Evaluation of the value of abdominopelvic acquisition without contrast injection when performing a whole body CT scan in a patient who may have multiple trauma.

PURPOSE: To evaluate the diagnostic value of non-contrast-enhanced abdominopelvic acquisition when performing a whole body CT scan in a patient who may have multiple trauma. PATIENTS AND METHODS: In a single centre, retrospective study over 1year, we included 84 patients suspected of having multiple trauma who indeed presented an abdominal or pelvic lesion during the initial CT scan. Two readers independently reread the acquisitions without injection, then those with injection, then all the acquisitions, and scored the presence or absence of abdominopelvic lesions. Statistical analysis focused on intra- and inter-observer agreement, and on the sensitivity and specificity of the different acquisitions in relation to consensus rereading.
RESULTS: This study did not reveal any significant difference, particularly concerning improvement in sensitivity, between interpretation of the acquisitions with contrast injection and interpretation of all the acquisitions with or without injection. Inter-observer agreement was substantial to almost perfect. Non-contrast-enhanced thoraco-abdominopelvic acquisition represented 20% to 25% of the effective dose for the entire examination.
CONCLUSION: Abdominopelvic acquisition without contrast injection in addition to acquisition with contrast injection in a patient suspected of having multiple trauma does not improve detection of traumatic lesions of the liver, spleen, kidneys or adrenal glands, nor of intra- or retroperitoneal effusion, but increases the dose and should be abandoned.