoracostomy. CONCLUSIONS: Our pilot study suggests that a CXR and an abdominal CT scan will identify most occult intrathoracic injuries. Reserving a thoracic CT scan for patients with an abnormal CXR or high-risk mechanism could safely reduce cost and radiation exposure while still diagnosing significant thoracic injuries.
OBJECTIVE: Our objective was to show that a chest X-ray (CXR) and an abdominal computed tomography (CT) scan are sufficient to identify most clinically significant thoracic injuries in traumapatients, rendering the thoracic CT scan useful in only a subset of patients. METHODS: A retrospective study identified thoracic injuries in 374 traumapatients evaluated with a CXR, a thoracic CT scan, and an abdominal CT scan. Injuries seen on the initial CXR versus those seen on a CT scan only (occult) were identified and assessed for clinical relevance. RESULTS: An abdominal CT scan identified 65% (15/23) of occult pneumothoraces, 100% (25/25) of occult hemothoraces, 64% (18/28) of occult pulmonary contusions, and 58% (18/31) of occult rib fractures. No occult pneumothoraces seen on the thoracic CT scan alone required tube thoracostomy. CONCLUSIONS: Our pilot study suggests that a CXR and an abdominal CT scan will identify most occult intrathoracic injuries. Reserving a thoracic CT scan for patients with an abnormal CXR or high-risk mechanism could safely reduce cost and radiation exposure while still diagnosing significant thoracic injuries.
Authors: Xavier Tomas; Catherine Facenda; Nuno Vaz; Edgar Augusto Castañeda; Montserrat Del Amo; Ana Isabel Garcia-Diez; Jaime Pomes Journal: Quant Imaging Med Surg Date: 2017-08
Authors: Shadpour Demehri; Frank J Rybicki; Benoit Desjardins; Chieh-Min Fan; Scott D Flamm; Christopher J Francois; Marie D Gerhard-Herman; Sanjeeva P Kalva; Hyun S Kim; M Ashraf Mansour; Emile R Mohler; Isabel B Oliva; Matthew P Schenker; Clifford Weiss; Karin E Dill Journal: Emerg Radiol Date: 2012-03-18
Authors: K Horst; T P Simon; R Pfeifer; M Teuben; K Almahmoud; Q Zhi; S Aguiar Santos; C Castelar Wembers; S Leonhardt; N Heussen; P Störmann; B Auner; B Relja; I Marzi; A T Haug; M van Griensven; M Kalbitz; M Huber-Lang; R Tolba; L K Reiss; S Uhlig; G Marx; H C Pape; F Hildebrand Journal: Sci Rep Date: 2016-12-21 Impact factor: 4.379
Authors: Robert M Rodriguez; Mark I Langdorf; Daniel Nishijima; Brigitte M Baumann; Gregory W Hendey; Anthony J Medak; Ali S Raja; Isabel E Allen; William R Mower Journal: PLoS Med Date: 2015-10-06 Impact factor: 11.069